1. NPS Health Services Report
Karen Rufo MS, PPCNP-BC, RN
Nurse Leader Natick Public Schools
October 7, 2014

2. The National Association of School Nurses (NASN) defines school nursing as:
A specialized practice of professional nursing that advances the well being, academic success, and lifelong achievement of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self- management, self advocacy and learning.

3. There are 14 Registered Nurses One Nurse Leader One School Physician
Health Services Staff
There are 14 Registered Nurses
One Nurse Leader
One School Physician
One want to be Therapy Dog

4. Facts
Combined the NPS nurses have an average of 27.6 years of nursing experiences (ER, OR, Critical Care, Pediatrics, Psychiatry, Oncology, Enterostomal RN, IV Therapy, Wound Care, Administration, Community Health, and Med Surg Nursing)
They have over 143 years of school nursing experience
They all have a minimum of a BSN
Five of them are Master’s prepared and one holds a graduate certificate in Nursing Education

5. Certifications They are all DESE Certified
They have all completed the ICS course for Emergency Preparedness (Incident Command Systems) and NIMS (National Incident Management System) 700 Training
They are all CPR Certified and ready to work as First Responders
Two Nurses have Advanced Cardiac Life Support Certification
Five of them hold Advanced National Certifications in School Nursing or as a Pediatric Nurse Practitioner
Eight of the current Nursing Staff has been trained in Smallpox Vaccination

6. Primary Responsibilities
Injury Prevention, Triage and Treatment
Illness Assessment and Care
Medication Administration and Monitoring
Health Counseling and Health Promotion
Communicable Disease prevention and Control
Individualized Health Care Planning
Case Management for Students with Special Health Care Needs
Communication with everyone!

7. Additional Responsibilities
1.IEP Consults
2.Medical 504 Coordinator
3.Education to parents and students about their medications, policies and illnesses
4.Physician consults for medical, social, behavioral, and emotional issues
5. Education to staff regarding
Epinephrine Autoinjector Administration, Life Threatening Food Allergies and Blood Borne Pathogens, First
Immunizations, policies, communicable disease and general health and wellness
Students with special medical conditions
About medications and the impact upon the students performance and what they need to know to about the medication for various field trips

8. Committees
School Level: Case Management, ACT, Crisis Teams and Smoking Cessation, Medical 504 Coordinators, Leadership Team
District Level: School Health Advisory Committee, STARS, Special Olympics, EAN, and SEPAC
Town wide: Natick Together for Youth, Medical Reserve Corps Volunteers
State wide: Essential School Health Grant, Massachusetts School Nurse Organization, National School Nurses Association, Metro West Childhood Obesity Task Force, Massachusetts Association of School Research Nurses, Massachusetts Department of Public Health Evaluation Team

9. Mandated Massachusetts DPH Screenings
Vision
Grades K-4, 5th, 7th and 9th
Hearing
Grades K-3, 7th and 9th
Postural/Scoliosis
Grades 5th thru 9th
Height/Weight and BMI
Grades 1st, 4th, 7th and 10th
SBIRT
Grade 7 and 9

10. Number of Nurse Visits by School
PreSchool 79
232
270
BenHem
6211
7329
7574
Brown
3115
3572
4410
Johnson
3965
4022
4077
Lilja
4016
4383
4286
Memorial
4740
5703
7448
KMS
4923
6571
7986
WMS
10,892
12,021
12,700
NHS
9791
7523
9037
TOTALS
47,732
51,356
57,788

11. RTC =94%

13. Number of Nurse Visits September 2013 vs September 2014

14. # visits September 2013
# visits September 2014
PreSchool 23 66
BenHem
775
926
Brown
426
728
Johnson
361
376
Lilja
460
367
Memorial
517
491
KMS
823
895
WMS
1314
1708
NHS
1013
1302

15. Factors to Consider for Nurse: Student Ratios
Number of Students Enrolled
Number of Medically Fragile Students
Number of Students with Developmental/Communication Needs
Number of Clinic Visits
Number of Procedures/Treatments
Role of the Nurse in the School

16. WMS 27 831 7,950 (132 hours) 81% NHS 15 351 4,374 (73 hours) 45% KMS
# of students
# of visits so far this year (23 days) data collected as of 9/29/14
time of those visits in minutes
Percentage of nurses time
WMS 27
831
7,950
(132 hours)
81%
NHS 15
351
4,374
(73 hours)
45%
KMS
290
2,853
(48 hours)
30%

17. Consistent with 1998 legislative report, Options for Developing School Health Services in Massachusetts, the recommended school nurse to student ratio is 1.0 fulltime equivalent (FTE) certified nurse in each building with 250 to 500 students. In buildings with more than 500 students, there should be 0.1 FTE for each additional 50 students. For buildings with fewer than 250 students, the ratio is calculated at 0.1 FTE: 25 students.

18. Natick Numbers Minimum recommended FTE= 10.8 Average: 16.1 FTE
Optimal situation: FTE

19. Recommended Nurse FTE to meet student needs
SCHOOL
# students enrolled
Nurse FTE
Recommended Nurse FTE to meet student needs
PreSchool
103
0.4
BenHem
622
1.4
0.1
Brown
486 1
1.5
Johnson
235
Lilja
406
Memorial
434
KMS
660
1.2 2
WMS
927 3
NHS
1499
TOTALS
5372
10.8 13