NASN Winter Webinar Series “Let’s Talk Documentation!”

Winter Webinar Series Date Webinar Title January 22, 2014 Individualized Healthcare Plans February 5, 2014 Emergency Care Plans February 19, 2014 Using Position Documents March 5, 2014 HIPAA and FERPA

Using Position Documents in your School Nursing Practice Host: Margaret Cellucci, NASN Director of Communications Speaker: Vicki Taliaferro, School Health Consultant

NASN Position Documents: A Valuable Resource Just what are position documents ?

Types of NASN Position Documents Position Statements Consensus Statements Resolutions Margaret, NASN has developed several position documents. Today we are going to focus on the three that are most useful in a school nurse’s everyday practice. Position Statements Consensus Statements and Resolutions

NASN Position Statements An evidence-based paper summarizing the historical, political, and/or scientific aspects regarding a topic related to school nursing, school health services and/or NASN. It is the official position of the organization that can be shared with members, community media and legislators. A position statement is defined as an evidence –based paper summarizing the historical, political, and/or scientific aspects regarding a topic related to school nursing, school health services and/or NASN. It represents the organization’s stand on a particular topic. Please note the very key words here – evidence based. We’ll discuss why this is important in a bit. NASN Position Papers and Reports (n.d.)

NASN Position Statements NASN position statements address over 38 topics i.e.: Allergy/Anaphylaxis Caseload Assignments Chronic Health Conditions Concussions Delegation Diabetes Management Medication Administration Mental Health of Students School Violence Unlicensed Assistive Personnel NASN position statements cover many pertinent topics for today’s school nurse and the students and families they serve. Here are just some examples of the over 38 topics addressed by the position statements. NASN Position Papers and Reports (n.d.)

NASN Position Statements The development of a position statement is a rigorous and comprehensive process. School nurses should have confidence that the position statements provided by NASN have been through a thorough and comprehensive process using many professionals and research to develop these statements.

NASN Position Statements Position Statement Development Process Authors Literature Review NASN Staff Content Experts Board of Directors NASN Attorney NASN’s position documents are developed by school nurses and other experts in the field. A thorough literature review is conducted to establish the need and current evidence to base the position. NASN professional nursing staff as well as content experts on the topic being addressed review the document and provide feedback to the authors. The NASN Board of Directors representing the members of NASN review the document and provide comments as wel1. Lastly, NASN’s attorney reviews the document. All this before it is brought to the NASN Board of Directors for approval. NASN How2Guide (2013)

NASN Position Statements Must be approved by the NASN Board of Directors. Reviewed at least every 5 years. Once the BOD have approved the document it is posted to the NASN website. To make sure that NASN’s positions remain current , the documents are reviewed at east every 5 years as a minimum. If a topic is no longer an issue the document can be retired or if it needs to be revised it is done so following the same rigorous procedure. NASN How2Guide (2013)

NASN Consensus Statements A timely response to a school health or school nursing issue for which NASN does not have a specific Position Statement or Resolution and represent an internal consensus. The second type of document that NASN provides is a consensus statement. The difference between the Position Statement and a Consensus Statement is the timely response. Should a topic need to be addressed more urgently (for example, a recent example would be the Legalization of Marijuana) the NASN executive committee can develop a statement that is researched and reflects the consensus of the organization. Know that these documents are viable for a year by which time they then must be converted to a Position Statement or retired. NASN Position Papers and Reports (n.d.)

NASN Consensus Statements Based on evidence and are approved by NASN’s Executive Committee. Reviewed within a year of development at which time the document will be revised into a Position Statement or retired. NASN How2Guide (2013)

NASN Consensus Statements Examples of NASN Consensus Statements include: Legalization of Marijuana The Use of Restraints or Seclusion in the School Setting

NASN Resolutions Resolution An elaborate, formally written expression of opinion or position by NASN. Lastly, NASN provides Resolutions, an elaborate formal opinion. One of the best examples of this would be the resolution NASN has supporting the belief that State School Nurse Consultants are essential positions to have in each state and the rationale for why NASN holds that belief. NASN Position Papers and Reports (n.d.)

