1. Student Health Services Seattle Schools Jill Lewis RN MN http://www.seattleschools.org/area/healthservices/index.dx ml

2. Learning Objectives Understand the major health concerns in SPS and their trends. Demonstrate current knowledge of the documents and elements required to have medications administered at school Participate in discussion related to the challenges of effective management of asthma in the school age child Understand effective ways to collaborate with schools in the effective management of asthma in the school aged child

3. Major Health Concerns Life threatening conditions- place students at risk of dying during the course of the school day total students797, total conditions 1105 Leading LTC allergies 779, diabetes 93, asthma 71, seizures 61, other 130 Requires Individual Health Plans and medication or treatments in place to attend school based on orders designed and implemented by school nurse

4. Most frequent Health Concerns of total 17,2752 Respiratory/sinus and allergies 4,376 Asthma 3,490 Vision 1,652 ADD/ADHD 1,269 Neuropsychological disorders 1,291 Sever Allergies 945 Hearing 595 Headaches 452 Seizures 355 Heart conditions 187

5. Trends Students with health concerns are increasing The standard of care in schools is increasing The medically fragile students require more access to nursing Nursing resources in schools are diminishing It critical to assure students have necessary levels of support and work toward readiness to learn It is critical to utilize the existing nursing resources in the most focused and targeted ways until such time as the resources can match the growing need New laws have added school staff training requirements to assure students are safe in school As school time expands so do the health requirements- extended day or extended school year Increasing interest in schools ability to influence health behaviors -STEPS Grant

10. Anaphylaxis Health concerns on life threatening allergies has increased by 400% since 2000 Students have more frequent multiple life threatening allergies Law require that students have plans and medication at school prior to attendance As more students attend after school and summer tutoring more attention is required to meet the health and safety requirements of these and other students with life threatening conditions

12. Schools to teach healthy behaviors Many health issues are on the rise including obesity, diabetes, and consequences of diminished physical activity and eating behaviors Schools are increasingly seen as a key in teaching behaviors to improve these trends Student Health is very central to understanding the need and with partners able to support improving life style choices to assure health

13. Documents required to have administered medications at school Medication authorization http://www.seattleschools.org/area/healthservice s/forms/medauth1.pdfhttp://www.seattleschools.org/area/healthservice s/forms/medauth1.pdf If life threatening condition also needs Individual Health Plan, medication, staff trained to carry out plan For student to self administer all staff are trained on the general condition for asthma and anaphylaxis http://www.seattleschools.org/area/policies/d/D 99.00.pdf School Board Policyhttp://www.seattleschools.org/area/policies/d/D 99.00.pdf

14. Delegation of medication administration Authorized by law in the school setting when all elements are present –RN delegates to a trained, willing, competent, school staff –Must have provider orders and parental permission to delegate –Only oral medications and epi pens

15. Barriers to effective management Brainstorm Q&A

16. Effective ways to collaborate with schools Nurses how to contact http://www.seattleschools.org/area/ healthservices/forms/schoolscurrent.pdfhttp://www.seattleschools.org/area/ healthservices/forms/schoolscurrent.pdf http://www.seattleschools.org/area/ healthservices/forms/nursescurrent. pdfhttp://www.seattleschools.org/area/ healthservices/forms/nursescurrent. pdf

17. Tools Partner with school nurse and other staff with parent knowledge and permission Encourage providers to write asthma management plans for child to be used at home and school Education of students and families about the disease and mitigate the factors that exacerbate home assessment Encourage students to be as functional as possible PE out door activity etc.

18. Summary Partner to support students have the best control possible and to be the best student possible Attend school ready to learn Advocate for the student when attendance is difficult homework, communicate with school about ER or hospitalizations