School Nursing and Health Services

 School Nurse Day 2023! 

On May 10^th, 2023, we celebrated National School Nurse Day! School Nurses have been critical in improving public health and ensuring student academic success for more than 120 years! The Arizona Department of Education’s Comprehensive School Wellness and Arizona School Nurse Access Program celebrated with school nurses, administrators, and educators across Arizona to honor school nurses' commitment to supporting our students and schools daily. During this time, we read the School Nurse Day Proclamation, celebrated our school’s nurses, and invited school administrators, board members, and health professionals in leading a discussion on fostering working relationships that allow the schools and school districts to be successful in meeting annual academic outcomes.

In addition, this year we celebrated several successes in Arizona School Nursing. We cannot wait to see what next year brings!

School Nurse Celebrations:

1. Multiple PD opportunities were offered to all school health staff. All opportunities were recorded and can be found on the ADE website.
2. National Certified School Nurses (NCSNs) in Arizona
   1. 74 National Certified School Nurses (NCSNs) in Arizona, of which 43 nurses participated in the ASAP program and successfully passed their exam to become NCSNs in the past year.
   2. “NCSN provides a valuable indication of competency in school nurse practice”- Stephanie Klever (Arizona Nurse, Oct 2022)
3. The Arizona School Nurse Access Program celebrated:
   1. 39 School nurses hired in rural schools through ASAP.
   2. 40 Mentor nurses trained to support new nurses.
   3. 52 New nurses participating in School Nurse Courses
   4. 13 Nurses participating in the Transition to Practice program.
   5. 2022 ASAP School Nurse Conference
4. At the 2022 School Nurse Convention, the first-ever Lifetime Achievement Award was awarded to Karen Reuter!

Thank you, school nurses, for the commitment you bring each day to keep our students safe, healthy, supported, and learning! We could not do it without you! To view the School Nurse Day Event and Celebrations presentation, click below:

School Nurse Day Event and Celebrations

 Arizona Health Care Cost Containment System (AHCCCS) Updates 

More than half a million Arizonans are at-risk of losing AHCCCS coverage as a result of changes made to AHCCCS/KidsCare medical coverage. Children’s Action Alliance is here to provide resources to assist individuals and families retain AHCCCS or if losing coverage, how to find affordable comprehensive coverage.

• AHCCCS (Medicaid in AZ) was not allowed to disenroll members during the pandemic. Membership has grown by about 1/3 to 2.5 million. Continuous Enrollment ended April 1, 2023.

• AHCCCS (DES) must redetermine eligibility for all 2.5 million members. The redetermination process will take about 12 months. AHCCCS estimates 650,000 members are at risk of losing coverage during 2023. Approximately 350,000 people are in households that have not responded to AHCCCS’s attempt to reach them.
• 36% of the at-risk AHCCCS members are children (not yet 19 years of age).
• Schools that invoice AHCCCS for therapeutic services may see a reduction in income.
• AHCCCS members need to update their contact information as soon as possible or may be dropped for lack of response.  Please see the attached flyer for consumers.

For more information, posters, memes etc., go to www.CoverAZ.org/Unwinding

For AHCCCS details go to: https://www.azahcccs.gov/Renewals

 The Arizona Seizure Safe Schools Act and Seizure Action Plan 

The Arizona Seizure Safe Schools Act – SB 1654 was signed on April 29^th, 2022. SB 1654 allows parents or guardians of a student with a seizure disorder to submit a seizure management and treatment plan to a school district or charter school and ensure the plan is made available to school personnel responsible for the supervision of the student. In addition, the act requires school personnel, who have regular contact with a student with a submitted plan, to complete online training on seizure recognition and first aid every five years. To read the full law, please click here.

To best prepare for this new law, in collaboration with the Phoenix Children’s Hospital, the Epilepsy Foundation, and the School Nurse Seizure Action Plan Committee, a seizure action plan has been created. To access this form, navigate to the School Nursing and Health Services page under Nursing Services, Tools, and Delegation, where you will find the Seizure Action Plan: Resources, Templates and Training Information. A webinar was hosted and can now be access here. (Passcode: TbhB!q3x)

We encourage you to bookmark this page to access additional specialized resources and detailed information on the guidelines surrounding School Health Services in Arizona.