Examples of NASN Resolutions include: Public Health as the Foundation of School Nursing Practice State School Nurse Consultants One of the best examples of this would be the resolution NASN has supporting the belief that State School Nurse Consultants are essential positions to have in each state and the rationale for why NASN holds that belief.

Types of NASN Position Documents Position Statements Consensus Statements Resolutions So Margaret, the three types of Position Documents NASN offers – Position Statements, Consensus Statements and Resolutions – are developed using a comprehensive process.   They are thoroughly vetted and school nurses, schools, families and the public can be assured that the positions NASN takes are current and reflect best practice for school nurses and the students they serve.

Using NASN Position Documents So how can I use these position documents in my everyday practice? So maybe Margaret can ask this question…

Using Position Documents – Let’s Count the Ways! Advocacy/ Education Strengthen School Nurse Practice Policy Development We want to emphasize that the Position Documents that have been developed by NASN are excellent resources for school nurses to use in their practice. We’ll touch on three areas that the documents can be used: policy development, advocacy and education and lastly strengthening the individual school nurse’s practice. Krin & Taliaferro (2013)

Policy Development Policy documents guide school nursing practice or establish direction for a school health issue Foundational to practice One of the most important pieces of documentation that I feel school nurses and school nurse programs require are policies. They are foundational to our practice, guiding and providing support to the school nurse’s practice. Krin & Taliaferro (2013)

Policy Development Sound policies protect schools and employees Provide support and direction CDC reinforces that sound school health policies legally protect schools and staff. In addition to support and direction, policies can also prevent controversies when conflicts arise. Krin & Taliaferro (2013); CDC (2010)

Policy Development NASN Position Documents are: Evidence based Thoroughly researched and vetted Represent best practice So recognizing the need and importance of school health policies, how can NASN’s Position Documents help? Policies should be grounded in evidence and using NASN’s documents can assist with that. Using these documents in addition to specific laws and regulations, and the Scope and Standards of Practice, will help to ensure that school health policies are appropriate and relevant. NASN is a recognized leader in school nursing. Once again, school nurses can utilize the position documents with confidence as they develop their own school district/program policies because they are evidence based, researched and vetted and represent current best practice. NASN’s positions have been used in legal situations as examples of standards of practice.

Advocacy/Education Parents/School Administrators Student Legislators The school nurse can establish collaborative partners to support the students, promote health and thus a successful learning environment. As an example, suppose as a school nurse you have identified the need for having stock epinephrine available in schools. You have been approached or you have approached legislators about changing laws to require schools to have epinephrine available. The Position Document on Allergy/Anaphylaxis Management in a School Setting can help you educate legislators and parents regarding the issue, with the confidence that this topic was carefully researched and the PS represents best practice nationally. School nurses are educators and advocates who speak for the children and youth. Position documents can be used as an educational/advocacy tool when explaining a school nurse’s role to families, administrators and legislators. Cornell & Selekman (2013)

Strengthening School Nurse Practice NASN’s Position Documents Guide individual school nurse practice Provide support and direction Are an educational tool Finally, the Position Documents can be used to strengthen the individual school nurse’s practice. Being familiar with the documents and their contents will help to guide practice and inform the school nurse of best practice. It can help the school nurse defend her practice if questioned by school administrators and can be used as an educational tool. Examine Caseload Assignments and see how that particular document may assist the nurse in developing or revising their job description. Taliaferro & Ozias ( 2010); Krin & Taliaferro (2013)

Locating The Position Documents Where do I access the documents?

