Virginia School Age Health Needs Assessment:

2013 Survey Responses

Janet Wright BSN, RN, NCSNJyoti Gupta MPH

Shahid Hafidh MPH

Survey Purpose:• Describe Virginia School Age Health Care Providers• Assess School Nurses’/ Unlicensed Assistive Personnel’s

Knowledge of Available Resources for Education, Training and Professional Development

• Identify Additional Training Needs• Identify Useful Information to Enhance School Health Practice

Survey Recipients: • Virginia School Nurses and Unlicensed Assistive Personnel (UAP)• Coverage across 132 Public School Divisions• Included Private Parochial School Nurses (PPSN)

Survey Respondents: 679

2008

N=723 N=678

2008

N=723 N=678

Work Settings were Similar in 2008 and 2013

55% (approx.)

3-6% (approx.)

17-19% (approx.)

High School

Some College

AAS/AD BA/BS/BSN

MA/MS/

MSN/ MPH

PhD

Oriented to Job-Role (Yes Response)

Orienting Person

Orientation Resources

Most Helpful Orientation Topics

Clinic Practices/Nursing

Activities

School Health

Policies

School Health

Guidelines

First Day

Laws/ Regulations

Resources Other

Orientation Topics

Most Helpful Orientation Topics(2013 Data (N=115)

CLINIC PRACTICES / NURSING

ACTIVITIES:--Tasks & Responsibilities--Day-to-Day Clinic Flow--Medical Procedures--Documentation--Immunizations & Screenings

SCHOOL HEALTH POLICIES:

--State/County/School District Policies--Medication Policies--Training, certifications, licensure

VA SCHOOL HEALTH

GUIDELINES:--Overview of Guidelines--Immunization & Medication--Day-to-Day Guidelines--Emergency Protocols--Computer Systems

OTHER:--Health Conditions/Diseases--First Aid

Receive Annual Employee Evaluation

Annual Employee Evaluator

N=677N=723

Similar Responses in 2008 & 2013

2008 2013

Attended Virginia Department of Education Summer Institute for School Nurses

(SISN)

Access/Support/Feasibility

Access to Webinars &

Teleconferences

Able to Travel to

Trainings / Conferences

Financial Support from

School/School Division

Interest in Leadership Development Training

Source of Knowledge/Information

VDH School

Age Health

Newsletter

CDC Website

Private/Parochial

School Nurse List Serve

VASN Website

School Nurse

Coordinator List Serve

(DOE)

Note: DOE School Nurse Coordinator MeetingsNumber Held Annually: 3Perceived Need for 3 Annual Meetings: 99.1% (2013 Data, N=116)

Research

Program Planning And Implementation

Community Collaboration/Partnership Building

Comfortable to Perform Health Screening Skills

Coordination Of CareMore than 60% Respondents (2013; N=642) knew how to:

Create/Use: Individualized Healthcare Plans (IHPs)

: Emergency Care Plans (ECPs)

Use Section 504 plans for Students with Disabilities

Work with Physicians Under “Standing Orders” in

the School Setting

Maintain Student Confidentiality & Legal Issues

More than 60% Respondents (2013; N=642) were aware of :

School Nurse Role in Special Education

School Nurse Role in Child Study Team (Special Education)

School Nurse Role in Individualized Education Program (IEP)

Team

59% were aware of HIPAA & FERPA

Note: HIPAA=Health Insurance Portability and Accountability Act of 1996; FERPA=Family Education Rights and Privacy Act

Understand HIPAA and FERPA

Note: HIPAA=Health Insurance Portability and Accountability Act of 1996; FERPA=Family Education Rights and Privacy Act

2013: 70-72%

2008: 80-81%

2013: 52-61%

2008: 76-81%

2013: 65%

2008: 82%

(Physical Assessment, Allergies, Asthma)

(Physical Assessment, HTN, Blood

Disorders)

(Physical Assessment)

Interest Seems Lower in 2013 than in 2008

Note: 2013 N=627; 2008 N=584

2013: 66-72%

2008: 84-87%

2013: 71%

2008: 88%

2013: 64%

2008: 85%

(Physical Assessment, Seizure

Disorders)

(Diabetes) (Physical Assessment)

Interest Seems Lower in 2013 than in 2008

Note: 2013 N=627; 2008 N=584

Behavioral Health

Manuals

Journals

Texts

Websites

Additional Resources

Note:

Greater Use of Websites and Journals in 2013 (N=627) compared to 2008 (N=573)

Slightly Lower Use of Manuals in 2013 compared to 2008

Manuals2008 (53-80%) 2013 (58-71%)

VDH Guidelines for Managing Asthma in Virginia Schools-A Team Approach

VDH Guidelines for Managing Asthma in Virginia Schools-A Team Approach

VDH Guidelines for Specialized Health Care Procedures

VDH Guidelines for Specialized Health Care Procedures

Virginia School Health Guidelines Virginia School Health Guidelines

Helping Student with Diabetes Succeed-A Guide for School Personnel (NDEP Guide)

Manual for Training of Public School Employees in Administration of Medication (DOE)

