Frequent Flyers Nancy Nadel Sharon-rose Gargula Nadel and Gargula 2012
Jan 19, 2016
Frequent Flyers Nancy Nadel
Sharon-rose Gargula
Nadel and Gargula 2012
The student will decrease unscheduled non-acute care visits to the nurse.
Nadel and Gargula 2012
Unscheduled Non emergency Unnecessary No significant complaint
Nadel and Gargula 2012
Chapped lips Invisible injuries Stomach aches just
before lunch Paper cut Frequent visits out
of the same class for vague complaints
Picking scab off healing cuts
Personal female care
Symptoms that just started 1 minute ago
Nadel and Gargula 2012
Scheduled medication Scheduled treatment Asthma attack Chronic Illness care (diabetes, seizures) Fever Vomiting Chest Pain Injury requiring first aid Significant mental health crisis
Nadel and Gargula 2012
Choose a group of students (between 10-150) that are at risk for frequent visits
Hint- the larger the group the better the outcome will be
Use eschool or DSC to determine who will be at risk
Past frequent flyer New student to the
building who has found their way to you
Nadel and Gargula 2012
50% of the selected cohort will show improvement over a defined period of time with a minimum of 4 weeks.
If your cohort is 20, then a minimum of 10 students will have a decrease in their unscheduled office visits by at least one visit during the second time frame you have chosen to measure.
Nadel and Gargula 2012
Any visit to the nurse
Include time of visit and length of visit
Chief complaints Is it vague or
specific? Is it medically
necessary?
Discuss with the student what the ultimate goal is for this visit (rest, pain free, go home)
Where is the student coming from or where is the student supposed to be going?
Nadel and Gargula 2012
History, including onset of complaint
Care provided at home
If an injury, where did it happen?
Are parents aware of the illness/injury?
How is this interfering with outside activities?
Physical assessment
Staff conference: what is the teacher seeing in the classroom?
How often is the student leaving the classroom?
Is the teacher aware that the student has come to the health suite?
Nadel and Gargula 2012
Choose 2 equal points in time Min 4 weeks max is school year Example Nov 1st-30th and April 1st-30th or 1st MP and
3MP
Compare the number of visits for the cohort (identified students)
Improvement can be by a single visit!
Nadel and Gargula 2012
Identify the real reason for the visit. Look for patterns such as a common time Is there a substitute teacher? Is it the same teacher who is making
excessive referrals? Ensure medication availability and
compliance
Nadel and Gargula 2012
Educate the student about acceptable reasons for visiting the nurse
Identify a motivator for staying in class which might include a reward system
Develop an IHP Teach student self care and facilitate a
means for this to happen Consider scheduling a time for an office
visit, just to check in
Nadel and Gargula 2012
Is there a plan for the substitute teacher and what to do with students who are frequent flyers?
Educate teachers on proper referrals - decision tree
Make teacher aware of excessive referrals
Attend PLC’s Utilize support staff,
IST, guidance counselor
Speak with administration about support for teachers
Nadel and Gargula 2012
Communicating concerns, genuine caring for student’s well being
Obtain a health history.
Set common goals with parent.
Conference with parents/teacher & nurse
Encourage parents to follow-up with PCP to rule out any physical cause for the student complaint.
Mental health issues if untreated can cause physical symptoms
Nadel and Gargula 2012
Students showing improvement
___________________ Total number of
students Acceptable growth rate is 50% - unless you chose something else in agreement with your administrator
Nadel and Gargula 2012
School nursing started with the premise that healthy children should be in the classroom and sick students should be at home.
By decreasing the frequency of non emergent visits we are supporting our teachers and helping students become successful.
The documentation for this indicator can lead to data for other indicators
We can combine this indicator with other indicators.
Nadel and Gargula 2012
Nadel and Gargula 2012