Medical Directors

MEDICAL DIRECTOR SURVEY 5/24/2018

We received information from 41 School Districts
9 of them had a Medical Director
32 of them did not.

Is the director paid or volunteer?
4 Paid
3 Didn't Know
2 Volunteer

Does the medical director write standing orders?
7 yes
2 No

Do they perform physicals?
1 Yes, for the general Population
1 Yes, for sports only
7 No

Is there another role they fill?

  • Advice and meet with district nurses once per year. Writes orders for epi pens, and reviews district policies.
  • Reviews and updates district health manual
  • There is an MD with whom we can consult when there are medical concerns or questions. He is not a director per se.
  • Serve as a resource for school nurses
  • Allow for purchase of medications, vaccines etc.
  • can contact with any questions. also offer some professional development
  • Doctor of Pediactrics in Concord NH
  • Medical and Concussion consultant
  • we do not have one
  • pediatrician for Core Pediatrics in Exeter

COMMENTS:

  • Our director is leaving the area. Our district has not yet sought a replacement.
  • we have 2 pediatric docs that we go to for orders for epi, stock inhaler, etc but they are not officially our medical directors
  • Wish we had one
  • We are a private boarding school with a licensed health center.
  • I have been trying to get one for about 7-8 years
  • Medical director is retiring at end of this school year and HR does not have plans at this time on who /when replacement will be transitioning
  • We have general medical directives for our schools written and signed by a local physician at no charge and with no oversight by Dr. Deborah Hansen.
  • I wish we did.....


What Computer Program Do You Use for Health Records?

3/26/2018

Survey of Electronic Health Records used for nursing documentation.

111 nurses responded:  4 nurses do not have their records computerized

Rating Scale used: 1 is the best, 4 is the worst

  • 1.      I love it and would highly recommend it.
  • 2.      I have learned to like it and slightly recommend it
  • 3.      There must be something better out there, but I've made it work for me.
  • 4.      I do not recommend it at all.

# of nurses

Program

Average rating

Yes User Friendly

NO not user Friendly

6

Aspen

3.0

2

4

6

Caredox

1.84

6

0

1

HealthMaster

1.0

1

0

7

Infinite Campus

2.0

5

2

1

Matrix

Not rated, uses for boarding students only

1

0

7

MMS

2.85

2

5

18

Power School

2.77

11

7

53

SNAP

1.30

51

2

8

Web2School

2.87

4

4


What do you wear to work? week ending 2-09-18

Week ending 2/09/2018   What do you weat to work?
114 Nurses responded, 79 wear regular clothes, 30 wear scrubs, 5 wear a lab coat 
Years of service did not show a preference of one over the other
# of Nurses county Regular Clothes Scrubs Lab Coat over Reg. Clothes Years as a SN of those that wear Scrubs 
11 Belknap 10 1 0 9
2 Carroll 2 0 0  
12 Cheshire 6 4 2 3 to 19
3 Coos 3 0 0  
10 Grafton 7 3 0 3 to 17
33 Hillsborough 19 12 2 3 to 30
14 Merrimack 13 1 0 22
20 Rockinham 12 8 0 1 to 20
5 Strafford 4 0 1  
4 Sullivan 3 1 0 5


Anaphylaxis Survey

91 nurses responded representing 37,020 students

974 students were prescribed EpiPens 

Of those students,  815 had food allergies, 169 had stinging insects allergy, 22 had a history of anaphylaxis with no identified allergy

3 had an allergy to latex, 2 had cold induced urticaria, 1 had heat induced urticaria and one had a mast cell disorder mastocytosis

54 nurses have administered Epi to a student with a known allergy

19 nurses have administered Stock epinephrine to a student/staff

87 Schools have stock epinephrine, 4 schools do not

Of the  87 schools that have stock epinephrine 82 get their stock from EpiPens4Schools program

Comments:

1.     Shortly after one of my students transferred to a private school, she experienced an anaphylactic reaction to nuts and was given    epi x 2 and transferred via ambulance. Her mom called me to thank me for all we had done.

2.    I believe it i s a must to have epi stock as their are many allergen children in the building without diagnosis , and I have had an adult have a system reaction undiagnosed as well, to have the emergency med avaialble can save lives.

