VA Association of School Nurses Conference November 7, 2015 2015 School Health Update

School Health Statistics

National School Nurse Data Set Effort by National Association of School Nurses and National Association of State School Nurse Consultants Create uniform data points Use for research that is school nurse specific

Virginia Data Not mandated Non-scientific Various levels of participation Many errors Uniform data set provided definitions for the data requested. Uniform, process for adding additional data points. Less data this year. Worked on developing systems for data collection.

Demographics Data collection methodology completely changed for the 2014-15 school year 123 of 133 divisions reporting 1753 schools reporting out of 1845 schools in the reporting divisions 1,249,257 students, 97.6% of students represented Uniform data set proposed by the National Association of School Nurses/National Association of State School Nurse Consultants

School Nursing Services 1128.3 FTE RN Positions providing direct care 377.3 FTE LPN Positions providing direct care 494 UAPs 55.8 RNs with special assignments Data does not include school nurse coordinator/supervisors Data does not include RNs in Fairfax and Chesterfield Counties due to the construction of the question. An additional 105 RNs work in these 2 school divisions providing case management and supervisions of unlicensed clinical staff. Upon further clarification from NASN, we will be including these nurses in the count for the 2015-2016 school year.

Statistics from the 2014-15 NASN/NASSNC National Data Set Survey Ratios Ratio of 1:1107.2 RN only Ratio with Fairfax & Chesterfield RNs, 1:1012.9 (1:900, 2014) Ratio of 1:829.7 RN & LPN 1:775.6 (1:764, 2014) State School Nurse Consultant Positions (1 DOE, 1 VDH) Statistics from the 2014-15 NASN/NASSNC National Data Set Survey We are losing ground with nursing services!

Chronic Conditions Asthma: 101,804 (8.15%) Diabetes Type 1: 3,399 (0.27%) Diabetes Type 2: 578 (0.046%) Seizures: 7,561 (0.61%) Allergies: 43,717 (3.5%)

National Asthma Prevalence

Seizure GeoMap

Allergy GeoMap

Health Office Visit Disposition 75% of school divisions reporting Uncertain how many students this represents Students seen by the RN and: Returned to class: 1,962,029 Referred for emergency care*: 947 Sent home: 187,474 Total seen by the RN: 2,150,450 Due to my error in setting up the spring survey, we did not capture which divisions reported or the total number of students represented. *Those referred for emergency care, whether or not the parent followed up.

Health Office Visit Disposition Students seen by the LPN and: Returned to class: 271,260 Referred for emergency care*: 142 Sent home: 32,700 Total seen by the LPN: 304,102

Epinephrine Use in the Public School Setting, 2014-15 58,765 students with reported allergies Unassigned Epinephrine: 221 doses 66- RN 4- LPN 148- UAP

Epinephrine Use in the Public School Setting, 2014-15 Student Specific Doses: 120 37- RN 3- LPN 78-UAP

2015 General Assembly Action

School Nursing Advocacy GA bills impact school nursing practice Be informed Advocacy starts with a relationship! Legislators Parents Each year in the General Assembly, bills are introduced which directly impact the practice of school nurses. Legislative Information System, VASN Website Meet with your legislators now!- Offer to be their content experts regarding school health legislation. You have the knowledge regarding how proposed legislation will impact school age children, nursing practice, and the education system impact. They don’t know about your practice unless you speak up! Know who your parents are that speak to the issues.

House Bill 134 (2014)- Diabetes §22.1-274.01.1- School boards shall permit students with diabetes to carry and use diabetes supplies while on the bus, school property, and at school sponsored activities. This bill was passed in 2014 and required the VDOE to revise the Manual for Training Public School Employees in the Administration of Insulin and Glucagon. The manual was posted to the DOE Health & Medical Web page in July. It will be complete with a PowerPoint for school nurses to use when training staff.

18 Bills followed by School Health Specialists Prohibiting questions about firearms in the home on the School Entrance Physical Exam form-FAILED Telemedicine- VDH to establish a 3 year pilot project- FAILED Mental illness advance directive added to the FLE SOLs- FAILED Subcommittee to student childhood obesity in VA Public Schools- FAILED

18 Bills followed by School Health Specialists Epinephrine in Private Schools-PASSED HB 2216 Superintendent’s memo 124-15, May 15, 2015 Meningitis requirement for 6th and 12th grade- FAILED Provides civil immunity for trained employees of private schools for students with disabilities and those accredited by the Virginia Council for Private Education who administer epinephrine to students believed to be experiencing anaphylaxis. DOE to develop regulations for private schools with disabilities to possess and administer epinephrine in every school for students with disabilities. Will probably see the meningitis bill again.

18 Bills followed by School Health Specialists HB 2004- School Nurse Ratio of 1:750 FAILED Unaware of Bill, no rallying. Failed Fast!

LEGISLATIVE ALERT! Watch for legislative proposals adding boys to the HPV requirement and adding an opt-out form to the requirement for girls and boys. Watch for legislative proposals adding a requirement for the meningococcal vaccine at 6th and 12th grades.

School Health Resources

Manual Revisions Manual for Training Public School Employees in the Administration of Insulin & Glucagon- July 2015 Manual for the Training of Public School Employees in the Administration of Medication- Fall 2015 Virginia School Health Guidelines-December, 2015 Guidelines for Specialized Health Care Procedures- December, 2015 First Aid Flip Chart- Fall 2015

CDC 1305 Chronic Disease Grant (VDH) 9 Nurses to the NASN National Conference in Philadelphia, June 24-27 SCOT Training Provided at SISN Parents, Teens, and Sex: the Big Talk Book (3rd Ed.) for SISN participants Data collaboration- combining health data for private, public and Parochial schools 7 nurses- blind, competitive process. Look for similar opportunities in 2016! 2 state school nurse consultants Data review and reporting- VDH Epidemiologist

DOE Funded Opportunities School Nursing: A Comprehensive Text (2nd ed.) provided for all SISN participants CEUs for SISN provided for all nurses attending 10 Nurses to the NASN National Conference in Philadelphia, June 24-27 30 qualified nurses to take the National Board for Certification of School Nurses exam Add number passing the NCSN exam Have all NCSNs stand.

Further information VDH School Age Health Web site: http://www.vahealth.org/childadolescenthealth/schoolhealth/index.htm DOE Health & Medical Web site: http://www.doe.virginia.gov/support/health_medical/index.shtml

Contact Information Janet Wright, BSN, RN, NCSN School Age Health Specialist, VDH Janet.wright@vdh.virginia.gov 804-864-7689 Tia Campbell, MSN, RN, NCSN, FNASN School Health Specialist, DOE Tia.campbell@doe.virginia.gov 804-786-8671