School Health Nursing: An Overview

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Questions and Answers

What is the primary focus of school health nursing?

Advancing the wellbeing, academic success, and life-long achievement of students.

What is the overarching aim of School Health Nursing (SHN)?

To protect, promote, and maintain the health of school children and reduce morbidity and mortality.

Can you list three specific objectives or goals typically addressed by school health programs?

Promotion of positive health, early diagnosis and treatment of diseases, and awakening health consciousness in children.

How does family and community involvement contribute to school health services?

<p>By providing support and resources to enhance the well-being of students and promote a healthier school environment.</p> Signup and view all the answers

What are the 6 high-risk behaviors among students that the CDC has identified as needing attention in health education courses?

<p>Alcohol and drug use, injury and violence, tobacco use, poor nutrition, lack of physical activity, and sexual behaviors leading to STDs or unwanted pregnancies.</p> Signup and view all the answers

List at least three essential members that should compose a school health team.

<p>School nurse, medical officer, teacher.</p> Signup and view all the answers

What are two key things the WSCC framework emphasizes regarding health and academic outcomes?

<p>It is CDC's framework for addressing health in schools, academic achievement, and the importance of evidence-based school policies and practices.</p> Signup and view all the answers

According to the NASN, what are the two minimum qualifications necessary to be a school nurse?

<p>Licensure as a registered nurse and a baccalaureate degree from an accredited college or university.</p> Signup and view all the answers

What are the three interdependent components of a school health program?

<p>School health services, healthful school environment, and health education.</p> Signup and view all the answers

Besides the original three, name two additional elements that are added to the newer version of school health program?

<p>School food services and school counseling and psychology program.</p> Signup and view all the answers

What is the primary purpose of vision and hearing screenings in a school health service program?

<p>To identify children with potential problems in visual acuity and hearing which can have an impact on the child's ability to learn.</p> Signup and view all the answers

Explain the value of annual height and weight measurements in school health programs.

<p>These measurements provide information for care givers and health care professionals about abnormalities in height and weight, which could become dangerous health problems as students develop.</p> Signup and view all the answers

What are two key aspects of immunization monitoring conducted by school nurses?

<p>Monitoring student immunization records and knowing about current immunization schedules.</p> Signup and view all the answers

Why are school children considered a high-risk group for communicable diseases?

<p>School children are a high-risk group because of bad healthy habits.</p> Signup and view all the answers

What are the three things the school nurse should do relating to readmission after being sick?

<p>The child should be examined by the nurse before readmission to school, once the child is isolated for communicable diseases, his or her home contacts and classmates should be put under supervision; and any food handlers attending to the child should be examined yearly and treated.</p> Signup and view all the answers

Describe the responsibility of the school nurse in facilitating quick response in case of a student emergency?

<p>The school nurse must also be responsible for the development of an Emergency Care Plan (ECP) that provides school staff with a guide for quick response in case of a student emergency.</p> Signup and view all the answers

Why is it important for a school to have a suitable room for emergency care?

<p>To provide a space which has proper supplies and equipment for treating a student in the event of an emergency.</p> Signup and view all the answers

How are parents notified in the event of an accident at school?

<p>Notify parents and authorities.</p> Signup and view all the answers

What is the prevalence of asthma in the school age population?

<p>Asthma is one of the most common chronic childhood conditions, causing more than 4.6 million people to miss more than 1 day of school or work.</p> Signup and view all the answers

What types of chronic illnesses does the school nurse monitor and administer medication for?

<p>Seizure disorder, diabetes, attention deficit hyperactivity.</p> Signup and view all the answers

What guidelines should the nurse adhere to related to medication administration?

<p>Properly received, stored, and labeled over-the-counter and prescription medications. Parental consent for the nurse to communicate and administration of medication without violating standing orders school district policies, nursing standards of practice, or state nurse practice acts.</p> Signup and view all the answers

How is the school nurse involved in development of Individualized Health Care Plans?

