5/2/2014 1 Teresa DuChateau, DNP, RN, CPNP Teresa DuChateau, DNP, RN, CPNP Teresa DuChateau, DNP, RN, CPNP Teresa DuChateau, DNP, RN, CPNP Wisconsin Public Health Association The learner will be able to: Identify gaps in the current school health services system in Wisconsin Identify policy and procedure resources that can improve the delivery of school health services 5 year project starting in 2011 Funded by Healthier Wisconsin Partnership Program ◦ A component of the Advancing a Healthier Wisconsin endowment at the Medical College of Wisconsin Two main goals: ◦ Develop and disseminate a state-wide school health services assessment tool ◦ Develop resources, templates and education materials to address priorities based on state-wide assessment results District level Online tool 100 questions 100 questions 100 questions 100 questions Sections: Policies & Procedures: Services : Health Services Nursing Services Communicable Diseases Medication Administration Crisis/Safety Planning •CPR/AED Pupils with Special Healthcare Needs Pupil Records Health Education Curriculum Nursing Services
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Teresa DuChateau, DNP, RN, CPNP Teresa DuChateau, DNP, RN, CPNP Teresa DuChateau, DNP, RN, CPNP Teresa DuChateau, DNP, RN, CPNP Wisconsin Public Health Association
The learner will be able to:
� Identify gaps in the current school health services system in Wisconsin
� Identify policy and procedure resources that can improve the delivery of school health services
� 5 year project starting in 2011
� Funded by Healthier Wisconsin Partnership Program◦ A component of the Advancing a Healthier Wisconsin endowment at the Medical College of Wisconsin
� Two main goals:◦ Develop and disseminate a state-wide school health services assessment tool
◦ Develop resources, templates and education materials to address priorities based on state-wide assessment results
� Assessment completed in March-April 2012� Assessment completed by 117 school districts (27%)� Results of assessment represent 44% of Wisconsin school children
� Invited to participate via email◦ 63% of assessments completed by email invitation to school nurse◦ 37% of assessments completed by email invitation to district administrator
� 68% of Wisconsin school districts ‘opened’ the assessment
� Average time to complete assessment: 5.5 hours (includes prep and online completion)
� 90% completed by school nurse and 52% by school administrator
� Average nurse:pupil ratio was 1:1623 or more
� 80% of school nurses employed by school district◦ 7% of responding school nurses employed by health departments
� 38% of districts have 1.0 FTE ◦ Average FTE was 2.2 48%
42%
57%
64%
0% 20% 40% 60% 80%
Quality Improvement
Evidence Based
Best Practice*
Mandatory items
Assessment
Response=115*some best practice results not incorporated
� IEP (Individualized Educational Plan) development and involvement of the RN
� Number of CPR/AED trained staff in each school
� AEDs in over 90% of schools
� 77% of RNs have BSN or Master’s Degree
� Over 75% of schools have a policy on asthmatic inhaler self-carry and allow the students to self-carry and administer metered dose inhaler or dry
powder inhaler
� 41% of districts have a policy and protocol manual for emergency nursing services provided during after school (extra curricular and sporting events)
� 48% of districts have a school nursing procedure manual
� 52% of districts have policy and procedure regarding medication errors
� 35% of districts amend policy based on medication errors
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� Emergency Nursing Services
� Medication Administration
� Concussion Management
� Sample policies and procedures are based on best practices
� Incorporate state and federal requirements
◦ *Current Wisconsin law
◦ ^Current federal law
� Administering Medications to Students Policy and Procedure
� Medication Disposal Procedure
� Medication Error Procedure
� Staff Administration of Glucagon Policy and Procedure
� Staff Administration of Non-Student Specific Epinephrine Policy
� Student Self-Administration of Emergency Medications
� Policy
� Administrative Rule ◦ School Responsibilities
◦ Nursing Responsibilities
◦ Special Circumstances
◦ Field Trips
� Procedure
� Policy
� Administrative Rule◦ Role of School District Administrator
◦ Role of the Medical Director
◦ Role of the School Nurse
� Delegated Nursing Services
� Other School Health Services
� Policy
� Administrative Rule◦ Education
◦ Classroom Accommodations: “Return to Learn”
◦ Management of Head Injury Occurring During the School Day and School Sponsored Events (Before and After School/Fieldtrip)
◦ Management of Head Injury Occurring During a School Sponsored Sporting Event
� 15 school districts piloting 4 of the resources and tools
� The case study evaluation will focus on:◦ Usability of the specific tools and resources ◦ Process changes◦ Capacity building ◦ Policy changes related to implementation of the resources
� The case study evaluation will help to identify why features of a resource/tool implementation succeed at a particular location and has challenges within a different setting
� Implement at least 3 (three) tools/resources in Fall 2013 and 1 (one) additional resources in Fall 2014
� Provide current documents/materials related to those resources (e.g., written policies or procedures)
� Participate in baseline and follow up data collection through written surveys, interviews, and focus groups as outlined in the timeline above
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� Preparation time: 5 hours� Time to complete online: 1.5 hours
� Average number of staff who assisted in completion: 4
� 69% of users who completed evaluation strongly agree/agree the time spent on the assessment was well spent
� 71% would use assessment tool again in the future
� Majority recommend completing assessment every 2-3 years
� Divide tool into sections:◦ Mandatory
◦ Best Practice/Evidence Based and Quality Improvement
� Allow the school district to choose which section(s) of the assessment they would like to complete
� As resources are developed (or identified), provide direct links to resources on the assessment tool