NASN School Nurse

School nurses care for students with asthma on a daily basis, but what happens when the asthma medication is administered and symptoms persist? As a part of care coordination, the school nurse provides ongoing assessment and care for students with asthma. When symptoms persist despite treatment, school nurses need to consider other issues such as Vocal Cord Dysfunction (VCD). The purpose of this article is to highlight the similarities and differences in the pathophysiology and treatment of both asthma and VCD.

Managed care coordination for Medicaid beneficiaries is being implemented in states across the country. Recently, 1.5 million Medicaid beneficiaries in five regions of Illinois began this transition. This article presents the findings of a study to learn if immunizations would continue to be a reimbursable service if provided to beneficiaries outside of the designated primary care setting. The findings revealed a lack of clarity among health plan representatives and billing personnel in how to obtain coverage information. Five contacted plans (25%) stated they were unable to verify coverage and unclear where to acquire this information. Similarly, six (30%) representatives could not answer the question and recommended calling the Illinois Department of Healthcare and Family Services hot line. Despite the potential benefit of improved coordination of care gained by transitioning to managed care entity model, this infrastructure change may inadvertently introduce barriers to services obtained outside the medical home, like school-located immunization.

It is a professional responsibility of school nurses to be engaged with their elected officials and the legislative process. Legislative contact can be an intimidating process, but nurses and the public in general can be prepared through their elected official’s website and professional association resources. Background information and voting history from legislative sessions along with current bills can guide the conversation leading to a productive encounter for all participants.

Step Up & Be Counted! (Step Up!) is a joint project of the National Association of School Nurses (NASN) and the National Association of State School Nurse Consultants (NASSNC). The goal of the initiative is to develop a National School Nurse Standardized Data Set that will be used by nurses across the country to uniformly collect data the same way. The data will be used to determine the health of children and youth, the care that is delivered in schools, and the impact of school nurses on academic success and well-being. This article focuses on the role of the Designated State Data Champion in the initiative.

The American Academy of Pediatrics (AAP) recently published a clinical report recommending expanded options for seizure rescue medications in the school setting. School nurses rely on prescribing professionals for medical orders to manage children with epilepsy in the school setting. The report suggests additional medications beyond rectal diazepam gel along with discussing the purpose of the medications, the variations in prescribing practices for seizure rescue medications, inconsistencies in legislation based on jurisdictions, and the need for school medical orders for students with epilepsy. There are many issues faced by school personnel when caring for students with a diagnosis of epilepsy, chief among them the presence of licensed health professions for the school to be able to respond quickly and appropriately in the event of a seizure. School nurses can assist health care providers in determining the rescue medication most easily delivered and monitored in the variety of activities that are part of the school experience, including transportation to and from school, field trips, and before- and after-school activities, all beyond the regular classroom setting.

School nurses coordinate student health care for prevention and treatment to remove health barriers to learning and to school attendance. They use a team approach to manage students with chronic conditions as they transition among home, school and healthcare settings, working to develop competent self-care aligned with developmental ages of students. Care coordination ensures the continuum of care is unbroken. Meeting the health needs of low-income students can be challenging, because those students are likely to be uninsured or underinsured and often lack necessary resources, such as transportation, to access primary health care. Care coordination is a tenet of school nursing and to optimally serve low-income students, school nurses form partnerships in the community. One innovative and successful partnership is Healthy Learners, an organization that works with community healthcare providers and school district nurses to connect eligible students to needed healthcare services. Always, the goal is to keep students in school, healthy, and ready to learn.

A substantial amount of U.S. teenagers experience physical or sexual abuse within their romantic relationship. With recent technological advances, teenage dating violence can also be perpetrated digitally by harassing or controlling a romantic partner through the Internet or mobile phone. School nurses are naturally positioned to act as first responders for victims of an abusive romantic relationship. As online and offline forms of dating violence are often intertwined, it is imperative that school nurses are able to identify different types of digital dating violence as this could signal the presence of offline forms of dating abuse. Therefore, being able to interpret potential warning signs could help school nurses to play an active role in prevention and intervention of different types of dating violence. In this article, we provide an overview of the recent research on the context and consequences of cyber dating abuse and outline several suggestions for prevention and intervention.

This paper describes a user-friendly, Excel spreadsheet model and two data collection instruments constructed by the authors to help states and districts perform cost-benefit analyses of school nursing services delivered by full-time school nurses. Prior to applying the model, states or districts need to collect data using two forms: “Daily Nurse Data Collection Form” and the “Teacher Survey.” The former is used to record daily nursing activities, including number of student health encounters, number of medications administered, number of student early dismissals, and number of medical procedures performed. The latter is used to obtain estimates for the time teachers spend addressing student health issues. Once inputs are entered in the model, outputs are automatically calculated, including program costs, total benefits, net benefits, and benefit-cost ratio. The spreadsheet model, data collection tools, and instructions are available at the NASN website (http://www.nasn.org/The/CostBenefitAnalysis).

Burn injuries are among the most painful injuries any child can endure. This article explains common sources of burn injuries in student populations, diagnosis and classification of burn injuries, initial burn management, and how to determine when a child needs to be evaluated by a physician.