NASN’s Website NASN’s position documents can be found at http://www.nasn.org/PolicyAdvocacy/PositionPapersandRepo rts Click the tab at the top of the page titled “Policy and Advocacy” The position documents can be found at NASN’s website. At the top bar one will see the tab for “Policy and Advocacy”. Click that and you will see a TOC displayed.

NASN’s Website You’ll find a list of alphabetized Position Documents that are hyperlinked: The documents are listed alphabetically and are hyperlinked for your convenience. Please take the time to explore!

Resources What other resources are available?

Resources: Policy Development School Nurse Administrator/Supervisor and District Policies School Nurse Administrators: Leadership and Management (NASN text) State School Nurse Consultant (http://www.schoolnurseconsultants.org/) There are several additional resources one can use to assist with policy development. Certainly start with your school nurse administrator or supervisor if you are fortunate to have one. They will be able to direct you to already established policies and can share the process that is used to develop and review the policies. If you don’t have a nursing administrator or supervisor, ask your supervisor where district/program policies can be accessed and review them for currency and applicability. I would refer listeners to a recent NASN text School Nurse Administrators: Leadership and Management which has an entire chapter addressing policy development and many other topics regarding managing a school nurse program and its development. Don’t forget to touch base with your state school nurse consultant who can be a valuable resource in providing resources in policy development. All but seven states have a SSNC – if you don’t know who your SSNC is – check out the NASSNC website listed here.

Resources: Advocacy/Education NASN’s Advocacy Tools http://www.nasn.org/PolicyAdvocacy/DRAFTPolicyAdvoc acy NASN has extensive materials to provide education on the role of the school nurse and children’s health issues at http://www.nasn.org. Advocacy is a strategic goal of NASN and they have a variety of tools on their website that individuals can access. Additionally, NASN has extensive materials that describe the role of the school nurse and can be used in educating others. Explore the NASN website for these resources!

Resources: Strengthening School Nurse Practice Professional Developmental Opportunities: NASN Online Professional Development NASN Annual Conference State Affiliate Conferences Publications: Text - School Nursing: A Comprehensive Text Text- Scope and Standards for School Nursing Text - Legal Issues in School Health Services NASN’s publications page NASN will soon be offering Clinical Guidelines on numerous topics. School Nurse Leaders School Nurse Supervisor State School Nurse Consultant (http://www.schoolnurseconsultants.org/) Mentors There are so many resources for school nurses to strengthen their individual practice. This slide outlines many of them. Besides school nurse conferences offered nationally and in individual states, NASN has many online professional development opportunities. I’d like to draw your attention to the number of publications that are available . Lastly, I would encourage individual school nurses to look to their school nurse leaders – their supervisors, SSNCs, their NASN Director, and reach out to an experienced school nurse that could serve as a mentor or if you are that experienced school nurse – consider volunteering to mentor a new school nurse!

References Centers for Disease and Prevention (CDC). (2010). School Health Policy. Healthy Youth! Retrieved from http://www.cdc.gov/healthyyouthy/policy/index.htm Cornell, M., & Selekman, J. (Ed. ). (2013). Collaboration with the community. In J. Selekman (Ed.), School nursing: A comprehensive text, 2nd ed. Philadelphia, PA: F.A. Davis Company. Krin, P., & Taliaferro, V. ( 2013). Establishing policies and procedures: The core of school nursing practice. In C. Costante (Ed.), School nurse administrators: Leadership and management (pp. 339-363). Silver Spring, MD: National Association of School Nurses. National Association of School Nurses .(n.d.) Position papers and reports. Retrieved from http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports National Association of School Nurses. (2013). How2Guide 110: Document development process. Board of Directors Publication. Silver Spring, MD: NASN. Taliaferro, V. & Ozias, J. (Eds.). (2010). School nurse program policies. In School nurse resource manual: A Guide to Practice (7th ed.) (pp. 283-322). Nashville, TN: School Health Alert.

Webinar Series: Let’s Talk Documentation! Speaker: Vicki Taliaferro, School Health Consultant