Every Child in Montana Deserves A School Nurse. One Full-Time Registered Professional School Nurse for Every 750 Students Sue Buswell, RN,MS,NCSN 2009. School Nurses as a Primary Source of Health Care.
Every Child in Montana Deserves A School Nurse One Full-Time Registered Professional School Nurse for Every 750 Students Sue Buswell, RN,MS,NCSN 2009
School Nurses as a Primary Source of Health Care • For increasing numbers of children, contact with a school nurse is the only consistent access to a health care professional available, especially for preventive care • 97% of American children spend their days at school • The registered professional nurse is the only school staff member who has the skills, knowledge base, and statutory authority to fully meet the health care needs of children in schools. NASN, 2008
Federal laws ensure the safety of students and provide access to education • Individuals With Disabilities Education Act • Section 504 of the Rehabilitation Act of 1973 • Americans with Disabilities Act of 1990 Children with special health care needs have the right to be educated with their peers in the least restrictive environment.
The School Nurse RoleH1N1 Influenza • Leadership and Collaboration • Development of Protocols • Education and Prevention • Advocacy • Vigilance • Triage • Active Surveillance
Research Suggests that Schools Employing School Nurses Have: • Fewer Student Absences • Decreased Drop-out Rates • Higher Test Scores Maughan, E. “The Impact of School Nursing on School Performance: A Research Synthesis.” The Journal of School Nursing 19.3 (2003):163-171. Pennington, N. and Delaney, E. “The Number of Students Sent Home by School Nurses Compared to Unlicensed Personnel.” The Journal of School Nursing 24.5 (2008): 290-298.
Minimum Recommended National Standards School Nurse to Student Ratio 1:750 Well students in the general population 1:225 Student populations that may require daily professional school nursing services or interventions 1:125 Student populations with complex health care needs 1:1 Individual students requiring daily and continuous professional nursing services
Montana Association of School Nurses School Nurse Survey 2009 • Purpose: to determine the current state of school nursing in Montana • Grassroots effort • Data collected by MASN members • Telephone survey • All 56 counties and 100% school districts reporting
Definition of A School Nurse in Montana • A Registered Nurse whose specialized practice involves the application of the Nursing Process to school children , their families, and school staff members, primarily in the school setting. • A Public Health Nurse (RN) who may provide services to schools as part of health promotion and disease prevention in the community and practices in a variety of community settings.
Montana School Nurse Numbers 2009 • 81 RN School Nurses, full-time and part-time • 26 RN Public Health Nurses – 1 hr/wk or more spent in schools • Total = 62.5 FTE RN School Nurses in Montana • 144,000 Students in Montana Public Schools
Current Ratio in 2009 School Nurse to Student Ratio in Montana 1:2304 Recommended 1:750
How Does Montana Rank Now? #45 Montana 1:2304
15,035 Students in Counties without RN School Nurse • 3,600 (24%) have vision deficiencies • 2,550 (17%) are obese • 1.954 (13%) are prescribed medication more than 90 days • 1500 - 3000 (10-20%) have mental health issues • 900 (6%) miss more than 11 days of school due to illness or injury – total of more than 9,900 days • 1800 ( 12%) have a history of asthma • 750 (5%) have seizure disorder • Approximately 30 have Type 1 diabetes
Nurse to Student Ratio in 12 Largest(#Students) Montana Counties • Ravalli 1:3362 • Silver Bow 1:1320 • Lake 1:1140 • Roosevelt 0:3204 • Hill 1:3057 • Glacier 1:1063 • 1. Yellowstone1:1469 • 2. Missoula 1:3858 • 3. Flathead 1:2527 • 4. Gallatin 1:5607 • 5. Cascade 1:11,879 • 6. Lewis/Clark 1:1000
American Academy of Pediatrics • Increasing numbers of students enter school with chronic health conditions that require management during the school day. • To optimally care for children…appropriate staffing levels of school nurses are important factors for success. • Improved student outcomes result where schools have a full-time nurse. AAP Policy Statement 2008
Montana State Board of Nursing • “The words ‘decision maker, problem solver, advocate and counselor’ come to mind.” • “One of the toughest challenges is educating school administrators on the importance of the role of a nurse in the public school system, especially in a system that does not require nurses. Swehla, B. and Zeisler, M. “School Nurses: True Angels to the Children of Montana.” Montana NURSE 1.1(2008): 8
Endorsement from a parent: “Without the support and care of a registered nurse at school I really doubt if my daughter would have been ready to move on to college…” “Having a chronic disease is hard enough but having an advocate at school allows the student to have a place to get help that can save their lives…” “In the long run I believe this extra care saves the taxpayers money. Preventive care is always the best solution.”
American Nurses Association • “ANA has learned that Montana schools are currently employing, on average, one school nurse to every 2300 students…The number of school nurses is inadequate to ensure daily availability. We believe Montana students deserve the opportunity to learn in an environment where their health care needs are met by a registered nurse.”
MEA-MFT Statement “MEA-MFT supports the Montana Association of School Nurses’ proposal that the ratio of registered, professional school nurses to students be 1 to 750. . . We stand ready to work with the Board of Public Education and MASN to achieve this standard.” Eric Feaver, President January 9, 2009
How Will This Standard Be Met? • 144,000 students in Montana public schools • Minimum of 190 full-time professional school nurses, additional to meet needs of high risk populations • Currently 62.5 FTE RN school nurses • 127 new full-time professional school nurses needed • Salary equivalent to teaching professionals
Montana Association of School Nurses Timeline • Presentations to MT Board of Public Education in January and March, 2009 • Montana School Nurse Survey completed in March, 2009 • Chapter 55, Administrative Rules of Montana, currently undergoing revision by the MT Board of Public Education, will address a school nurse standard • Development of a realistic school nurse standard for Montana schools by Spring, 2011 • Recruitment of 127 additional school nurses by 2013
Forging Ahead to Meet the Needs of Every Child in Montana Schools Montana School Nurses 2009