Individual Health Care Plans Research Articles

School Nursing Services

To describe the quantity and type of school health services provided by nurses in Boston Public Schools. In 2001, the 63 024 students enrolled predominantly belonged to minority groups (48% black, 28% Hispanic, and 9% Asian) and were eligible for a free or reduced-price lunch (71%). Analysis of the 2001-2002 Boston Public Schools Health Services database. A total of 63 024 students generated 721 291 individual encounters with 93.5 full-time equivalent school nurses, including episodic care (57.8%), medication administration (31.5%), procedures (6.2%), and screening (5.1%). A total of 2420 students had an individual health care plan for the administration of medications and procedures during the school day. Students with individual health care plans averaged 117.9 encounters per year with school nurses, and students without averaged 7.2 encounters per year. Outcomes of encounters included school dismissal (3.0%); verbal communication with parents (10.6%), school staff (3.9%), and community agencies or health care providers (1.1%); and referral to a primary care provider (4.6%) or emergency services (<0.1%). Some school-age children receive a large amount of health care from school nurses in Boston Public Schools. We estimate that these children are 8 times more likely to see a school nurse than a pediatric health care provider. These school nurses were involved in the care of children with mental health and chronic health care needs. Despite the extensive amount of care, little is known about the efficacy of the care provided or the effect of these services on health care use.

Caring for Children With Autism in the School Setting

Children with autism present unique challenges related to communication, behavior, and social skills. Each child with an autistic spectrum disorder (ASD) exhibits individual characteristics of the disorder. Early identification of autistic spectrum disorder has been shown to improve the child’s benefit from educational interventions. There may be health issues related to autism including seizure disorders and dietary restrictions. Students with autism need special consideration when they come to the health office for screening, assessment of injuries, or administration of medication. Collaboration between educators and school nurses is needed to develop and implement Individual Education Plans and Individual Healthcare Plans. Community resources provide valuable assistance to families of children with this challenging disorder.

Guidelines for managing life-threatening food allergies in Massachusetts schools.

During the past decade, prevalence of food allergies among children increased. Caring for children with life-threatening food allergies has become a major challenge for school personnel. Prior to 2002, Massachusetts did not provide clear guidelines to assist schools in providing a safe environment for these children and preparing for an emergency response to unintended allergic reactions. In 2001, the Asthma and Allergy Foundation of America/New England Chapter, Massachusetts Department of Education, Massachusetts Department of Public Health, Massachusetts School Nurse Organization, parents, and other professional organizations forged a successful collaboration to develop guidelines for managing life- threatening food allergies in schools. The guidelines assist schools by providing information on food allergies and anaphylaxis, emphasizing the need for team planning and development of an individualized health care plan, giving guidance on strategies to prevent accidental exposure to specific allergens in school settings, and offering information on emergency responses should unintended exposures occur. The collaborative process for developing the guidelines, which continued during the distribution and implementation phases, set a tone for successful multidisciplinary teamwork in local schools.

Using Expanded Individualized Health Care Plans to Assist Teachers of Students With Complex Health Care Needs

Using Expanded Individualized Health Care Plans to Assist Teachers of Students With Complex Health Care Needs

An observational study investigating the health provision for children with epilepsy within secondary schools in the East Midlands, UK.

Epilepsy is a common medical condition affecting many children in mainstream education. The practice of local secondary schools and the health service with regard to pupils with epilepsy was examined. The extent to which these children had activities at schools restricted and the schools' perception of the health service with regard to epilepsy was explored. A structured interview was conducted with selected staff members from mainstream secondary schools in East Midlands region, UK. Fourteen out of 17 schools participated. Fifty-seven children were identified from a total pupil population of 14 534. Seven schools used the DOH/DfEE (The Department of Health/Department for Education and Employment) 'Supporting Pupils with Medical Needs' publication as a resource. No schools created individual health care plans for children with epilepsy. Six out of seven schools reported appropriate provision for children during swimming activities. The commonest restriction was related to computer use. Nine schools stated a need for more training for staff members with regard to seizure management. Schools rely heavily on obtaining medical information from non-medical sources. Individual health care plans for children with epilepsy are not commonly undertaken. Few children had any restriction or special provision placed upon them because of their epilepsy except in the area of computer use. Further action is needed to consider how the system for providing for such children can be improved so that each child's individual health needs can be satisfactorily met.

A Lyme Disease Case Study and Individualized Healthcare Plan

A Lyme Disease Case Study and Individualized Healthcare Plan

Are school nurses using the recommendations of the Diabetes Control and Complications Trial in the care of students with diabetes?

