WHY DO WE NEED SCHOOL HEALTH SERVICES?

The goal of school health services is to strengthen and facilitate the educational process by improving and protecting the health status of children and staff. Parents/guardians, childcare workers, and educational professionals know that the health and intellectual development of children are inextricably related. For this reason, the need for nursing services in schools has been recognized since the early twentieth century. State mandates have accordingly required services to prevent the spread of infectious disease, to detect developmental problems, and to assist students who become ill or injured. In New Jersey, laws concerning school health services were first enacted in 1903. Certain health services are mandated by the state because they are necessary either to protect the public health or to support the continuing participation of children in school. For instance, screening of students for current immunization helps to reduce absences due to illness. Screening for reduced vision or hearing identifies the need for equipment or accommodations to remove obstacles to learning. School health services staff provide physical and emotional support so that children can better cope with periodic illness and injury, which are commonly a part of growing up. Increasingly, schools also provide daily support to students with chronic health needs who require these services in order to participate in educational settings, whether regular or special education. Such daily services may include administration of medication, glucose blood monitoring, inhalation therapy, or maintenance of tubes and catheters. Other examples of mandated school health services are listed below, together with their function in supporting community health and student educational participation.

 

 

Mandated School Health Service	Related Education Function
Immunizations for school attendance	Prevention of epidemics and illness in the school and community
Exclusion of students with infectious conditions	Reduction of absenteeism for students and staff
Athletic physicals	Assurance that students are healthy to participate in athletic competition
Vision and hearing screening	Identification of potential barriers to learning
Care for urgent illness or injury	Creation of a safe, secure environment
Care of special needs students	Optimization of learning during time in school
Administration of medication	Reduction of absences

Student Health Records

Every school is required to maintain health records on standardized forms provided by the NJ Department of Health and Senior Services and by the Commissioner of Education. This form, identified as form A-45, is the only form schools are permitted to use.

Individual Student Health Folder

Every student has an individual health folder containing the following:

•  
  • Form A-45
  • Medication orders and records of administration
  • Healthcare provider’s directives for limitation of physical activity
  • Reports of physical examinations
  • Reports of referrals
  • Copies of health summaries for Child Study Team referrals
  • Copies of accident/incident reports

Health Screenings

 Auditory Screening:

The purpose of a school auditory screening program is to identify students with any hearing loss that may impact their intellectual, emotional, social, speech, or language development.

High School Auditory Screenings are conducted for students who are:

•  
  • Enrolled in grade 10
  • Entering the district with no recent record of audiometric screening
  • Referred to the child study team for evaluation
  • Referred for screening by a teacher, a parent/guardian, or at the student’s own request
  • At risk for noise exposure

Blood Pressure Screening:

High blood pressure in children can signal the possibility of serious underlying problems, such as heart or kidney disease. The American Heart Association and the Academy of Pediatrics strongly recommend annual blood pressure checks for all children above the age of three. Identification of children who have elevated blood pressure allows their healthcare provider to evaluate the cause and institute proper treatment to reduce their risk of cardiovascular disease as they grow into adulthood.

High School Blood Pressure Screenings are conducted for all students as per protocol. When a referral is necessary for additional evaluation by a healthcare provider, the parent/guardian will be notified in writing. The results of the school screenings will be included in this notification.

Vision Screening:

In order to detect visual impairment, the vision screening process is essential for all students enrolled in school.

Impaired vision in children can:

•  
  • Seriously affect their learning abilities, leading to educational problems and limited academic success
  • Lead to poor self-esteem and social isolation
  • Result in emotional and behavioral problems
  • Negatively impact on the student’s educational and vocational choices

National studies indicate that among 15-19 year olds, 30% of students have vision problems that require professional eye care. School screening programs generally focus on visual acuity and are designed only to identify students who may need further evaluation.

Vision Screenings for High School Students are performed on the following students:

•  
  • Students registering for driver education
  • All teacher referred students who show signs or symptoms of visual problems
  • All students at high risk of having vision disorders that is students with disabilities and special needs
  • All students referred to child study team
  • Enrolled in grade 10

Visual Acuity Screening is performed using the Titmus Vision Tester as per protocol. When screening results deviate from normal, parents/guardians are notified in writing of these results and of the need for additional evaluation by a healthcare provider.

 Some useful links:

aappolicy.aappublications.org/cgi/reprint/pediatrics;110/3/638.pdf 

 http://www.sussex.nj.us/Cit-e-Access/webpage.cfm?TID=7&TPID=1557

Recent Publications:

Prescription for Trouble
http://nursing.advanceweb.com/Article/Prescription-for-Trouble-4.aspx

Preventing Teen Pregnancy
http://nursing.advanceweb.com/Article/Preventing-Teen-Pregnancy-2.aspx