School Health Services Update: October 3, 2018

​Dear Colleagues,

A recent nursing blog written by a school nurse entitled “The Challenges of Being a School Nurse and How to Resolve Them” by Tessa Curry (found at https://nursegrid.com/blog/the-challenges-of-being-a-school-nurse-and-how-to-resolve-them/ ) highlighted the challenges of “working as the school nurse at a learning institution” and discussed how practicing nursing outside of a healthcare environment comes with its own unique challenges. We all know how this  can lead to competing interests, ethical issues, and concerns related to practicing safe nursing care.

This has been highlighted recently by the challenges of school nurses in managing students with Type 1 Diabetes in our schools in collaboration with parents, primary care providers, and specialists in endocrinology.  Each of these groups has a very different understanding of what the practice of nursing should be in determining “self-administration” for students with Diabetes.  The DPH and DESE Guidelines state definitively that there is no “independent” care but that care in school should be provided using an “interdependency” model.  While a student may be self-sufficient in care, the school nurse remains responsible for the assessment, planning and evaluation of care as needed.  This includes ongoing documentation of the students outcomes of this care plan.  In addition, it is essential that school nurses recognize that they must have medical directives (orders) from an authorized, licensed prescriber.  Please see the attached BORN Advisory Ruling revised in April 2018 that continues to reinforce the need for proper medical orders.

Another issue that has recently come to our attention is the dilution of insulin for administration to newly-diagnosed young children with Diabetes.   Licensed nurses cannot administer this diluted insulin unless the medication vial is properly labeled according to BORN protocols with all the required elements of a properly dispensed medication by a pharmacist.  No school nurse should administer any substance to a student unless it is prepared and dispensed by a licensed pharmacist or the nurse themselves has prepared the medication or other substance for administration.  And also please note that diluted Humalog expires within 14 days if kept at room temperature and 28 days if refrigerated.

I hope that everyone has something planned for the coming holiday weekend that will provide a much needed break from the frenzy of the first few weeks of school! Take the time to relax and renew! And thank you for all you do!

Your School Health Team,
Mary Ann, Allison and Janet

Your energy is a valuable resource; distribute it wisely.” –Jay Samit, digital media innovator

SCHOOL NURSES IN THE NEWS!

Marianne Dewing, BSN,RN, NCSN, an esteemed school nurse at Driscoll School in Brookline for 17 year has recently been nationally certified in school nursing! Congratulations, Marianne!

Jill Connolly MEd, BSN, RN has begun her journey as the Metro-West Regional School Nurse Consultant as of October 1st.  She comes to the position with many years’ experience in nursing, the last 11 years in school nursing at both the high school and elementary level.   Welcome, Jill!  (See the contact information listed at the end of the email for how to reach Jill in her new position).

MDPH PUBLIC HEALTH NURSING I POSITION:

Public Health Nursing Advisor I, Sexual and Reproductive Health Clinical Advisor (Part Time) – Bureau of Community Health & Prevention  https://massanf.taleo.net/careersection/ex/jobdetail.ftl?job=180006ID​

NEW ENGLAND PUBLIC HEALTH TRAINING CENTER:

Free Webinar: Personal Presence When Making the Case for a Program

This webinar explores first impressions and how they generate and sustain your professional brand. The perceptions others have of us impact our ability to influence decisions, opinions and outcomes. The struggle is often about the need to be authentic, while presenting a professional persona. We will bring those two concepts together through awareness and techniques for honest presentations using a fine tuned delivery system.

Tuesday, October 16, 9:15-10:15am EST. Register here. Free!!

FROM THE SCHOOL-BASED MEDICAID PROGRAM:
Thank you for your enthusiastic participation in last week’s Back to School Trainings for the School-Based Medicaid Program! Over 500 of you attended or live streamed the training.

Attached  are final copies of the various training materials and handouts. We hope that you will share with anyone else at your LEA who is interested and works on the SBMP currently or should be involved in the preparations for the program’s expansion.

