CLINICAL RESOURCES

Looking for a clinical resource or reference to support your school nursing practice? Here it is! ASNC has partnered with Yale University to offer this valuable (free), practical, and useful resource:

Advocacy

ASNC has a very active Government Relations Committee (GRC) that works closely with the Connecticut Nurses Association (CNA) to monitor, negotiate, and provide testimony to legislation that potentially impacts school health and school nursing. We welcome any school nurse who is willing to learn more about the legislative process and help address these issues. Please contact our GRC Chair for more information. ASNC is also committed to collaborating with multiple community partners, parent groups, and policy makers, including:

Connecticut School Nurses Information Resources

Click here This website designed for Connecticut school nurses by librarians at Cushing/Whitney Medical Library (Yale University) has links to resources freely available for healthcare evidence (use the “Database” link).  Under Quick Links use “Ask a Librarian” to send a question to Janene Batten, the librarian available to answer information needs to support practice. Use the “Request Journal Articles” link to have known articles emailed to you. Librarians are also available to visit your district to train school nurses in basic techniques to access healthcare information, simply email Janene. The Yale Medical Library School Nurse Article of the Month: Sortedahl, C. (2012). Effect of online journal club on evidence-based practice knowledge, intent, and utilization in school nurses. Worldviews on Evidence-Based Nursing, 9, 117-125. doi:10.1111/j.1741-6787.2012.00249.x The CT State Department of Education (SDE) Health Promotion Services/School Nurse web page has most of what SDE has to offer for school nurse-related resources, including:

Click here for the CT SDE brochure on Cadre of Nurse Educators to see some of the program offerings you can request for your district or region. Members of ASNC actively participate on the CT AAP School Health Committee, working closely with school medical advisors to address professional development opportunities, school health-related legislation, and clinical processes and protocols that impact student health. This section will highlight common health conditions that have a significant impact on student health and academic achievement. We’ve included links to documents and electronic resources that are relevant to school nurse practice.

Asthma

Asthma is the leading cause of serious chronic illness in children. The chronic inflammatory nature of the disease requires ongoing assessment of control and the ability to effectively educate the student and family in daily and emergency aspects of care. Asthma affects an average of 10% of children nationally. However, in many of CT’s classrooms that rate climbs to 1 in every 5 or 6 students, especially in our larger urban areas. Poorly controlled asthma negatively impacts academic achievement by increased absenteeism, spending more time in the health office/less time in class, poorer quality of sleep, and decreased activity tolerance.

Some Keys to Effective Asthma Management in Schools:

To request a CT Cadre of Nurse Educators district or regional program on Overcoming Barriers to Effective Management of Asthma in School

Here are some additional Asthma-Related Resources for Schools:

The CT Department of Public Health Asthma Section includes:

                • Electronic Asthma Action Plans
                • The 2012 CT Asthma Burden Report
                • Patient Education Handouts
                • Indoor Air Quality (IAQ) Tools for Schools
                • Becoming a Certified Asthma Educator (AE-C)

Community Resources

                • Community Asthma integrated Resources (CAiR) provides free asthma education and home environmental supplies in the greater New Haven area
                • Little AIR program provides free asthma education and home environmental supplies in the greater Middlesex area
                • Putting on Airs provides free home visits for asthma education and environmental interventions, based out of most of CT’s regional health departments

Sample School Forms

Concussion

A concussion is a complex pathophysiologic process affecting the brain, induced by traumatic biomechanical forces secondary to direct or indirect forces to the head. The disturbance is related to neurometabolic dysfunction rather than structural injury. Concussions result in a constellation of symptoms including: Physical, Cognitive, Emotional, and Sleep related. See Concussions Corps to learn more about concussions.