3.    Stock epi used for first time bee-sting reaction. She now has her own epi.

4.   I will use stock epi to send on field trips when a student did not have their own

5.    I stock Epi-Pens because most students in my school don't carry their own despite attempts to get their parents to provide the Epi Pen. When I used an Epi Pen on a student with a known peanut allergy who didn't have his Epi Pen the school did not get reimbursed nor did the parent replace my stock Epi Pen. If a parent refuses to cooperate what are school nurses to do?

6.    I have a handful of students who should have an epipen but still waiting for parents to take them to MD to get orders

7.    Another faculty had to use a stock Epipen on a student for 1st reaction on camping trip.

8.    ConvenientMD care provides our school with emergency epipens for those with unknown emergency reactions. I'm grateful for this program and hope it continues.

9.       Would like information about EpiPens for schools program.

10.     Is there a way to repeat the original 2 weeks of questions now that you have a better sample size of schools participating? The results are so interesting, and could be very helpful in preventing our district from reducing the nursing staff. Thank you!

Nurses County students Epipens prescribed Food Stinging Insects unknown allergen other allergen Epi given to known allergy How many have stock Use Epi4schools How many times have you used stock?
8 Belknap 3157 75 56 18 0 1 6 7 6 3
2 Carroll 382 12 11 1 0 0 2 0 2 0
8 Cheshire 2918 57 33 25 1 0 1 11 10 1
2 Coos 227 6 4 2 0 0 0 1 1 0
11 Grafton 3472 112 98 21 3 0 8 10 10 7
1 Hillsborough 10793 262 229 38 10 2 25 18 14 3
10 Merrimack 5330 133 111 21 3 0 8 17 17 1
18 Rockingham 6630 241 211 26 3 1 4 14 13 2
17 Strafford 2574 38 34 7 0 0 0 4 4 2
15 Sullivan 1537 38 28 10 2 3 0 5 5 0


Diabetics

Diabetics: 106 Schools Responded

44439 students 
168 Type 1 Diabetics
96 managed with pumps
72 managed with shots

330 nurse visits for 168 diabetics Averaging two visits per diabetic

# of schools reporting County Student Population # of Type 1 Diabetic # that use a pump # mangaged with shots 
6 Belknap 2714 8 4 4
  elementary   2    
  middle   0    
  High   6    
           
3 Carroll 618 2 0 2
  all elementary        
           
14 Cheshire 2308 11 6 5
  elementary   8    
  middle   3    
  High   0    
           
1 Coos 225 0 0 0
           
7 Grafton 2508 14 10 4
  elementary   0    
  middle   9    
  High   5    
           
21 Hillsborough 12064 46 29 17
           
           
14 Merrimack 6439 20 9 11
   elementary   3    
   middle   6    
   high   11    
           
24 Rockingham 12676 50 27 23
  elementary   18    
  middle   9    
  High   23    
           
11 Strafford 3945 13 8 5
  elementary   3    
  middle   2    
  High   8    
           
5 Sullivan 942 4 3 1
  elementary   2    
  middle   0    
  High   2    
           
106 TOTALS 44439 168 96 72

Parent / Student Contacts

How many student contacts did you have?

How many parent contacts did you have?

THE RESULTS:

# of schools reporting county Student Population Parent Contacts Student Contacts
4 Belknap 1626 43 136
1 Carroll 244 2 25
9 Cheshire 2293 91 274
2 Coos 636 15 74
7 Grafton 2288 64 198
15 Hillsborough 6943 184 617
11 Merrimack 3693 131 382
22 Rockingham 12561 347 989
4 Strafford 1079 26 114
3 Sullivan 893 17 111
Totals        
78   32256 920 2920

9% of the school population had contact with a school nurse

31% of those student contacts required contact with a parent

Illness Exclusion Policy 12-24-2017

Illness Exclusion Survey Results
61 Schools Responded
33 schools
have a policy
28 Schools
have no policy
Total out of
61 schools
When to send home for fever:
> 100.0 F and don't feel well 27 24 51
> 100.4 F and don't feel well 5 3 8
> 101.0F and don't feel well 1 1 2
Return to school after a fever
in 24 hours without advil or tylenol 33 26 59
less than 24 hours 0 2 2
Return to school after vomiting
Case by case 4 3 7
No vomiting in last 12 hours 3 2 5
No vomiting in last 24 hours 26 23 49

SAU 3 Policy

Dover School Board Policy

Laconia  

Hampton School District

SAU 74 Policy


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