Highlights of School Health Care Highlights of School Health Care ServicesServices

April 26, 2010April 26, 2010

Ann Powers, MS, RN, CPNPAnn Powers, MS, RN, CPNP

School Nurse LeaderSchool Nurse Leader

Highlights of School Health Care Highlights of School Health Care ServicesServices

April 26, 2010April 26, 2010

Ann Powers, MS, RN, CPNPAnn Powers, MS, RN, CPNP

School Nurse LeaderSchool Nurse Leader

At a GlanceAt a GlanceAs of November 2009As of November 2009

95% of the Student Emergency Health Cards were returned to the nurse’s 95% of the Student Emergency Health Cards were returned to the nurse’s officeoffice– Slight increase over 94% returned November 2008Slight increase over 94% returned November 2008

19% of students are enrolled in Mass Health19% of students are enrolled in Mass Health– Consistent with November 2008Consistent with November 2008

22% have no recorded dental insurance/provider22% have no recorded dental insurance/provider– Increase of 8% from November 2008Increase of 8% from November 2008– Still only one Mass Health Dental Provider in PlymouthStill only one Mass Health Dental Provider in Plymouth

41% of student population considered to have limited or no access to 41% of student population considered to have limited or no access to routine/preventative oral health careroutine/preventative oral health care– Represents a 8% increase from November 2008Represents a 8% increase from November 2008

599 elementary students are participating in the Fluoride Mouth Rinse Program599 elementary students are participating in the Fluoride Mouth Rinse Program– Decrease of 35 students from 2008Decrease of 35 students from 2008

6,319 students have signed permission slips for KI administration6,319 students have signed permission slips for KI administration

At a GlanceAt a Glance

Growth Screening Trends 2008-09Growth Screening Trends 2008-09

36% of Plymouth students screened in grades 1, 4, 7 and 10 are 36% of Plymouth students screened in grades 1, 4, 7 and 10 are at risk for being overweight or obeseat risk for being overweight or obese– Consistent with data for 2007-2008Consistent with data for 2007-2008

34% of students in the same grades in other ESHS reporting 34% of students in the same grades in other ESHS reporting districts in the state are at riskdistricts in the state are at risk– Represents a 6% increase from 28% for other districts for 2007-Represents a 6% increase from 28% for other districts for 2007-

20082008– This brings Plymouth closer to the rest of the schools in other This brings Plymouth closer to the rest of the schools in other

reporting districtsreporting districts

Spring 2009 1,068 BMI letters were mailed home on students Spring 2009 1,068 BMI letters were mailed home on students with a BMI < 4with a BMI < 4thth percentile or > 85 percentile or > 85thth percentile percentile

Plymouth Public SchoolsPlymouth Public SchoolsHealth Care Services Health Care Services

Total Reported Special Health Care NeedsTotal Reported Special Health Care Needs2006-20092006-2009

0

500

1000

1500

2000

2500

SHCN IHCP

2006

2007

2008

2009

(Source: Student Health Cards, M.D. documentation)

0

100

200

300

400

500

600

700

800

Allergies Asthma Cardiac ADHD/ADD Depression Diabetes Migraines Seizures Oth. Beh.*

2006

2007

2008

2009

Plymouth Public SchoolsPlymouth Public SchoolsHealth Care ServicesHealth Care Services

Selected Special Health Care NeedsSelected Special Health Care Needs2006-092006-09

(Source: Student Health Cards, M.D. documentation)*Other Behaviors includes ASD population

School Year Activities Report Essential School Health Services Program

1. Month in which these health encounters occurred: School Year 2008-2009

2. Person completing report (include Name and Position):

3. Health Services Activity Number of student and staff health encounters this month. (Do not count health screenings or casual conversations)

Office Visit TypesOffice Visit Types

Injury/Injury/First First AidAid

Illness Illness AssessmenAssessmen

tt11

Mental/Mental/BehavioralBehavioral

Health Support Health Support 22

IndividualIndividual Health Health

Ed.Ed.

Other Other EncounterEncounter

ss

Scheduled Scheduled MedicationMedication

ss

ScheduleScheduled d

ProcedurProcedureses

TotalTotalEncountersEncounters

STUDENTSTUDENTENCOUNTERSENCOUNTERS 16,70716,707 29,01429,014 1,3471,347 294294 11,28611,286 11,45811,458

5,0745,07475,18075,180

STAFFSTAFFENCOUNTERSENCOUNTERS 305305 831831 5050 9595 720720 178178 2,1792,179

Note: It is assumed that every encounter will include nursing assessment and health education. When the primary issue is health education and does not include illness or injury, the individual health education category should be used. 1 An illness encounter may include illness assessment, acute illness, chronic health condition, etc. It excludes scheduled medication administrations (e.g. daily med administration for ADHD) and scheduled procedures (ostomy care, scheduled glucose testing).2 Mental/Behavioral Health Support includes any encounter requiring active listening, anticipatory guidance, stress management, altered mental health status or behavior modification/program support. The primary reason for the encounter is related to a mental/behavioral health need.