Some Keys to Effective Concussion Management in School:

                • Educate School Nurses on concussion assessment
                • Educate school staff on recognizing potential head trauma and when to refer students to School Nurse for assessment
                • Know that the mechanism of injury does not always correlate with its severity
                • Remove student with any type of head trauma from physical activity until evaluated
                • Have emergency plans for students who do experience significant head trauma
                • Identify a school team to work with students, families, and health care providers to facilitate individual care plans that address:
                  • Return to Plan
                  • Return to Learn

Sample forms and publications can be found on the Concussion Corps website

Diabetes

Type 1 diabetes is a chronic condition in which the pancreas no longer produces enough insulin to meet the body’s metabolic demands, requiring supplemental insulin therapy. Type 1 diabetes in children used to be known as juvenile diabetes or insulin-dependent diabetes, and affects approximately 1 in 400 children and adolescents. A significant challenge for people with Type 1 diabetes is that it requires daily management and frequent lifestyle adaptations in order to minimize the potential complications it can have on multiple body organs, either over time or those that can be acutely life-threatening. In addition to implementing the Diabetes Medical Management Plan (DMMP), the School Nurse’s role includes promotion of a normalized, developmentally appropriate lifestyle and inclusion in the same educational and recreational activities available to students without diabetes – a concept that can be applied to all chronic health conditions.

Some Keys to Effective Type 1 Diabetes Management in School:

                • Obtain a DMMP prior to the start of each school year
                  • The pediatric diabetes centers at Yale and CCMC have collaborated with ASNC to format a DMMP that meets the needs of CT students
                  • Ask parents to complete page 1 prior to their clinic visit (just like page 1 of the HAR-3)
                  • Available in PDF and Word (customize demographics for your students)
                  • Can use the Addendum page for updates and revisions that occur during the school year
                • Take advantage of diabetes-related professional development opportunities to stay current on treatment trends and insulin pumps
                • Promote student’s self-management skills
                • Participate in 504 meetings and educate staff on the potential medical and cognitive implications of diabetes
                • Consider developmental, social, and safety factors when collaborating with parents and diabetes providers to establish individual plans for various activities, sports, and field trips

Here are some additional diabetes-related resources for school:

To request a CT Cadre of Nurse Educators district or regional program on The High-Tech of Diabetes

Epilepsy

Medicines for Epilepsy
International Classification of Epileptic Seizures Fact Sheet
Instructions for the Administration of Diastat
Epilepsy Fact Sheet
What Teachers Need to Know
Seizure Action Plan
Powerpoint for participants CDC

Food Allergy

Approximately 8% of US children experience potentially life-threatening food allergies (anaphylaxis) with 25% of first time reactions occurring in school. The foods most commonly associated with food allergy reactions are: peanuts, tree nuts, milk, eggs, soy, wheat, fish and shellfish. Effective prevention and management of food allergies in school requires a collaborative relationship between families, schools, primary care providers, and allergists that can provide a safe and effective individualized plan for each student, promote access to emergency medication, and implement practices that minimize the potential for accidental exposure.

Some Keys to Effective Food Allergy Management in School include:

                • Post your District Life-Threatening Allergy Prevention and Management Plan on your public website
                • Provide food allergy education to staff and students each year and as needed
                • Know the difference between being a “Nut-Safe”(recommended) and a “Nut-Free” School
                • Consider District protocols such as:
                  • No eating on the bus
                  • Encourage students not to share food
                  • Not serving nut, peanut, or shellfish products from your cafeteria
                  • Not using food for celebrations, especially if made at home without an available list of ingredients
                  • Have a Standing Order for a School Nurse to administer emergency stock epinephrine to anyone experiencing symptoms of anaphylaxis

Here are some Food Allergy-Related Resources for School

New AAP Customizable Food Allergy Plan Posted 4/17

Student Health and Fitness/Nutrition Guide

OnlineSchools.org provides crucial resources and information to students pursuing an online education. Recently, the site published a health and wellness guide that covers nutrition and fitness issues for students of all ages. It includes tips and advice on maintaining a healthy lifestyle at all ages of learning. For more information, you can find the resource here: http://www.onlineschools.org/student-nutrition-guide/.

Infectious Disease

Enterovirus D-68

CDC FAQ
CDC Fact Sheet

Ebola

NASN Resources
CDC Ebola Information
Fact Sheet Handout
Fact Sheet Handout Spanish
Fact Sheet Handout French
What you need to Know about Ebola
Protect Yourself Poster
Protect Yourself if You Have Symptoms
Ebola Algorithm
HHS Information Resources