Arizona School Nurse Convention 

The October 1st School Nurse Convention was a great success! 90 attendees met at the Wild Horse Pass Hotel in Chandler for presentations delivering updates on new Arizona laws impacting school health services, diabetes, seizure disorders, stock medication programs, and mental health disorders and management solutions. The event brought 15 fantastic school health vendors and celebrated the new school nurses, mentors, and NCSNs through the Arizona School Nurse Access Program. A special congratulations to Karen Reuter, MSN, RN, for being awarded the first Arizona School Nurse Lifetime Service Award! 

SN Convention.png

It was truly a full day of honoring school nursing and the commitment school nurses make to our schools each day. 

Please see below for copies of each presenter's slides.

1. Epilepsy and Seizures in Schools 
2. Stakeholder partnerships and the Stock Inhaler for School Program: Expanding access across Arizona
3. Arizona Policy Update for School Nurses
4. Mental Health Crisis in Adolescents
5. Privacy laws impacting the School Nurse

 

Guidance Documents 

1. Stock Inhaler Program: Quick Reference Guide for Schools
2. Joint Guidance on the Implementation of HIPAA and FERPA

 

 Healthy Kids AZ Mobile App

Healthy Kids AZ is a mobile app built specifically for Arizona’s school nurses and children carchildcareo take care of our pediatric population daily. The app provides access to an up-to-date resource in the palm of their hand. With Healthy Kids AZ, school nurses and childcare staff have the ability to: 

1. Access the AZ Infectious Disease and Childcare & School Health “Flip Charts”
2. Search for public clinics, FQHCs, RHCs, dental clinics, and vision & hearing clinics in your area
3. Contact your local public health department with one 1-click
4. Find AZ-required vaccines and infection control guidance

  If you haven't before, make sure you check out this great resource!

 The Bivalent Booster Approval

The Center for Disease Control and Prevention (CDC) has recommended that teenagers and adults get updated booster shots from Pfizer or Moderna. This shot, also called a bivalent vaccine, targets both the original coronavirus strain and the current omicron sub-variants BA.4 and BA.5. Now, to be fully vaccinated, this would include the first 2 vaccines (primary series) and the bivalent booster. 

The suggestion for timing for the shot was 12 weeks (post-infection or last vaccination) as the ‘ideal’ spot, but your risk and concerns may modify this. A booster shot aids in temporarily neutralizing antibodies to help prevent infection and transmission, and helps the secondary line of defense. In terms of the type of booster, research doesn’t show a difference with mixing/matching. However, for younger men under 30 years, the risk of myocarditis is higher, so Pfizer may be better as it has less RNA and is seen to have a lower risk. It is okay to get the bivalent booster with other vaccines and we will likely see PSAs encourage same-day vaccination for the bivalent booster and the flu vaccine, especially in those over 65 years.

Lastly, the Pfizer booster is recommended for those 12 and older and the Moderna vaccine is recommended for those 18 and older. This poses a question for our children. Those 5-11 years hope to see the bivalent booster by the end of 2022. Until then, it is recommended to keep up to date with the primary boosters.

This is very exciting news as we continue to navigate COVID-19 together.  

For more information, please read here.

Arizona School Nurse Access Program (ASAP)

ADE with funding support from ADHS will be implementing the Arizona School Nurse Access Program (ASAP), an aptly named program to expediently increase the number of school nurses in Arizona. The ASAP will support the professional growth and development of both new-to-practice school nurses as well as the incumbent workforce.

Learn more about the goal, mission, and outcomes of the ASAP program HERE.

Stock Medication Programs In Schools

Arizona offers three stock medication programs for schools: Stock Inhalers, Epinephrine, and Narcan. A school may decide to participate in none, one, two, or all programs.  The following information will help you learn more about each program and the necessary steps to complete to offer these programs at your school.

School Surveillance and Medication Program (SSMP)

Maricopa County Department of Public Health (MCDPH) offers an online program, the School Surveillance and Medication Program (SSMP), to assist schools in participating in the stock programs. The SSMP walks you through the requirements including annual training and items that will be needed to implement the program. Currently, MCDPH is working with all Arizona public schools to implement the stock inhaler and epinephrine programs, collecting data and offering the annual standing orders assuming schools sign up through the SSMP and follow the requirements. By starting with the SSMP site, you will gather the information and tips to establish a stock medication program.

The Stock Albuterol Program in Schools was put in place in 2017 by state law HB 2208, Emergency administration of inhalers by trained personnel; immunity; definitions and is in law as ARS 15-158. The Arizona Asthma Coalition has a thorough description of the program. Questions specific to the implementation may be sent to Ashley Lowe via email at [email protected].