<p>The nurse is responsible for the development of an Individualized Health Care Plan (IHP) for all students requiring continuous nursing management while at school.</p> Signup and view all the answers

Describe how student health records should be protected?

<p>Student health records should be afforded the same level of confidentiality as that given to clients and patients in other settings.</p> Signup and view all the answers

List three of the most common eating disorders.

<p>Anorexia, bulimia, and binge eating.</p> Signup and view all the answers

List four warning signs that a student may be undergoing a high level of stress?

<p>Problems eating or sleeping, Use of alcohol or other substances, Problems making decisions, and Persistent anger or hostile feelings.</p> Signup and view all the answers

Give two aspects of having a good, physical school environment:

<p>Prevention of communicable diseases and injuries and helps in better education.</p> Signup and view all the answers

Name four necessities for the physical learning environment which should be followed for students:

<p>Class rooms usually 6x 8 or 5 x7 meter, number of students should not exceed 30 to 40 students; Doors &amp; Window- The windows should be broad with bottom sill at a height of 2&quot; - 6&quot; from floor level combined; Ventilation: the windows should be arranged in both side walls to allow for cross ventilation; and Water supply: Safe water supply should be available using drinking fountains.</p> Signup and view all the answers

List at least three necessities related to sanitation for hygiene, inside and around the school.

<p>Lavatories: provided with soap, placed near water closets for hand washing; Refuse and sewage disposal: refuse should be collected daily. Small baskets should be distributed in the class rooms and playground to collect paper and waste materials; and Insect control: the school environment should be free from any breeding places, application of insecticides usually used when necessary.</p> Signup and view all the answers

Give at least two qualities a non physical environment should have for students.

<p>Good relationship between students and teachers and parents, Good relationship between children themselves.</p> Signup and view all the answers

Who is the main individual the school health nurse will health conferences with to discuss students' health problems.

<p>Conducting health conferences with teachers about students' health problems.</p> Signup and view all the answers

List three disabilities eligible for Individualized Education Plans.

<p>Autism, Deaf-blindness, and Deafness.</p> Signup and view all the answers

List four common causes of morbidity in school aged children.

<p>Parasitic diseases, Respiratory diseases, Skin diseases, and Infectious diseases.</p> Signup and view all the answers

Please rank the top three causes of morbidity in school age children.

<p>Injuries, Infectious diseases, and Rheumatic fever.</p> Signup and view all the answers

List three ways a SHN can show they are regarding professional and personal development.

<p>Ensures continuing competency, Maintains record of learning and professional development activities, Promotes and maintains a positive image of nursing</p> Signup and view all the answers

What does primary prevention entail?

<p>Prevention of childhood injuries, Substance abuse prevention education, Disease prevention education, Vaccination for school children</p> Signup and view all the answers

List two of the core nursing duties for secondary prevention in a school setting.

<p>Provide triage and communicate with emergency medical personnel.</p> Signup and view all the answers

Can you list at least three examples for secondary prevention in a school setting?

<p>Screening children for pediculosis (Lice), Identification of child abuse or Neglect, Efforts to prevent suicide</p> Signup and view all the answers

List four of the main ways tertiary prevention is applied in a school setting?

<p>Children with Asthma, Children with Autism or Attention hyperactivity Disorder, Children with special needs, Children with DNAR</p> Signup and view all the answers

How long should a child with chickenpox be excluded from school?

<p>14 days</p> Signup and view all the answers

What skills/qualifications are necessary for a school health nurse in KSA?

<p>Registered nurse and a baccaulaureate degree from an accredited college or university. Minimum 3 years' experince as a nurse preferably in a school. Nurse certification. Needs to have a Saudi NHS registration</p> Signup and view all the answers

Flashcards

School Health Nursing

The specialized practice of professional nursing that advances the wellbeing, academic success and life long achievement of students.

Aim of School Health Nursing

To protect, promote and maintain health of school children and reduce morbidity and mortality in them

School Health Team

The school health team should be comprised of school medical officer, school health nurse, an auxiliary health worker, teacher, parents and student representative from the community

Qualifications of School Health Nurse

Licensure as a registered nurse and a baccalaureate degree from an accredited college or university.

