Public Health- The School Nurse

The major role of a school nurse
Facilitate normal development
Promote student health & safety
Provide quality care for potential and actual health problems
Provide case management services
Collaborate with others to enhance student and family
Education for All Handicapped Children Act
PL 94-142 passed in 1975. SHNs provide more complex care for conditions such as Seizures, Asthma, CF
Americans with Disabilities Act (ADA)
Enacted in 1990 that is intended to make American society more accessible to people with disabilities.
Early Periodic Screening, Diagnosis, and Treatment (EPSDT)
Passed in 1969, requires that children & adolescents < 21 yrs of age have access to periodic screenings
Individuals with Disabilities Education Act (IDEA)
Enacted in 1990 & reauthorized in 1997 designed to protect the rights of students with disabilities by ensuring that everyone receives a free appropriate public education & early intervention, regardless of ability.
strives to grant equal access to students with disabilities & to provide additional special education services and procedural safeguards.
Mainstreaming: integrating children with serious illnesses or handicapping conditions in regular school settings and classrooms whenever possible.
Primary Prevention Strategies for school populations
Promoting health: Health education in the school setting provides a foundation for health behaviors in adulthood
• Provide anticipatory guidelines for growth and development & support parents in effective parenting, promoting
• nutrition at home and in schools, dental health, physical activity, & positive social skills
Preventing Illness & Injury: Prevent mortality, prevent communicable diseases (raising the rate of complete up to date immunization records at school), eliminate hazards, prevent pregnancy, sports injuries, chronic conditions, injuries, bullying, violence, suicide
Secondary Prevention Strategies for school populations
Resolving existing health problems
Screen for health problems, referral, counseling, & treatment for minor or chronic conditions.
Development of Individualized Health Plans (IHPs), Policies for self-admin medication. (after knowing dx)
Tertiary Prevention Strategies for school populations
(Restoring Health & Managing Long Term Conditions)
Assist with rehabilitation, prevent consequences, and promote adjustment to chronic illness/disability,
Promote recovery after a disaster, sustaining SBHCs
What is the Coordinated School Health Program
An integrated set of planned, sequential, school-affiliated strategies, activities, and services deigned to promote the optimal physical, emotional, social, & educational development of students
Goals of a Coordinated School Health Program
To increase health-related knowledge, attitudes, & skills among members of the school population
To increase positive health behaviors & outcomes & to decrease risk behaviors
To improve educational outcomes
To improve social outcomes, such as self-discipline and respect for and tolerance of others
Components of a Coordinated School Health Program
Health education, Physical education, health services, Nutrition services, Counseling, Psychological and Social Services, Healthy and Safe School Environment, Health promotion for staff, Family and community involvement
Specific Evaluation Tools for Coordinated School Health Programs
Health Education -can be evaluated using Health Education Curriculum Analysis Tool (HECAT)
Physical Education-can be evaluated using Physical Education Curriculum Analysis Tool (PECAT)
Continuous Quality Improvement Tool for School-based Health Centers is available to evaluate SBHC performance. It helps school health team organize in reporting risk assessments. ex. tobacco use, pregnancy risk, parent/child conflict, & depression.
Evaluation Tool for School Health Programs
School Health Index (SHI): developed by CDC
Healthy School Report Card: developed in Canada
School Health index
A self-guided tool to evaluate adequacy of school health programs
Developed by CDC
Examines several aspect of Coordinated School Health Programs
1. Degree of establishment (per component): Ex, is the school health services “not in place” “under development” “partially in place”, or “fully in place”?
2. How is each component functioning and performing? Includes performance-related evaluation (Ex. Of topics: physical activity, physical education, nutrition, tobacco use prevention, asthma, safety, and sexual health
Biological determinants of the health of school populations
Maturation and aging
Genetic inheritance
Physiologic function
Psychological Determinants the Health of School Populations
Mental illness and the school setting
Family dynamics, Parental expectations, & discipline
Parental coping and their mental health
abuse and treatment
School climate
Environmental Determinants of the Health of School Populations
Physical environment of school, home, and surrounding areas
Safety hazards
noise levels
Food sanitation
Effective disaster response plan
Sociocultural Determinants of the Health of School Populations
Family structure/living arrangement
Cultural, ethnicity, religion
Language barriers
Economic resources (edu. level, income, employment)
Latchkey (child care)
Crime in neighborhood
Behavioral Determinants of the Health of School Populations
organization of the school day
safety precautions
physical activity/sleep patterns
TV/ computer use
Diet and nutrition
Risky lifestyle behaviors
substance use
parents behaviors
Health System Determinants of the Health of School Populations
Individual level
Is there access to and use of regular source of health care?
Use of health-promotive, illness-preventive, and curative services?
Or healthcare is crisis oriented, treating acute conditions
Are there unmet health needs because their families cannot afford care?
Population level
Presence or absence of a coordinated school health program & school-based health centers

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