If a school opts to implement the Stock Inhaler Program there are rules, R7-2-810 Emergency Administration of Inhalers, in place by the State Board of Education regarding training, obtaining the medication standing order, and administering procedures in emergencies. 

The Stock Epinephrine Program in Schools was put into place in 2018 by state law HB 2085, Emergency administration of epinephrine auto-injectors by trained personnel; immunity and is in law as ARS 15-157. 

If a school opts to implement the Stock Epinephrine Program there are rules, R7-2-809 Emergency Administration of Auto-Injectable Epinephrine, in place by the State Board of Education regarding training, storage, and use of the medication in schools. The Kyah Rayne Foundation also helps with the Stock Epinephrine Program in Schools. 

 The Stock Narcan Program is part of the AZ Opioid Epidemic Act/Action Plan implemented in 2018. The Arizona Department of Health Services (ADHS) has a website with information offering a standing order for Narcan and a form to complete to receive a supply of the medication. ADHS also offers some links to Narcan administration training though none are specific for schools.  Development of training for schools is in development and discussions are underway to incorporate the Stock Narcan Program within the SSMP. This site will be revised as updates are available.

If you are looking for more resources and how to implement this program within yourschool, please click here. 

 June 6th, 2023: 2023 Trauma Sensitive Schools Symposium 

The Trauma Sensitive Schools Symposium, taking place on June 6th 2023, from 8:00 AM - 3:00 PM, will host a range of engaging sessions that will expand participants’ knowledge of trauma-sensitive school systems and education approaches - particularly focusing on the power of resilience, and the many definitions the word holds, in our current educational systems and communities at large.

Register Here!

 June and July: NASN Conferences 

NASN’s 55th annual school nurse conference will have two option, which includes:

• An in-person event from June 30 to July 3, 2023 at the Hyatt Regency Orlando, 9801 International Drive, Orlando, Florida 32819; and
• A virtual event from July 10 to July 12, 2023.

Participants will:

• Identify two new evidence-based practices or resources from NASN2023, exhibitors, or poster presentations that can be used to promote student health, academic success and the health of students and communities
• Describe three evidence based nursing interventions for students with chronic health conditions including mental health to address health disparities across all communities
• Apply new knowledge of the role of the school nurse in the delivery of culturally competent care in schools
• Devise a plan to implement practice changes to include leadership and interprofessional collaboration for the benefit of student success
• Justify the necessity for school nurses to participate in assessment, planning, and implementation of crisis prevention in schools.

Click here for more information

 June 12th and 13th, 2023: Back to Basics: The ABCs of School Nursing

The School Nurses Organization of Arizona invites you to join them for the 34th Annual School Health Services Conference, Monday, June 12^th, and Tuesday June 13^th, 2023, at the Desert Willow Conference Center. This conference will once again offer participants hands on workshops, a wealth of resources and ideas to provide safe and quality school health services for Arizona’s students. RNs, LPNs, Unlicensed Assistive Personnel, Health Educators, School Administrators and School Health Services Stakeholders are encouraged to attend. Please refer to the SNOA website for the save the date and further information. 

Save the Date

Scope of Practice, Standards, and Delegation: Oh My! 

School nursing is a unique specialty in the nursing profession, one that is often quite foreign to nurses when they enter this field of practice with only acute care experience. This webinar provided experienced school nurses with a refresher about the scope of practice and standards of nursing practice as it relates to our state nursing practice laws and introduced new nurses to this important school nursing practice information. 

Presentation Outcomes:

1. List at least two unique differences between nurse scope of practice and standards of practice
2. Discuss the state scope of practice for nurses and two ways they apply to the school nurse.
3. State two components of the school nurse’s standard of practice and their application.
4. Understand the role of nurse delegation to unlicensed assistive personnel (UAP) staff while maintaining the delivery of safe student care in the school setting.
5. Recognize the five Delegation Principles as the right task, right circumstance, right person, right direction and communication, and right supervision and evaluation.
6. List the best practice steps for nurses to use to assure UAPs are prepared and able to complete delegated activities in the school setting.

Access the Slides Here

Access the Recording Here

Passcode: d7!#YAw*

School Nurses, Students, and Long COVID: What Do We Know Now?  