Plymouth Public SchoolsPlymouth Public SchoolsHealth Care ServicesHealth Care Services

Number of Students Returned to ClassNumber of Students Returned to Class(Sept-Dec 2009)(Sept-Dec 2009)

(Source: Healthmaster MA Monthly Report)

20500

21000

21500

22000

22500

23000

23500

24000

24500

25000

2007-082008-092009-10

Plymouth Public SchoolsPlymouth Public SchoolsHealth Care ServicesHealth Care Services

Significant Disposition of StudentsSignificant Disposition of Students (Sept-Dec 2009) (Sept-Dec 2009)

0

200

400

600

800

1000

1200

1400

1600

1800

2000

911 UrgentReferals

Dismissed ill DismisssedInjury

2007-08

2008-09

2009-10

(Source: Healthmaster MA Monthly Report)

In Addition…In Addition…Fall 2009 H1N1 Flu SeasonFall 2009 H1N1 Flu Season

– H1N1 and Seasonal Influenza Clinics at H1N1 and Seasonal Influenza Clinics at Middle and High Schools, Grades 6-12Middle and High Schools, Grades 6-12

– 1,628 students immunized1,628 students immunized•985 students for Seasonal Flu985 students for Seasonal Flu

•643 students for H1N1 Flu643 students for H1N1 Flu

•Utilization of nursing students instrumentalUtilization of nursing students instrumental

•Coordinated effort with the school health Coordinated effort with the school health and administrative staff, MDPH, Board of and administrative staff, MDPH, Board of Health, Jordan Hospital, and AMR staffHealth, Jordan Hospital, and AMR staff

In Addition…In Addition…

Fall 2009 - Municipal Medicaid continued to fund each of the Fall 2009 - Municipal Medicaid continued to fund each of the school nurses to work 2 days prior to start of school nurses to work 2 days prior to start of – Review new student health records, conduct student/parent health Review new student health records, conduct student/parent health

interviews, prepare for known SHCN, immunization compliance, etc. interviews, prepare for known SHCN, immunization compliance, etc.

Ongoing review/revision of the medication administration policies Ongoing review/revision of the medication administration policies and related nursing proceduresand related nursing procedures– Revised Parent Consent For Medication AdministrationRevised Parent Consent For Medication Administration– Developed Medication Specific Consent Forms Developed Medication Specific Consent Forms – Revised Student Health and School Bus Emergency Information CardsRevised Student Health and School Bus Emergency Information Cards

>200 staff trained by the nurses in Heartsaver AED (custodians, >200 staff trained by the nurses in Heartsaver AED (custodians, CRT, etc.) CRT, etc.)

Ongoing clinical education of student nurses: Cape Cod Ongoing clinical education of student nurses: Cape Cod Community, Laboure, and Simmons CollegeCommunity, Laboure, and Simmons College

School Health Advisory Committee

This Year At The SHAC This Year At The SHAC

Transition Year with Committee membership and leadershipTransition Year with Committee membership and leadership

Reviewed and updated the Reviewed and updated the Plymouth Area Resource GuidePlymouth Area Resource Guide located located on our school health websiteon our school health website

Reviewed and supported MA legislation Reviewed and supported MA legislation An Act Relative to School An Act Relative to School Nutrition Nutrition passed by the MA State Senate and House of passed by the MA State Senate and House of Representatives in March, 2010, now awaiting the governor’s Representatives in March, 2010, now awaiting the governor’s signature to pass into lawsignature to pass into law

Developing goals for 2010-2011 school yearDeveloping goals for 2010-2011 school year

– Review our district programs in relation to requirements in the School Review our district programs in relation to requirements in the School Nutrition ActNutrition Act

– Continue focus on student and staff wellness in relation to nutrition and Continue focus on student and staff wellness in relation to nutrition and physical activity physical activity

• Implement BlueCross BlueShield programImplement BlueCross BlueShield programWalking Works Walking Works for staff in the fall, for staff in the fall, 20102010

Continue efforts to improve nutrition and physical activity for students and staffContinue efforts to improve nutrition and physical activity for students and staff

Plymouth Public SchoolsPlymouth Public SchoolsHealth Care ServicesHealth Care Services

Questions?Questions?

13

Thank You