Diabetes is one of the most common chronic diseases of childhood. It is listed as a disabling condition under the Americans with Disabilities Act, and therefore accommodations must be made for these children in school. School nurses are responsible for large numbers of children, usually in more than one setting. The Diabetes Control and Complications Trial examined intensive therapy and its effects on the long-term morbidity and quality of life of diabetic adolescents. A number of recommendations were made that apply to school nurses. The purpose of this article is to determine if any studies have been conducted to explore whether school nurses are using the results of the Diabetes Control and Complications Trial to write individualized healthcare plans defining the care of students with diabetes.

Teaching Teachers About School Health Emergencies

The passage of laws requiring that all children receive appropriate public education in the least restrictive environment means children with special health care needs who are at increased risk for health emergencies have entered regular public classrooms. Therefore, teachers must deal not only with health emergencies of normal children, but with emergencies of children with special health care needs. The purpose of this study was to evaluate the effectiveness of a nurse-led educational intervention for 324 teachers on their knowledge of and anxiety about management of children having health emergencies. The intervention resulted in increased knowledge and decreased anxiety about emergency response. This study demonstrated the feasibility and value of nurses educating teachers about school emergencies and in placing the individual health care plan into action.

Academic pediatric departments, government agencies, and children with special health care needs

Academic pediatric departments, government agencies, and children with special health care needs

A World Wide Web-Based Health Resource

Two hundred ninety-two school nurses in Missouri participated in a mailed survey to aid in the design of SchoolhealthLink, a World Wide Web (WWW)-based information service for Missouri school nurses and children. The nurses identified specific health information resources likely to benefit school nurses and school children and prioritized these resources. The school nurses assigned high priority to 11 types of health information resources: individualized health care plans, emergency care plans, communicable disease control plans, acute illness, injuries, communicable diseases, hotline numbers, medications in schools, immunization protocols and standards, community-based health care resources, and Department of Elementary and Secondary Education regulations that affect school nurse practice. The four most common health problems school nurses identified were asthma, attention deficit disorder, diabetes, and head lice. SchoolhealthLink will provide a one-stop WWW-based resource for school nurses and school children.

The use of standardized language in individualized healthcare plans.

The specialty of school nursing can benefit from the use of standardized language to communicate what school nurses do and to articulate their value during times of budget cuts and reduction of services. The use of a standardized language in IHPs is helpful in communicating with other health professionals and the educational team. The use of NANDA, NIC, and NOC assists school nurses in using a common language to describe what they do to meet student outcome goals. Linkages among NANDA, NIC, and NOC facilitate careful selection of appropriate interventions and outcomes. The diagnoses, interventions, and outcomes are coded and written in a manner that can be entered into computerized information systems--information needed for potential reimbursement. It also is essential that this information is entered into data bases that will tangibly demonstrate the contribution of school nurses to the health of the children they serve.

Newman's theory and insulin dependent diabetes mellitus in adolescence.

Application of Margaret Newman's theory of Health as Expanding Consciousness is presented as beneficial for both the school nurse and the adolescent with Insulin Dependent Diabetes Mellitus (IDDM). The tenets of Newman's theory are reviewed and application drawn to adolescent development, the management of IDDM, and the development of an Individualized Healthcare Plan (IHP). Implications of the theory for school nurse case management and the process of identifying an adolescent's meaning of health are explored.

Adaptation: a concept analysis.

The concept of adaptation is historically evident in nursing practice. Florence Nightingale showed how the environment required adaptation to meet the needs of the patient. Following her lead, several nurse theorists developed models with examples of the concept of adaptation: the nurse either adapts to the patient's needs, works to help the patient adapt to the environment, or adapts the environment to the needs of the patient. Sr. Callista Roy's Adaptation Model of Nursing is one such nursing model. Although this model has been applied in many clinical and administrative areas, the use of the concept in a school setting with special-need's student requires additional definition and clarification. The goal of this concept analysis paper is to clarify and explore the definition of adaptation in the school setting with application to an Individualized Healthcare Plan (IHP).

A health care plan for the student with diabetes.

This article presents a generic healthcare plan for the student with diabetes. This plan provides the basis for comprehensive assessment and subsequent interventions and evaluation for the student with diabetes in the care of the school nurse. For this plan to be useful, it must be tailored to the student's individual needs. Individual problems must be identified and addressed, resulting in an Individual Healthcare Plan (IHP). The IHP presented includes an emergency health plan for treatment of hypoglycemia; management of diabetes in schools, including glucose monitoring and insulin administration; education regarding diabetes; and psychosocial assessment of students with diabetes.

The School Nurse??s Source Book of Individualized Healthcare Plans, Volume I

The School Nurse??s Source Book of Individualized Healthcare Plans, Volume I