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Chapter 42 The Nurse in the Schools. Objectives. Discuss professional standards expected of school nurses. Differentiate between the many roles and functions of school nurses. Describe the different variations of school health services and coordinated school health programs. - PowerPoint PPT Presentation
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1Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Chapter 42
The Nurse in the Schools
2Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Objectives
1. Discuss professional standards expected of school nurses.
2. Differentiate between the many roles and functions of school nurses.
3. Describe the different variations of school health services and coordinated school health programs.
4. Analyze the nursing care given in schools in terms of the primary, secondary, and tertiary levels of prevention.
5. Anticipate future trends in school nursing.
3Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
History of School Nursing
Late 1800s: Metropolitan Association of Nursing provided medical examinations for children in London schools
1897: New York City schools began to identify ill children Excluded ill children from class so classmate not
infected Health education
1902: Henry Street Settlement nurses began going into homes and schools to assess children.
4Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
History of School Nursing, Cont’d
1910: Teachers College in New York City added course on school nursing
1949s: Nurses employed by the school districts
1950s: Increased use of immunizations and antibiotics
1960s: Call for high levels of education for school nurses ANA position paper
5Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Federal Legislation
Section 504 of the Rehabilitation Act of 1973 Education for All Handicapped Children Act Americans with Disabilities Act (1992) Individuals with Disabilities Education Act
(IDEA) (1997) Individualized education plans (IEPs) Individualized health plans (IHPs)
No Child Left Behind Act of 2001 Child Nutrition and WIC Reauthorization Act
of 2004
6Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Standards of Practice
National Association of School Nurses (NASN) NASN Standards (Box 42-1)
American Academy of Pediatrics (AAP) AAP Guidelines (2008)
7Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Educational Credentials
NASN and AAP recommend school nurses be RNs who also have bachelor’s degrees in nursing and a special certification in school nursing. Not all school nurses have been educated this
way.• Varies from state to state
APNs in schools
8Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Roles and Functions of School Nurses
Direct caregivers Educators Counselors Consultants Case managers Community outreach Researcher
9Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
School Health Services
Federal School Health ProgramsSchool Health Policies and Program Study 2006
School-Based Health Programs
10Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Federal School Health Programs:Eight Components of a Coordinated
School Health Program
11Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
School Health Policies and Program Study 2006
Student-to-school nurse ratio Recommended 1 nurse for every 750 students
Access to mental health counselors Schools’ cafeteria
Tended to have food high in salt and fat Parental involvement
12Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
School-Based Health Programs
School-based health centers Family-centered, community-based clinics run
within the schools School-linked program
Collaborative Model for School Health in Pitts County, North Carolina
13Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Healthy People 2020
Many objectives are directed toward the health of children.
Several point directly at the care that nurses give to children in the schools. These objectives are concerned with: Children with disabilities in the schools Number of children with major health problems Ratio of nurses to children in the schools
14Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Levels of Preventions in Schools
Primary PreventionSecondary Prevention
Tertiary Prevention
15Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Primary Prevention
Teaching health promotion concepts in the classroom For students and teachers Substance abuse and disease prevention education
Preventing childhood injuries Safe Kids Campaign
Preventing substance abuse behaviors Reducing the risk of the development of chronic
diseases Monitoring the immunization status of children
16Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Secondary Prevention
Caring for ill or injured students and school employees
Nursing care for emergencies in the school Emergency plan Emergency equipment in the school nurse’s office
Giving medications in school Assessing and screening children at school
Vision, hearing, height, weight, oral health, tuberculosis, scoliosis
Pediculosis screening Identification of child abuse or neglect
17Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Secondary Prevention, Cont’d
Communicating with health care providers Efforts to prevent suicide and other mental
health problems Violence at school
Six characteristics of a student who may be thinking about inflicting violence
School crisis teams
18Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Tertiary Prevention
IEPs for students with long-term health needs Children with asthma Children with diabetes mellitus Children who are autistic or have ADHD Children with special needs in schools Children with DNR orders Homebound children Pregnant teenagers and teenage mothers
19Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Controversies in School Nursing
Sex education Reproductive services Screening for STIs
20Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Ethics in School Nursing
Student or parent beliefs may conflict with the nurse’s beliefs.
Care should never be denied or ignored. Referral is a good option.
21Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
Future Trends in School Nursing
Amount of health care given in the school is increasing.
Telehealth and telecounseling Internet use