News Alerts November 30, 2001 - CDC Recommends School-Based Dental Sealants A Report and Recommendation released by the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report today strongly supports school-based and school-linked dental sealant programs and community water fluoridation as proven methods of preventing dental caries (tooth decay) in children.
The Centers for Disease Control and Prevention today announced the availability of $1 million in 2002 funds for three one-year awards for research to develop multi-level interventions to prevent sexually transmitted diseases, including HIV and pregnancy, in adolescents. Continuation funds will be available for project periods of up to eight years. Applications should include adolescents 11- to 13-years old and middle adolescents 14- to 16-years old; both will be followed through late adolescence. Eligible applicants include public and private nonprofit organizations and state or local governments and their agencies. Letters of intent are requested but not required by March 1, 2002; deadline for submission of applications is June 1. The grant announcement appeared in today's Federal Register. An article to be published in the November 28 issue of the Journal of the American Medical Association describing the symptoms of anthrax that health care providers should be looking for has been released in advance of the publication date because of the importance of the diagnostic information. The article by doctors at the National Institute of Health and physicians in Maryland and the District of Columbia who treated early anthrax victims stresses the need for laboratory tests if there is any suspicion of anthrax, even if the patient presents with non-specific symptoms similar to flu or other common infections. Two postal workers who subsequently died of inhalation anthrax had been sent home by hospital emergency rooms after complaining of nausea, vomiting, stomach pain, muscle aches, discomfort, and fatigue. Both developed chest pains and breathing difficulty, eventually requiring a respirator. A later review of laboratory data showed pathology different from common infections, including increased white blood cell counts and concentrated red blood cell counts and long chains of the distinctive anthrax bacilli. "Laboratory tests should be ordered if there is any suspicion of anthrax," said Dr. Luciano Borio of the NIH, lead author of the report.
The following notice
concerning new guidelines for hand hygiene in healthcare facilities
was posted in the Federal Register today. Comments are requested on
the draft guidelines.
A Statement by the American Academy of Pediatrics School Nurse Activities Changes in society, the provision of health care, education, and the family have increased the need and demand for school health services. New paradigms are evolving for school health services as school systems develop comprehensive school health programs to address the diverse and complex health problems of today's students. In addition to health issues, schools must cope with problems caused by immigration, homelessness, divorce, remarriage, poverty, substance abuse, and violence. The school nurse has a central management role in the implementation of the school health services program for all children and youth in the school. Ideally, the school nurse collaborates with primary care physicians, specialists, and local public health and social services agencies to ensure a full spectrum of effective and quality services that sustain children, youth, and their families. All school health services are delivered in the overall context of the child, the family, and the child's overall health plan. The goals of a school health program that relate directly to the health service component as outlined in the American Academy of Pediatrics (AAP) manual School Health Policy and Practice are to:
These goals are a major component of the larger school health program and focus on prevention and early intervention. The school nurse has a critical role within this school health program and provides acute, chronic, episodic, and emergency health care. In addition, the school nurse provides health education and health counseling and advocates for students with disabilities. School nurses are well positioned to take the lead for the school system in partnering with community physicians, community organizations, and Medicaid and State Children's Health Insurance Program staff to assist families and students to enroll in the state health insurance program and find a medical home for each student. School Health Services Team The school nurse functions as a member and often the coordinator of the school health services team. The team may include a school physician, licensed practical nurses, health aides and clerical staff, school counselors, school psychologists, school social workers, and substance abuse counselors. A pediatrician often fills the school physician role because he or she is knowledgeable about general pediatrics, school health, and adolescent health. In some schools, a pediatric family nurse practitioner functions as the school nurse and may provide additional services. If unlicensed assistive personnel are part of the school health services team, their performance of skilled nursing procedures must be supervised by the school nurse in accordance with state laws. Some schools may have a school-based health center in or adjacent to the school, which may provide primary care and psychosocial services. The school nurse coordinates the activities of the school health services team with the child's primary care physician and/or the school-based health center to provide continuity of care and prevent duplication of services. The School Nurse and Children with Special Health Needs The school nurse has a unique role in the provision of school health services for children with special health needs, including children with chronic illnesses and disabilities of various degrees of severity. These children are included in the regular school classroom setting as authorized by federal and state laws. As a leader of the school health team, the school nurse must assess the student's health status, identify health problems that may create a barrier to educational progress, and develop a health care plan for management of the problems in the school setting. The school nurse ensures that the student's individual health care plan is part of the individual education plan or other written plan and that both plans are developed and implemented with full team participation, with parents and the child enlisted as partners. The school nurse's participation in the educational plan development heightens the potential for achieving the goals of the health care plan, which are to maximize the student's educational experience and to provide adequate preparation for responses to urgent situations. The school nurse develops this plan with the student, parents or guardians, and the child's primary care physician. Dialogue with sub-specialists, community agency staff, and case managers can add important information. The school nurse must provide safe and effective direct services or facilitate the performance of special health care procedures, such as tracheostomy suctioning, bladder catheterization, ostomy care, nasogastric feeding, maintenance of orthopedic devices, and ventilator care, for all students who need them. The school nurse should collect important information, such as special needs, modifications to routine medical procedures, allowance to administer stock over-the-counter medications in school (if offered), medical home, health insurance, emergency measures, and parental permission to interact with the student's health care providers. The Emergency Information Form from the AAP and the American College of Emergency Physicians, for example, could be used as a template for formulation of the individual medical plan. Professional Preparation for School Nurses The AAP supports the goal of professional preparation for all school nurses. The National Association of School Nurses has determined that the minimum qualifications for the professional school nurse should include licensure as a registered nurse and a baccalaureate degree from an accredited college or university. In addition, there should be a process by which certification or licensure for the school nurse is established by the appropriate state board. The AAP recommends the use of appropriately educated and selected school nurses to provide school health services. In its Healthy People 2000 objectives, the U.S. Department of Health and Human Services recommends at least one nurse per 750 students, with variation depending on the community and its student population. Conclusion The AAP recommends and supports the continued strong partnership among school nurses, other school health personnel, and pediatricians. These partners should work together closely to promote the health of children and youth by facilitating the development of a comprehensive school health program, ensuring a medical home for each child, and integrating health, education, and social services for children at the community level. This statement is reprinted with permission of the journal Pediatrics. Members of the Committee on School Health of the American Academy of Pediatrics are Howard Taras, MD, chair; Barbara Frankowski, MD, MPH; Jane McGrath, MD; Cynthia Mears, DO; Robert Murray, MD; and Thomas Young, MD. |
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