ESPDT School Health Nurse Grant Program: Clinical Evaluation Indicators Summary Report Kaye Bender, PhD, RN, FAAN Bower Foundation Board Meeting August 21, 2006

Components of the EPSDT Visit Physical Assessment with appropriate lab Developmental Assessment Vision Testing Hearing Screening Oral Health Assessment Counseling and Education Referral and Followup

Clinical Evaluation Indicators Assessment According to Standards ? Nursing Diagnosis Appropriate for Assessment ? Intervention Appropriate ? Results of Intervention ?

EPSDT Screenings Total = 13,747 Assessments $1,037, Billed $703, Paid (68%) * Data from Screen-Plus

Assessment According to Standards Age Appropriate Billable Intervention and Follow-up According to School Nurse Protocol and EPSDT Guidelines

Assessment by Service Vision Screening (4,290) Preliminary Data 2005

Assessment by Service Vision Screening (12,925)

Assessment by Service: Vision Screening (12,925) Nursing Diagnoses –Sensory/perceptual alternations Intervention –Notification of parents or guardian –Referral to Physician Follow-up – 92%

Assessment by Service: Dental Screening (4,261) Preliminary Data 2005

Assessment by Service: Dental Screening (13,008)

Assessment by Service: Dental Screening (1331) Nursing Diagnoses –Altered oral mucous membrane –Dental caries Intervention –Notification of parents or guardian –Referral to Dentist Follow-up – 38%

Assessment by Service: Developmental Screening (4,248) Preliminary Data 2005

Assessment by Service: Developmental Screening (11,120)

Assessment by Service: Developmental Screening (11,120) Nursing Diagnoses –Altered growth and development –Impaired social interaction –Impaired verbal communication –Self-esteem, alteration in Intervention –Notification of parents or guardian –Referral to Physician or other appropriate provider Follow-up – 86% (includes in-school referrals)

Assessment by Service: Hearing Screening (4,290) Preliminary Data 2005

Assessment by Service: Hearing Screening (10,406)

Assessment by Service: Hearing Screening Nursing Diagnoses –Sensory/perceptual alterations Intervention –Notification of parents or guardian –Referral to Physician or Nurse Practitioner Follow-up – 88%

Assessment by Service: Hct/Hgb (4,677) Preliminary Data 2005

Assessment by Service: Hct/Hgb (12,673)

Assessment by Service: Hgb/Hct Screening Nursing Diagnoses –Anemia –Potential for Anemia Intervention –Notification of parents or guardian –Referral to Physician or Nurse Practitioner –Standing Order for Iron Follow-up – 90%

Assessment by Service: Urinalysis (11,913)

Assessment by Service: Urinalysis Nursing Diagnoses –Altered urinary elimination –Diabetes related symptoms –Potential for urinary tract infection Intervention –Notification of parents or guardian –Referral to Physician or Nurse Practitioner Follow-up – 68%

Random Findings From Initial Physical Assessment Data 5-11 Years Activity intolerance Altered health maintenance Dressing/grooming self-care deficit Impaired skin integrity Potential for infection Potential for trauma Pain Coping deficits * Data

Random Findings From Initial Physical Assessment Data Years Activity intolerance Altered health maintenance Impaired skin integrity Potential for infection Pain Rape/trauma syndrome * Data

Implications of This Evaluation Strategy Validation of credibility and safety of the program Nursing training Referral gap identification Clinical lab and other quality assurance Baseline data for long-range tracking

Complete Report on this Phase of the Clinical Evaluation Indicators will be available October Next Clinical Evaluation Report Scheduled for December For questions, contact Dr. Kaye Bender, ;