HD19 - A Study on Ways to Encourage Local School Divisions to Recognize the Importance of School Nurses and the Feasibility of Establishing Standards for School Health Services
Executive Summary: The Department of Education, in cooperation with the Department of Health, was requested by the 1988 General Assembly of Virginia to study ways to encourage local school divisions to recognize the importance of school nurses and the feasibility of establishing standards for health services in the public schools in the Commonwealth (House Joint Resolution Number 33 (HJR 33)). A study committee was established to respond to the task as defined by HJR 33. Activities of Study Committee The collection of data, discussion of issues, and development of recommendations regarding the importance of school nurses and school health standards were generated through these activities: 1) analyses of statewide survey and questionnaire; 2) public forum on "The Importance of School Nursing and the Health Needs of School-Age Children; and 3) presentations during committee meetings. Findings A descriptive survey, The Importance of the Role and Function of School Nurses in the Provision of School Health Services, was conducted to assess the importance of school nurses in implementing comprehensive school health services. Of the 315 respondents, 180 (57.3%) were school nurses and the remaining number of respondents 135 (42.7%) included teachers, principals, psychologists, counselors, social workers, and central office administrators. Based on the findings of the survey, the following data highlight the importance of school nurses: • 72.3% of the respondents ranked school nurses as being very important in reducing absenteeism and tardiness. • 50% of the respondents indicated that school nurses are important in reducing the number of dropouts. • 84.8% of the respondents indicated that school nursing practice is important in increasing positive health behavior. • 83.2% of the respondents rated school nurses as being very important in the provision of care for handicapped and chronically ill pupils. • 81% of the respondents indicated that nurses are very important in the identification of high-risk population for health-related interferences to learning. • 85.1% of the respondents ranked school nurses as being very important in collaborating with school teams and 74.8% indicated their importance in collaborating with community resources. • 89 -2% of the respondents indicated that it is important for school nurses to be involved in emergency care procedures. • 80.3% of the respondents indicated that it is important for nurses to be involved in performing specialized physical care procedures for handicapped children. • 86% of the respondents indicated that it is important for nurses to be involved in maintaining protocols for administering medication. • Other areas which indicated a high percentage of the respondents' ratings regarding the importance of the involvement of school nurses included: Safety measures and programs (75.5%); Health education (61.9%); training of health aides and volunteers (17.8%); inservice programs (80.3%); identification of handicapped and at-risk students (84.1%); promoting awareness concerning academic stress in relationship to mental health of students (76.5%) ; and assessing health status in relationship to educational and personal achievements of students (82.7%). Through this survey data, the recognition of the importance of school nurses in implementing comprehensive school health services was valued by the majority of the respondents. However, it was apparent that, the role and function of school nurses varied and standards to govern and regulate the practice of school nursing in the public schools of Virginia need to be developed. The one-day forum on the Importance of School Nursing and the Health Needs of School-age Children addressed issues pertaining to standards for school health services and quality education; role and function of school nurses; the new morbidities and the implications for trends in education; and the involvement of the medical community in school health services. The 210 participants attending the forum responded to a questionnaire which focused on the following questions: 1) What innovative and creative approaches would you recommend to encourage local school divisions to recognize the importance of school nurses? 2) What are the benefits of school health services and school nurses to the educational achievement of school-age children? 3) What do you feel would contribute to continuity and consistency in the delivery of health services in the school environment? Examples of solutions given in regards to the questionnaire include the following: • Marketing and public relations campaigns regarding the importance of school nurses; • Research on the role of school nurses in relationship to the enhancement of educational skills of students, • Inservice opportunities regarding the health status of children, using nurses as key presenters; • School nurses and educators should collaborate as a team on issues involving the health of school-age children; • Promotion of school health services to establish continuity and consistency in the delivery of health services; and • Documentation of health encounters to aide in the establishment of standards of practice for school health. The health needs of Virginia's school-age population warrant top priority when considering health-care costs, poor school performance, and incidence of the new morbidities. Virginia's children deserve more than minimal attention to their unmet health needs when many of them suffer appreciably from unfavorable socio-economic conditions. Based on the study committee's research and formal discussions, the following recommendations are offered as ways to encourage local school divisions to recognize the importance of school nurses and the feasibility of standards for school health services: Recommendation 1: Qualified school nurses should be required in every school division contingent upon appropriate funding. Recommendation 2: The goal for nurse/student ratios should conform to the standards set by the National Association of School Nurses, American Nurses Association, and the American School Health Association. Recommendation 3: School health advisory boards, composed of public and private sector representatives, should be established to enhance community support for school health services and to assist in the development of local school health policy. Recommendation 4: Minimum standards for school health services in Virginia should be developed jointly by the Departments of Education and Health. Recommendation 5: A nursing position should be established by the Departments of Education and Health within their respective departments to supervise and coordinate the provision of school health services. Recommendation 6: School nurses should be involved as members of school teams to facilitate learning by providing care and treatment to students with chronic and handicapping conditions. Recommendation 7: Students and school personnel should be counselled as a means of reducing the "new morbidities." Recommendation 8: A cooperative agreement should be established in every school division with a physician to serve in the capacity of consulting medical director to provide medical care, consultation, and backup to nursing personnel. Recommendation 9: Formal written emergency medical procedures should be developed in every school division within the state. Recommendation 10: Appropriate documentation on all student injuries should be maintained by all school divisions as part of a program of comprehensive risk management. Recommendation 11: Continuing education opportunities, especially in the new morbidities, should be co-sponsored by the Departments of Education, Health, Mental Health and Mental Retardation on a regional basis, and at regular intervals for school nursing personnel. Recommendation 12: Qualifications for school nurses should be developed jointly by the Departments of Education and Health. |
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