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MICHELLE HEUSIKRYSTAL MORRIS
SPRING AND SUMMER 2012
Integration of the Family Nurse Practitioner in a School Based Setting
Purpose Statement
To determine the need and potential usage of Nurse Practitioners in Kansas public schools
To perform a needs assessment by gathering aggregate data through a parent/guardian survey and by an open ended script to be completed by the school nurse
School Based Health Care
First School Based Nurse Practitioners in the early 1970s
Initial focus targeted teen pregnancy in inner city high schools
Common goal of “decreasing school absenteeism and missed work days by providing convenient primary and acute care while children are in school”
Review of Literature
Databases CINAHL, SAGE, CochraneKeywords Nurse Practitioners and Schools School Based ClinicsKey Points Nurse Practitioners expand the care given in public
schools School Based Clinics with Nurse Practitioners are
financially sustainable Legal Issues and Scrutiny surround Nurse
Practitioners in School Based Clinics
Martha RogersThe Science of Unitary Human Beings
Project Objectives
1. Survey parents/guardians of Tecumseh South and Jennie Wilson Elementary students
2. Perform written interviews of the nurses at both schools regarding their role and expectations of their job
3. Analyze data results from the surveys to determine the needs for a Nurse Practitioner in the school based setting
Tecumseh South Elementary
USD 450: Shawnee Heights School District in Topeka, KS
2011-2012 enrollment 468 students
Kindergarten – 6th Grade
Principal: Mr. Scott Dial
Tecumseh South Demographics
Ksde.org
Jennie Wilson Elementary
USD 457: Garden City, KS
2011-2012 enrollment 215 students
Kindergarten- 4th grade
Principal: Ms. Melinda Stewart
Jennie Wilson Demographics
Kdse.org
Tecumseh South Implementation
Online Survey sent to parents through email
Email sent to 480 parents/guardians
Survey emailed on April 16, 2012 and closed on April 30, 2012
Jennie Wilson Implementation
Paper surveys sent home with students with consent form and envelope to use to return the survey to school
220 Parents Surveyed, 1/3 of surveys printed in Spanish
Survey distributed on April 26, 2012, picked up from school on May 10, 2012
Tecumseh South Jennie Wilson
114
366
Returned SurveysNo Re-sponse
87
133
Returned SurveysNo Re-sponse
Data Analysis
72 English surveys returned15 Spanish surveys returned
0 Days 1-2 Days
3-4 Days
5-6 Days
7+ days
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
1. Over the past year, how many days was your child absent from school due to illness?
Tecumseh SouthJennie Wilson
Days Missed
Perc
en
t of
Resp
on
ses
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
2. What were the majority of days missed for illness related to?
Tecumseh SouthJennie Wilson
Illness
Perc
en
t of
Resp
on
ses
RespiratoryIllness
Gastrointestinal Illness
Chronic Medi-cal Condition
Other
0 days 1-2 days 3-4 days 5-6 days 7+ days0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
3. As a parent/guardian, how many days of work did you miss due to your child's ab-
senteeism from school?
Tecumseh SouthJennie Wilson
Days Missed
Perc
en
t of
Resp
on
ses
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%4. What type of insurance does your child
have?
Tecumseh SouthJennie Wilson
Type of Insurance
Perc
en
t of
Resp
on
ses
No Insurance
Medicaid Private/ Commercial
Other
Docto
r
Nur
se P
ract
ition
er
Phys
icia
n's Ass
ista
nt0.00%
20.00%
40.00%
60.00%
80.00%
100.00%
5. What type of health care provider does your child usually see?
Tecumseh SouthJennie Wilson
Type of Health Care Provider
Perc
en
t of
Resp
on
ses
Yes No Comment0.00%
10.00%20.00%30.00%40.00%50.00%60.00%70.00%80.00%90.00%
100.00%
6. If a Nurse Practitioner worked in a school based health clinic, would you allow your
child's health care needs to be addressed by this provider?
Tecumseh SouthJennie Wilson
Response
Perc
en
t of
Resp
on
ses
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
7. If school based health services were of-fered, what type of health care needs would you feel comfortake in your child receiving
at school?
Tecumseh SouthJennie Wilson
Type of services
Perc
en
t of
Resp
on
ses
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
8. What types of services do you think would be most valuable for a school based health
center to offer?
Tecumseh SouthJennie Wilson
Types of Services
Percen
t of
Resp
on
ses
Comments from Tecumseh South Parents
“What an asset nurse practitioner could be inside the school system. So often it is such a natural environment to identify needs, academic-social emotional-socioeconomic-personal-peer...not all families have access to the services they need but all children have access to a public education. Collaboration between school counselors/social workers, educators, and trained and qualified medical providers comprehensively assesses the whole person.”
“I would feel comfortable with having a NP at the school if the fees are included with the enrollment or at no cost to the parents. Also, the NP at the school would be in addition to and not replacing the family Doctor.”
“This survey does not really pertain to my child in that she has health insurance readily available to her. If she did not, then I believe a school-based health service would be great.”
Comments from Jennie Wilson Parents
“Nurse practitioners in schools are a great assist, especially for families that aren’t able to afford to take their kids to the doctor.
“It is nice to have medical services offered in a convenient fashion, however a parent should never be told which medical services are required for their child.”
“I think it would be of great assistance for those children without access to health care.”
“If the ARNP could see my child year around and work with the pediatrician, I might let them treat my child’s asthma and other chronic issues.”
School Nurse Script
1. How many hours are you present in the school weekly?2. When you aren’t present in the school, who is responsible for the healthcare of the
students?3. In your own words, what do you consider your job description?4. As a school nurse, what types of chronic conditions do you see among your
student population? 5. Do you know specific numbers of students with each condition?6. What are the most common reasons that students at your school come see you?7. On an average week, approximately how many students do not come to school
because of illness?8. On an average week, approximately how many students leave school early due to
illness?9. Do you have specific criteria for sending students home early from school?10.Do you feel that your students have primary care providers outside of school?
Where do you think they get their primary care at?
Dissemination of Plan
Project objectives were met:
Aggregate data was gathered regarding current health care, potential usage, and concerns about Nurse Practitioners in the school setting
Description of roles and expectations of the Nurse at both schools was explored
Data synthesis and comparison was made with data from each school