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Components of School Health Program

School health services, healthful school environment, and health education

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Additional Elements in Health Programs

Integrated efforts of school and community agencies, school physical education program, school food services, school counseling and psychology program, and school programs to protect and improve the health of the staff

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School Health Services

Vision and hearing screening, height and weight management, and immunization monitoring

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Vision and Hearing Screening

To spot visual acuity and any early identification of possible health problems

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Height and Weight Management

Annual measurement to provide valuable information for care givers and healthcare professionals about any abnormalities in height, weight before they become a dangerous health problem.

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Immunization Monitoring

Monitoring student immunization records, knowing about current immunization schedules and monitoring communicable diseases control.

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Communicable disease risk

High risk group, due to their bad healthy habits. So, they are more liable to many infectious diseases

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Emergency Care

Preparing a suitable room for emergency care with proper supplies and equipments. Performing training programs for students, & teachers in first aid procedures and how to handle emergency situations.

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Medication administration.

Medication administration in the schools is a serious undertaking. Issues facing the school nurse include safety, monitoring of both therapeutic and side effects, proper documentation, confidentiality, and ongoing communication with the student and family.

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Children With Special Health Needs

Individualized Healthcare Plan (IHP)

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Student Records

The Family Educational Rights and Privacy Act (FERPA), a strong privacy protection act, protects student education and health records.

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Eating Disorders

Anorexia, bulimia, and binge eating are the three most common eating disorders, and anorexia is ranked number three in terms of chronic disorders in adolescents

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Warning Signs of Stress

Problems eating or sleeping, use of alcohol or other substances, problems making decisions, persistent anger or hostile feelings,inability to concentrate, Increased boredom, Frequent headaches and ailments and Inconsistent school attendance.

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Non physical environment (social)

Good relationship between students and teachers and parents. Good relationship between children themselves. The school day and homework are properly arranged to prevent fatigue.

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School health education

Conducting health conferences with teachers about students' health problems. Contributing to the health of the family through discussion on home visits. Participate in class discussion in occasions such as immunization, comprehensive medical examination and injuries.

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First cause of mortality

Injuries

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Primary prevention

Prevention of childhood injuries, substance abuse prevention education and disease prevention education.

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Secondary prevention

Nursing care for emergencies, provide triage and communicate with emergency medical personnel

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Tertiary prevention

Children with Asthma, Children with Autism or Attention hyperactivity Disorder and Children with special needs

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Physical environment

Providing a good condition for studies

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Study Notes

School Health Nurse Introduction

  • School nurses provide healthcare for children and families
  • School nursing started in the late 1800s in England
  • The Metropolitan Association of Nursing provided medical examinations for children in London schools
  • In the early 1900s, school nurses screened children for infectious diseases
  • By 2002, school nurses offered direct care, health education, counseling, case management, and community outreach

Objectives of School Health Nursing

  • Discuss professional standards for school nurses
  • Differentiate roles/functions of school nurses
  • Variations of school health services and coordinated programs
  • Analyze nursing care in schools based on primary, secondary, and tertiary prevention
  • Anticipate future trends in school nursing

Demographics and Need

  • About 30% of the general population is comprised of children in schools
  • In the U.S. in 2019-2020, nearly 1 in 5 children (19.4%) had special healthcare needs

Definition and Aim

  • School health nursing is a specialized practice
  • It advances wellbeing, academic success, and lifelong achievement
  • The goal is to protect/promote school children's health and reduce morbidity/mortality

Specific Objectives

  • Promote positive health
  • Disease presentation
  • Early diagnosis, treatment, and follow-up for defects
  • Raise health consciousness in children
  • Provide a healthy environment

School Health Services

  • Integral components including:
    • Health education
    • Health services
    • Healthy school environment
    • Family and community involvement
    • Health promotion for staff
    • Physical education
    • Nutrition services
    • Counseling, psychological and social services