The rapid spread of the virus that causes COVID-19 in Arizona has had devastating consequences, yet we lack vital information about these health consequences. The CoVHORT study at the University of Arizona and Arizona State University is a collaborative effort between public health and medical researchers to try and learn how COVID-19 affects the residents of Arizona. Listen to CoVHORT CATS and the AZ CoVORT as individuals from the study speak on the epidemiology of COVID in youth, the impact of COVID on the whole Child and how families can get involved.

At the end of the webinar, attendees will:

1. Understand the epidemiology of COVID in youth.
2. Identify the impacts of COVID on the whole child.
3. Learn how families can contribute to our understanding of COVD and long-COVID

Access the Recording Here

1. Passcode: bRKNA.c7
2. Access the Slides Here

Implementing SB 1654: How Schools Can Successfully Meet the Law's Requirements and Establish Seizure Action Plans at Their School 

The Arizona Department of Education hosted a webinar: Implementing SB 1654: How Schools Can Successfully Meet the Law's Requirements and Establish Seizure Action Plans at Their School. During this session, participants recieved information about the law, and details for complying with the law. In addition, participants were informed about training requirements, and participated in a Q&A. The recording and slides are now avliable.

Access the Recording Here

Passcode: TbhB!q3x

Access the Slides Here

Resources mentioned during the webinar: 

Introduction of SB1654; Schools; Seizure management; Treatment Plans Resources:

Arizona Senate Bill 1654

15-160.02 Law: Seizure Management and Treatment Plans

CDC Epilepsy Data and Statistics

CDC Epilepsy in Schools

Managing Epilepsy in Schools 

Epilepsy Foundation

Arizona State Board of Education: Approved Training & Related Training Requirements

AZSBE Website and Submission of Personalized Trainings

Training Review Guidelines for School Nurses

Training Review Guidelines Other School Personnel

Board Approved Epilepsy Foundation Seizure Safe Schools Courses

Seizure and Epilepsy Resources

New Seizure Action Plan (SAP) Templates:

Arizona Seizure Action Plan – Fillable (must download)

Arizona Seizure Action Plan – Non-Fillable (must download

Amended Model Board Policy for School Districts and Charters:

Online policy bridge site (Policy JLCD)

Arziona Department of Health Services: Sensory Screening Program Overview and Changes to Screener Training 

On the April School Nurse Huddle, Morgan Scadden, Sensory Screening Program Manager at the Arizona Department of Health Services (ADHS), presented on the Sensory Screening Program at the Arizona Department of Health Services and the changes being made to the ADHS Sensory Screener Training. The recording and slides are now available. 

Resources: 

Administrative Rules: Vision Screening https://www.azdhs.gov/director/administrative-counsel-rules/rules/index.php#rulemakings-active-vision-screening

ADHS Sensory Screening Program https://www.azdhs.gov/prevention/womens-childrens-health/cyshcn/index.php#hearing-screening

View the Recording Here

Passcode: pHWJ2gy^

View the Slides Here

 NASN Learning Center: School Nurse-Led Case Management - Application of the Nursing Process

School Nurse-Led Case Management – Application of the Nursing Process

School nurses, refresh your perspective about how the application of the nursing process guides the provision of School Nurse-Led Case Management (SNLCM) for vulnerable students. This free course offers evidence-based current information, tools/resources, and strategies to support the confidence and competence of the school nurse role in promoting health equity for students with a known (asthma) and suspected (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - ME/CFS) health condition using SNLCM. 

Program Overview: School nurses will refresh their perspective about how application of the nursing process guides the provision of SNLCM for vulnerable students. Evidence-based current information, tools/resources, and strategies will support the confidence and competence of the school nurse role in promoting health equity for students with a known (asthma) & suspected (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - ME/CFS) health condition using SNLCM

Intended Audience: This continuing education program is a knowledge-based activity developed to meet the educational needs of registered nurses who are interested in child and adolescent health

Complete the Course

 14th Annual School Healthcare Training Event 

If you missed the 14th Annual School Healthcare Training Event, all recordings and PowerPoints are available to view!

Target Audience: All school nurses, medical office staff, administration, teachers, and school personnel.

Topics Include:

1. Student Health Management in Asthma
2. Cystic Fibrosis
3. Diabetes
4. Medication

Om-Demand Recordings and PowerPoints

Youth Substance Use in Arizona: Current Trends and Prevention Practices to Mitigate Risk 

The ADE Comprehensive School Wellness Program hosted a  free virtual discussion on Youth Substance Use In Arizona on October 24, 2022.