School Nurse Activities in Utah

Karen Roylance, RN, BSN
State School Nurse Consultant-Utah Department of Health
kroylance@utah.gov

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2003-2004 School Nurse Activities Report

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OVERWEIGHT
9 out of 100 Utah children and youth (ages 10-17) are overweight and at risk for developing health problems, including type II diabetes. Another 12 children are at risk for becoming overweight. 1

PRESCRIPTION MEDICATION
11% of Utah children and youth under the age of 18 have used a prescription medication due to health conditions lasting 12 months or longer. Approximately 59% of Utah children currently use or have used prescription medication during the past 12 months. 1

ADD / ADHD
5 out of 100 Utah children and youth (ages 2-17) have been told they have Attention Deficit Disorder with or without hyperactivity. 1

ABSENTEEISM DUE TO ILLNESS / INJURY
5 out of 100 Utah children and youth (ages 6-17) missed 11 or more days of school over the past 12 months due to illness or injury. 1

ASTHMA
8 out of 100 Utah children and youth under the age of 18 have a history of asthma, with approximately 5 of those having an attack within the past 12 months. Additionally, another 15 children have been told by a doctor or health professional they had hay fever or other respiratory allergy. 1

NO PREVENTIVE DENTAL CARE
26 out of 100 Utah children (ages 1-17) did not receive routine preventive dental care during the past 12 months. 1

FOOD ALLERGY
4 out of 100 Utah children (ages 0-17) have been diagnosed with a food or digestive allergy. 1

MENTAL/EMOTIONAL/BEHAVIORAL
17% of Utah children and youth (age 3-17) have 1 or more difficulties in the areas of emotions, concentration, behavior, or getting along with others. Additionally, 4% of children and youth (age 2-17) have been told by a doctor or health professional they have a behavioral or conduct problem. Another 7% of Utah children have received mental health care or counseling during the past 12 months and 4% of children/youth (ages 2-17) have been told they have depression or anxiety problem(s). 1

NO HEALTH INSURANCE
8 out of 100 Utah children and youth (ages 0-17) have no health insurance coverage. 2

THREATENED BY WEAPON
7% of Utah children have been threatened or injured by a weapon on school property one or more times during the past 12 months. 3

The chart on the reverse side represents the incidence of some common health conditions and concerns in Utah’s children and youth and is not meant to imply that every student has a health condition or concern. It only illustrates that out of every 100 Utah children, there are likely 100 health conditions or concerns that would benefit from having a school nurse available onsite. Even children without a health condition or concern can benefit from the services of a fulltime professional registered nurse. A school nurse can provide health screenings such as vision and scoliosis. School nurses also provide communicable disease monitoring, health education, health promotion and crisis management, including immediate assessment and first aid. Healthy People 2010 recommends one registered nurse per every 750 regular education students. 4

References:
1. Child and Adolescent Health Measurement Initiative (2005) National Survey of Children’s Health. Data Resource Center on Child and Adolescent Health website. Retrieved January 2006 from http://www.nschdata.org
2. 2003-2004 Health Status Survey, Office of Public Health Assessment, Utah Department of Health. Retrieved January 2006 from http://ibis.health.utah.gov
3. Youth Risk Behavior Survey 2003 (YRBS) CDC, NCCDPHP Retrieved January 2006 from http://www.cdc.gov/HealthyYouth/yrbs/index.htm
4. Healthy People 2010 U.S. Department of Health and Human Services (USDHHS). (2000). Healthy people 2010 (2nd ed.). Washington, DC: U.S. Government Printing Office. December 2003

Utah School Nurses Care About Utah’s Children

There are approximately 125 school nurses, serving 483,685 school-age children in Utah. The ratio of school nurses to children is 1 nurse to 6,022 students.

The National Association of School Nurses (NASN) recommends that the maximum ratio of nurse to student should be one nurse to no more than 750 regular education students. In order to be in line with NASN recommendations, Utah would need approximately 562 more school nurses.

Chronic Conditions found among Utah’s School Children

In 2002-2003 there were 53,381 students categorized as Special Education Students. Many of these students require care plans completed by the school nurses to assure they receive the health care they need while at school.
From 1991 to 1996, there was a 19% increase in the percentage of children, who suffer from asthma in Utah. The 2001 Utah Health Status Survey estimates that about 36,000 children (age 0-17 years) living in Utah have asthma. It is the most common chronic childhood disease.
From 1990 to 1999 there was a 198% increase in the number of children at Primary Children’s Medical Center who were newly diagnosed with diabetes. The 2000 Utah Child Health Survey estimates that there are 1,800 Utah children who have diabetes. There were 214 children newly diagnosed with diabetes in 2003.
In one school in 1999-00 there was one child on a ventilator, while in 2000-2001 there were five children on ventilators.
There were a total of 1900 children in 2002-2003 who required medical procedures that were delegated to other individuals (including unlicensed assistive personnel) by the school nurse. This means other people were performing nursing duties under the direction of the school nurse because there are not enough school nurses to perform these procedures directly.

School Injuries in Utah
(from the Utah Department of Health’s Violence and Injury Prevention Program, ABC’s of School Injuries in Utah, 2000)

Every hour a student is injured at school.
Every 4 hours a student suffers an injury resulting in a possible fracture.
Every day 911 is called because of a school injury.
Every day a student suffers an injury resulting in a possible concussion.
Every 3 days a student suffers an injury resulting in a loss of consciousness.

School Nurse Activities
In the 2002-2003 school year, school nurses performed the following activities (data taken from the statewide annual school nurse survey):

School nurses supervised 206,722 preschool and elementary vision screenings and 62,567 middle school scoliosis screeenings.
School nurses taught 4,139 specialized health topic classes, which included hygiene, communicable diseases and dental health.
School nurses conducted 4,769 staff wellness clinics/programs.
School nurses arranged 265 first aid trainings and 372 CPR trainings. They personally trained 2,388 school personnel in CPR.
School nurses spent about 20% of their time developing student health care plans for teachers and other school staff to use in caring for children at school.

School Nurse Funds
The only funding which exists for school nurses is a block grant for school districts to decide how to spend it. School nursing is only one of the suggested uses for this block grant. Currently, two school districts have opted to not provide school nurses for students in their districts leaving gaps in the care school children may need while at school.

Information compiled by Caroline E. Green, CHES, BSN – State School Nurse Consultant – Utah Department of Health. For more information on school nursing in Utah, please call (801) 538-9219.