Manual for Training of Public School Employees in Administration of Insulin and Glucagon (DOE)

Homebound Instructional Services Guidelines (DOE) (17%)

Journals

2008 (35%) 2013 (39%)

NASN Journal of School Nursing (Research-based)

NASN Journal of School Nursing (Research-based)

NASN School Nurse (Clinical)

Texts

2013 (25-36%)

School Nursing Scope and Standards of Practice, 2nd Edition (NASN)

Managing Chronic Health Needs in Child Care and School, A Quick Reference Guide (AAP)

Managing Infectious Diseases in Child Care and Schools, A Quick Reference Guide, 2nd Edition (AAP)

Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd Edition

School Nursing: A Comprehensive Text by Dr. Janice Selekman, Editor

AAP Red Book 2009 Report of the Committee on Infectious Diseases, 28th Edition

Websites

2008 (39-44%) 2013 (47-51%)NASN: National Association of School Nurses

NASN: National Association of School Nurses

Virginia Department of Education (VDOE) School Health Specialist

Virginia Department of Education (VDOE) School Health Specialist

VASN: Virginia Association of School of Nurses

VDH School Age Health Specialist VDH School Age Health Specialist

Additional Resources

HEALTH CONDITIONS / DISEASES:--Asthma--Diabetes--Allergies--Health System Disorders (e.g. arrhythmias, seizures, rashes)--Health & Hygiene

MENTAL HEALTH:--ADD/ADHD--Anxiety/Panic/OCD Disorders--Autism Spectrum--Behavioral & Emotional Health--Bullying

HEALTH SCREENING / ASSESSMENT:--General Assessment Skills--Health Systems Assessments--Ear Examinations--Assessments of Autistic and other Special Needs Children

CLINIC PRACTICES / NURSING ACTIVITIES: --Medical Care at School, IEP--Continuing Education--Communication with Parents--Medical Alert Problems--Leadership

TRAINING & EDUCATION:--Professional School Nurse Evaluation Tools--Resources: Research, Finance--Grant & Policy Writing--Collaboration Skills--Nurse Management Issues

OTHER:-- Policies & Legal issues--Injuries--Nutrition/Weight--First Aid

School Health Professional Profile in Virginia: Most work in Public Schools, are RNs, have a Bachelor’s degree, have >5 years’ School Health Experience

Improvements from 2008-2013:– Almost All Nurses Have Internet Access

– Increased use of Websites (e.g. VASN/NASN) and other Resources (e.g. VDH First Aid Guide, Handwashing Poster) in clinical setting

– Increased interest in being more active in Community Partnerships

– Increased interest in Leadership Development Training

– Increased attendance at SISN (VDOE)

– Increase in awareness of HIPAA and FERPA (still <60%)

Low Engagement in Professional Development Activities:– Less than Half (42%) Attended SISN Conference

– 35% Attended VASN Conference and Participated in SHAB

– 27% are VASN/NASN Members

Low Access/Support for Capacity Building:– Not All (84%) Have Access to Webinars/Teleconference

– Less than Half (39%) Receive Financial Support from Schools

Not All Nurses Receive Annual Employee Evaluations (86%)

Gaps in Orientation:– Only 73% were oriented to the Nursing Role (N=164)

Gaps in School Health Practice:– Only 55% applied Research-Based Interventions in nursing practice

– Less than 40% understood Program Planning Process

– Less than half (48%) were comfortable to implement New School Health Programs

– Only 44% knew where to access help with Planning and Implementing new programs

– Less than half (46%) actively participated in Community Partnerships

– Less than 60% were aware of HIPAA and FERPA

– While 97% of UAPs Administered Medication, only 84% of UAPs’ Medication Administration Skills were tested annually

Perceived Orientation Needs:– Clinic Practices / Nursing Activities

– Job Issues (e.g. nursing roles, duties, protocols, time management, legal issues)

Perceived Training Needs: Health Conditions / Diseases Clinic Practices / Nursing Activities Mental Health Training & Education

Improve Access to & Awareness of:– Webinars / Teleconferences for professional development

– Resources for professional development: Improve financial support to school health professionals and time available to engage in professional development

– Resources for planning and implementing new school health programs

– Opportunities to participate in community partnerships

Enhance Training & Education in:– Applications of research-based interventions in nursing practice

– Planning & implementation processes in school health programs

– HIPAA and FERPA

– Clinic practices / nursing activities; ie., daily workflow expectations, collaboration skills, nurse management issues

– Health conditions / diseases, including mental health

Ensure Appropriate Orientation for School Health Professionals (RN/LPN/UAP)

Increase % of school health personnel who receive an annual employee evaluation using an evidenced-based school health professional self-evaluation tool (Example: School Nurse (RN) Self-Evaluation Form)

Increase Annual Medication Administration Competencies for Unlicensed Assistive Personnel (UAPs)

Thank you

Contact:Janet Wright, BSN, RN, NCSNSchool Age Health Specialist

Office of Family Health ServicesVirginia Department of HealthJanet.wright@vdh.virginia.gov

www.vdh.virginia.gov