Health Education

  • Healthy People 2020 promotes health education courses in middle/high schools
  • The CDC identified six high-risk behaviors for health education:
    • Alcohol and drug use
    • Injury and violence
    • Tobacco use
    • Poor nutrition
    • Lack of physical activity
    • Risky sexual behavior

School Health Team Composition

  • Medical officer
  • School health nurse
  • Auxiliary health worker
  • Teacher
  • Parents
  • Student representative

Whole School, Whole Community, Whole Child (WSCC)

  • WSCC is CDC's framework for health in schools
  • Emphasizes community support
  • Links health, academic achievement, and evidence-based policies

Qualifications for School Health Nurses in KSA

  • Licensure as a registered nurse with a baccalaureate degree from an accredited institution
  • Minimum 3 years' experience, preferably in a school setting
  • Nurse certification
  • Saudi NHS registration

School Health Program Components

  • Interdependent components:
    • School health services
    • Healthful school environment
    • Health education

Expanded School Health Programs

  • New versions of school health programs add five elements to the original three:
    • Integrated efforts from school and community
    • School physical education
    • School food services
    • School counseling and psychology programs
    • Programs to protect/improve staff health

School Health Services - Screening

  • Early detection of health problems
  • Encompasses physical, psychological, and social health
  • Including:
    • Vision and hearing screening
    • Height and weight management
    • Immunization monitoring

Vision and Hearing Screening

  • Identifies potential vision problems impacting learning
  • Students ideally screened annually
  • Nurses follow up with students who fail screenings

Height and Weight Management

  • Annual measurements provide valuable health information
  • Early detection of abnormalities in height and weight help prevent dangerous health problem

Immunization Monitoring

  • Involves tracking student immunization records
  • Staying informed about current immunization schedules
  • Monitoring communicable disease control

Communicable Disease Control

  • School children are at high risk
  • Respiratory illnesses include rhinitis, sinusitis, ear infections, acute pharyngitis or tonsillopharyngitis, epiglottitis, and laryngitis
  • Food/waterborne diseases include Salmonella, diarrheal disease, E. coli infections
  • Skin and parasitic diseases include pinworm

Exclusion Periods for Communicable Diseases

  • Hepatitis A: 21 days
  • Whooping cough: 18 days
  • Mumps: 14 days
  • Measles: 14 days
  • Chickenpox: 14 days
  • Scarlet fever: 10 days
  • German Measles: 7 days

Control of Communicable Diseases

  • Children should be examined by the nurse before returning to school after illness
  • Home/class contacts of children with communicable diseases need supervision
  • It's important to know the reason for student absence
  • Food handlers in schools should be examined and treated yearly

Emergency Care

  • School nurses develop Emergency Care Plans (ECPs)
  • Provide a guide for the school staff to facilitate quick response in case of a student emergency
  • Key aspects of emergency care:
    • Preparing a suitable room and appropriate equipment
    • Training programs for students/teachers in first aid/emergency response
    • Injury prevention
    • Immediate care and referral
    • Notification of parents/authorities

Care of the Ill Child

  • Asthma is a common chronic condition
  • It causes over 4.6 million people to miss school/work days annually

Medication Administration

  • A critical responsibility
  • Issues include safety, monitoring, documentation, confidentiality and communication
  • Nurse responsibility in monitoring and administering medication
  • For chronic conditions like seizure disorder, diabetes, and ADHD

Medication Administration Guidelines

  • Properly received, stored, and labeled over-the-counter and prescription medications
  • Parental consent for nurse communication with primary care providers
  • Administration of medication without violating standing orders, school district policies, nursing standards of practice, or state nurse practice acts

Children with Special Health Needs

  • The nurse should develop Individualized Health Care Plans (IHPs)
  • All students need continuous nursing management at school

Student Records

  • The Family Educational Rights and Privacy Act (FERPA) protects the student education and health records
  • Student health records need the same level of confidentiality

