Arkansas School Nursing: Out with the Old, In with the New

1. Arkansas School Nursing:Out with the Old, In with the New Paula Smith, RNP, MNSc. State School Nurse Consultant Arkansas Department of Education Arkansas Department of Health

2. Objectives • Describe changes in Screenings for School Year 2009-2010 • Describe 2009 Legislation that will impact school nursing practice and the school environment. • Discuss assessment/survey tools utilized in identifying practice issues common to school nurses in the state and nation.

3. Screenings and Reporting • Vision • Hearing • Scoliosis • Growth (Height and Weight) • Programming changes • Report Deadlines

4. Vision • Initial Screenings NEED to be completed by end of Fall semester. • If screenings are performed during registration in August, will not be able to enter into APSCN until August 19, the first official day of SY 09-10. • Any data completed needs to be entered soon after. • Data pulls will be Cycle 3 (Nov. 15) and Cycle 6 (April 15). DO NOT wait until then to enter. Make your deadline to enter Oct. 31 and March 31. Have to make time to run error reports and fix the errors before submitting report to ADE. Deadline may be sooner if your APSCN person requires that.

5. Hearing and Scoliosis for SY 09-10 • Data belongs to ADH • Enter all Hearing and Scoliosis data into APSCN • Data will be pulled in Cycle 7, June 15, 2010; • Make your deadline June 1, 2010 • No more paper summary

6. 2009 Legislation and school nursing • Act 496, “Antony Hobbs III Act • ADE will write the rules • All in place by May, 2011 • More details to follow • Seasonal Flu Vaccine clinics • Oct. 15-Dec. 31 • Collaborate with LHU • No liability issues for School Nurses giving injections

7. Immunizations • New and improved rules • Kindergarten requirements for entry • 1st – 12th grade requirements • 7th grade requirements • Responsibility for enforcement • Documentation • Exemptions

8. Kindergarten Requirements • DTaP/DTP or DT- 4 doses • Polio – 3 doses • MMR-2 doses • Hepatits B – 3 doses • Varicella – 2 doses

9. 1st through 12th grade requirements • DTaP/DTP/DT-ped or Td-adult or Tdap-adult– 3 doses • Polio – 3 doses • MMR – 2 doses • Hepatitis B – an appropriate series

10. 7th grade requirements • In addition to those listed in the previous slide— • Tdap • a 5-yr interval between Td and Tdap. May be shorter than 5 but not less than 2 yrs. If protection from pertussis is needed. • Varicella – 1 or 2 doses • 1 dose required if less than age 13 • 2 doses, separated by 28 days, are required if dose 1 is given at or greater than age 13. • A parent/guardian or physician history of disease may be accepted in lieu of receiving Varicella vaccine

11. Responsibility for enforcement • School boards, superintendents and principals shall be responsible for enforcing immunization requirements for K-12. • May temporarily admit a child provided the child becomes appropriately immunized, is in-process of receiving the needed doses of vaccine, or shows proof that they have applied for an exemption for those vaccines he/she has not received within 30 calendar days after the original admission. • Must have written statement that the student is in process. • If no documentation, they must be excluded until documentation is provided.

12. School Nurse Survey • 87 Schools completed the survey • Look for the results before school starts • Link is on www.arkansascsh.org

13. Epinephrine • Use of Epi-pens at school • Track usage of epi-pens • Form will be sent to your CHNS for distribution to all school nurses • Each time an Epi-pen is used, please complete the form and can fax or email it to me • Gathering data