1. © 2007 McGraw-Hill Higher Education. All rights reserved. 1 School Health Services: Promoting and Protecting Student Health Chapter 2

2. © 2007 McGraw-Hill Higher Education. All rights reserved. 2 School’s Role in Providing School Health Services  School Health Services provide the following for students and school personnel Appraisal Appraisal Protection Protection Promotion Promotion  Services are offered by teachers and allied health professionals

3. © 2007 McGraw-Hill Higher Education. All rights reserved. 3 School’s Role in Providing School Health Services, cont.  A system of referring students and families to agencies and health professionals with careful follow up is the key component  Follow up is necessary to make sure the intended services were rendered and properly recorded

4. © 2007 McGraw-Hill Higher Education. All rights reserved. 4 Teacher’s Role with Health Services  Observation of students behavior, appearance, or expressions  Detect students’ needs  Offer supporting role even in emergencies  Intervene when necessary

5. © 2007 McGraw-Hill Higher Education. All rights reserved. 5 School Nurse Role with Health Services  Advocate for staff and students, considered the “cornerstone” of health services  Roles also include: Care provider Care provider Change agent Change agent Educator Educator Therapist Therapist Manager Manager

6. © 2007 McGraw-Hill Higher Education. All rights reserved. 6 Responsibilities of School Nurses  Maintain health records and histories  Interpret results of appraisals  Identify health concerns  Provide information to school personnel  Perform health screenings  Train other school personnel who often must assume responsibilities for school health services  Help students seek appropriate help for personal issues  Initiate referrals to parents, school personnel, etc  Provide emergency care for injuries/illnesses  Administer medications  Control communicable diseases through a variety of methods

7. © 2007 McGraw-Hill Higher Education. All rights reserved. 7 Responsibilities of School Nurses, cont.  Provide appropriate counseling to parents, students, etc.  Participate as the health team specialist on the child education evaluation team to develop individual education plans  Initiate health management procedures for children with special needs  Assist in the formulation of health policies for the school/district  Conduct evaluations of school health services to improve services  Serve as a resource to students interested in pursuing a health career  Provide health education The American Nursing Association recommends 1 school nurse for every 750 students

8. © 2007 McGraw-Hill Higher Education. All rights reserved. 8 School Health Aides  School districts employ health aides to assist the school nurse  Provides a variety of tasks, administrative as well as basic first aid  Health Aides need to be knowledgeable about many health topics and standards  The scope of practice of a School Health Aide is limited and is under the supervision of the school nurse

9. © 2007 McGraw-Hill Higher Education. All rights reserved. 9 Confidentiality of Student Health Information  Family Education Rights and Privacy Act Establishes confidentiality of all students’ information, records, and rights of parents to access this Establishes confidentiality of all students’ information, records, and rights of parents to access this Families do not have to disclose certain health conditions to school staff (i.e., HIV status) Families do not have to disclose certain health conditions to school staff (i.e., HIV status) School staff need to be trained in requirements of state law and school policies School staff need to be trained in requirements of state law and school policies  Health Insurance Portability and Accountability Act Sets standards for the privacy of identifiable health information Sets standards for the privacy of identifiable health information

10. © 2007 McGraw-Hill Higher Education. All rights reserved. 10 Community Partnerships  Can increase capacity to offer more health services  The degree of services are dependent upon needs of the students  Full service schools involve the following: Educational, social, and health services delivery Educational, social, and health services delivery Improve the quality of life for individuals/families Improve the quality of life for individuals/families

11. © 2007 McGraw-Hill Higher Education. All rights reserved. 11 School Based Health Centers  Provide on-site comprehensive health care for young students you cannot receive adequate care  Easily accessible location on school premises  Becomes the sole source of health care for many young students  Such centers exist in only 2% of all U.S. schools Lack of access is cited as the major reason for proliferation of these centers

12. © 2007 McGraw-Hill Higher Education. All rights reserved. 12 Support for School Based Health Centers  Health care services is costly, however, there are strong arguments in support of the school- based centers  School based clinics have reduced the visits to the ER  Cuts health care costs for poor children  Lowers the number of STD’s (Lawson, 2000)

13. © 2007 McGraw-Hill Higher Education. All rights reserved. 13 Accommodations for Special Students  Rights of students with disabilities are protected (Section 504/Rehabilitation Act of 1973)  Schools must make provisions to accommodate the special needs of students  Written plans must state the child’s disability or impairment, needs, and how these accommodations will be met  Teachers may be responsible for administering these services (i.e., administering medications)

14. © 2007 McGraw-Hill Higher Education. All rights reserved. 14 School-Based Mental Health Services  The American Academy of Pediatrics advocates that school personnel work with pediatric health care professionals and mental health specialists to develop and implement effective school-based mental health services  The proportion of child and adolescent needing care and assistance for psychosocial problems has increased substantially in recent years  20% of children have mental health problems requiring mental health interventions  School based programs can improve access to these interventions

15. © 2007 McGraw-Hill Higher Education. All rights reserved. 15 Administration of Medications at School  A written order must be from a family physician that identifies the following: Dose Dose Type Type Time of administration Time of administration Purpose Purpose Side effects Side effects  An emergency care plan should be developed for students who might require the administration of emergency medications by injection  Parents are responsible for supplying and informing the school of any changes with the medication or child

16. © 2007 McGraw-Hill Higher Education. All rights reserved. 16 Administration of Medications at School, cont.  Strict statements are required regarding who administers the medication  Record keeping is essential by the school nurse or designated person  The most common medication dispensed are for ADHD (Attention Deficit Hyperactivity Disorder) Field trips will require an action plan with regards to medication administration

17. © 2007 McGraw-Hill Higher Education. All rights reserved. 17 Emergency Care in Schools  Schools must be prepared for students and staff becoming injured or ill on a daily basis  Emergency step procedures must be set up and in place  Every employee must know their role/scope when an emergency arises through proper training/emergency response plan

18. © 2007 McGraw-Hill Higher Education. All rights reserved. 18 Emergency Care in Schools (cont’d)  Individual students need to be recognized who have specific health conditions that can lead into an emergency situation  An Emergency First Aid kit should be current and accessible  Understand limitations and scope of one’s abilities (i.e., DNR and information provided, first aid manual)  Parents/Guardians will need to be notified when a child has been injured/become ill at school  Proper forms need to be documented to protect against liability

19. © 2007 McGraw-Hill Higher Education. All rights reserved. 19 Do-Not-Resuscitate Orders  (DNR) orders instruct school personnel to make no effort to resuscitate a child who appears to be dying and not to call emergency medical services (EMS)  School officials are not in favor of DNR orders, arguing that schools do not apply  It is best to consult with your local school district to understand if DNR orders are legal

20. © 2007 McGraw-Hill Higher Education. All rights reserved. 20 School Health Services: Promoting and Protecting Student Health Chapter 2