1. School Nurse Case Management: The Importance of Process and Outcomes Maria M. Bonaiuto, RN,MSN,NCSN Mecklenburg County Health Department 249 Billingsley Road Charlotte, NC 28211 mbonaiuto@carolinas.org 704-336-4707

2. 2 School Nurse Panel Mary Cappleman, RN, MPH, NCSN Glenna Cook, RN, MPH Dixie Furr RN, BSN, NCSN Denise McIlwain, RN, BSN

3. 3 Lillian Wald 1867-1940

4. 4 Mecklenburg County School Nurses: Our Place in History

5. 5 Who Should be Case Managed? Students who have:  Multiple complex interactions with the nurse  Chronic health conditions (poorly controlled)  Academic concerns, with a health component  Health or behavior issues that impede learning  Multiple absences  A goal for improving health or other related criteria that effect learning

6. 6 Improved Quality of Life….what is it ?  Increased participation in activities, sports  Improved nutrition, healthy weight  Improved relationships, acceptance by others  Decreased anxiety, depression  Decreased tobacco use, substance use  Decreased risk taking behaviors  Self report of increased well being  Improved score on a formal Q of L Tool

7. 7 Steps to Case Management  Select students, using established criteria  Set goals with student, family, school, provider (SMART goals)  Document baseline  Identify strengths, needs, stakeholders, and resources  Implement strategies  Monitor, evaluate, repeat  Document outcomes  Celebrate!!!

8. 8 SMART Goals  Specific  Measurable  Attainable  Realistic  Time related

9. 9 Documentation of Outcomes Part of the Individual Student Health Record Outcomes Before CM After CM Improved Yes / No Attendance Behavior Grades Health Compliance Quality of Life Goal in one or more areas:

10. 10 Outcomes of Nursing Case Management School Year ‘02-03‘03-04’04-05‘05-’06‘06-’07 # of Students Case Managed 2403206851,6251,554 Improved Attendance 34%29%31%26%33% Improved Behavior 27%21%21%26%31% Improved Academic Performance 29%19%29%27%28% Improved Quality of Life 59%54%60%64%81% Improved in health/health Compliance 63% No data 69%66%79% Improved In one or more areas 92%74%84%84%94%

11. 11 School Nurse Case Management and YOU