Nutrition and Eating Disorders

  • Nurses should be aware of eating disorders like anorexia, bulimia and binge eating
  • Binge eating is recurrent, out-of-control eating of large amounts of food regardless of hunger
  • Anorexia is severely restricted intake due to fear of weight gain
  • Bulimia is anorexia that is characterized by a chaotic eating pattern with binging and purging

Counseling, Psychological, and Social Services

Warning signs of stress to watch out for include:

  • Problems with eating or sleeping
  • Use of alcohol or other substances
  • Problems making decisions
  • Persistent anger or hostile feelings
  • Inability to concentrate
  • Increased boredom
  • Frequent headaches and ailments
  • Inconsistent school attendance

Healthful School Environment

  • Includes physical and non-physical aspects

Physical Environment

  • Reduces communicable diseases and injuries
  • Provides better education
  • Leads to healthful habit formation

Key Elements in Physical School Environment

  • Location away from noise, traffic, and pollution that is safe
  • Classrooms of appropriate size with 30-40 students
  • Broad windows with low sills
  • Ventilation to allow for cross ventilation
  • Natural and artificial lighting
  • Properly designed desks and seats
  • Safe drinking water fountains

Other Considerations for Physical Health

  • Provide lavatories with soap near water closets
  • Baths and douches for personnel
  • Refuse collected daily, with small baskets in classrooms/playgrounds
  • Sanitary sewage disposal
  • Insect control
  • Food sanitation in the canteen

Non-Physical Environment (Social)

  • Good relationships between students, teachers, and parents
  • Positive relationships among students
  • Proper arrangement of the school day/homework to prevent fatigue
  • Availability of social activities
  • Opportunities for developing talents and skills

School Health Education

  • Conducting health conferences with teachers about students' health problems
  • Contributing to family health through home visits
  • Participating in class discussions on immunization, medical examinations, and injuries

Students with disabilities

  • Eligible for Individualized Education Program (IEPs)
  • Autism
  • Deaf-blindness
  • Deafness
  • Emotional disturbance
  • Hearing impairment
  • Intellectual disability
  • Multiple disabilities
  • Orthopedic impairment
  • Other health impairment
  • Specific learning disability
  • Speech or language impairment
  • Traumatic brain injury
  • Visual impairment, including blindness

Causes of Morbidity in School-Age Children

  • Parasitic diseases like ascaris
  • Respiratory diseases like influenza and tonsillitis
  • Skin diseases like scabies and tenias
  • Infectious diseases like typhoid and mumps
  • Chronic diseases like rheumatic fever and DM
  • Injuries
  • Diarrhea and food poisoning
  • Nutritional problems like stunting
  • Exceptional conditions like visual/hearing impairments
  • Dental problems like caries and plague

Causes of Mortality

  • Injuries
  • Infectious diseases
  • Rheumatic fever

SHN Responsibilities for Professional Development

  • Assume responsibility for professional growth
  • Maintain competency in BLS and PALS
  • Keep records of learning experiences
  • Promote a positive image of the nursing profession
  • Use research and best practices in nursing

Primary Prevention

  • Includes:
    • Prevention of childhood injuries
    • Substance abuse prevention education
    • Disease prevention education
    • Vaccination (MMR, DPT, OPV)

Secondary Prevention

Includes:

  • Provide triage
  • Communicate with emergency medical personnel
  • Assess the school community for the presence of shock and stress
  • Recommend reduced television viewing of the disaster
  • Provide grief counseling
  • Communicate within the children, parents and school personnel
  • Follow up with assessment of children for anxiety, depression, regression

Other Aspects of Secondary Prevention:

  • Emergencies equipment in the school nurse’s office
  • Giving Medications in school
  • Assessing and screening children at home
  • Screening children for pediculosis (Lice)
  • Identification of child abuse or Neglect
  • Communicating with health care providers
  • Efforts to prevent suicide
  • Violence at school

Tertiary Prevention

Includes:

  • Caring for children with asthma
  • Caring for children with autism or ADHD
  • Caring for children with special needs
  • Caring for children with DNAR orders
  • Supporting housebound children
  • Teenage pregnancy support

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