Please find the following materials:

1. Final copy of the MassHealth / UMMS presentation slides (attached)
2. The following materials may be accessed on the recently updated School-Based Medicaid Program website at: www.mass.gov/masshealth/schools in the resource center (https://www.mass.gov/info-details/sbmp-resource-center)
3. SBMP Dates and Deadlines for SFY 2019
4. School District Contact information  Form
5. SBMP Authorized Designee information Form
6. School Based Medicaid Program Guide for Local Education Agencies
7. Local Education Agencies Covered Services and Qualified Practitioners
8. SBMP Billable Procedure Codes
9. Please review the attached DESE slides even if you attended in person/via webinar. They have been updated and clarified since they were originally distributed.
10. To access the DESE parental consent instructions/advisory and the required form, please go to the DESE website at: http://www.doe.mass.edu/sped/advisories/13_1.html.

Finally, we’d appreciate your feedback on your experience attending the training or information about why you did not attend.  Please take a few minutes to respond to our brief online training evaluation which can be accessed here: https://www.surveymonkey.com/r/2MMXDYJ by Wednesday, October 10^th.  If you have any questions about the School-Based Medicaid program, please contact the UMMS help desk at 1-800-535-6741 or SchoolBasedClaiming@umassmed.edu.  If you have any questions about the updated guidance related to parental consent, please contact DESE’s Office of Student and Family Support at 781-338-3010 or achievement@doe.mass.edu. DESE is in the process of developing a FAQ document in response to questions that arose during the training.

OPTIONS FOR THE PREVENTION OF SUBSTANCE MISUSE AND PROMOTION OF SOCIAL AND EMOTIONAL LEARNING:

DESE is continuing its partnership with the Massachusetts Department of Public Health to offer free evidence-based prevention of substance misuse and promotion of Social and Emotional Learning (SEL) trainings.

Grades 3-9

These free opportunities include ½ day, as well as day-long trainings, CEUs, PDPs, and complete curriculum supplies for teachers and/or health personnel.

1. A brief informational session and lunch will be held for Administrators, Curriculum Specialists, and other leaders of elementary and middle schools, October 17 at 12:30-2:30
2. Integrating “A Circle Tied to Mother Earth” with LifeSkills Training, Oct. 17, 9:30 AM-12:30 (including Lunch) Integrating the book our dedicated Native American Team developed, “A Circle Tied to Mother Earth” with LifeSkills Training can be an effective way to support diversity, Native culture, and help prevent Prescription Drug Misuse & Other Drug Use.
3. LifeSkills Training One-Day Certification Trainings, October 16, 18, or 19, 8:30-4:30

The most comprehensive opportunity is a full-day LifeSkills Training at locations across the state. Any one of these training days certifies people to offer the LifeSkills Training program to youth at any level, grades 3-9. Many have already taken this training and really enjoyed it.  The Description below explains a bit about this training.

Life Skills Training Program (LST) is an interactive program based on the science of promoting positive behavioral skills and preventing substance use. Over 30 years of research have documented the powerful impact it has had on students. When it is offered to middle school youth, their rates of substance misuse are lower, and this tends to persist as they become young adults. Recent literature has documented decreases in prescription drug misuse rates when it is implemented with fidelity.

Please visit http://www.cvent.com/d/74q78p/6T for the required registration and/or forward this to other health, educational, and community leaders as soon as it is convenient.

Thanks for helping to keep our youth healthy!

REGIONAL CONSULTANT CONTACT INFORMATION:

Mary Ann Gapinski, MSN, RN, NCSN
Director of School Health Services/ School SBIRT Coordinator
MA Department of Public Health
250 Washington Street – 5^th Floor
Boston, MA  02108
mary.gapinski@state.ma.us

Website: http://www.mass.gov/eohhs/gov/departments/dph/programs/community-health/primarycare-healthaccess/school-health/

SBIRT information:  www.masbirt.org/schools