ANA Releases Back-to-School Healthy Student Checklist

Nurses play an integral role in a child’s wellbeing, from health screenings and preventive care to first aid and emergency care. With the start of a new school year, the American Nurses Association (ANA) has a few tips for parents to help optimize students’ health, safety, and capacity for learning.

1. Make sure immunizations are current
Review your child or teen’s vaccination records and make sure that he/she is up to date on all shots before heading back to school. Most schools will require proof of current  immunization in order to attend. Visit www.anaimmunize.org/schools for general information on which vaccinations your child will need. Ask your school nurse if you  have questions.

2. Don’t forget an eye exam
Healthy vision is an important part to the learning process and success in school. Experts believe that approximately 80 percent of learning comes through vision. Your child should get an eye exam every two years. Ask about special testing for eye teaming disorders if your child struggles to read.

3. Establish a routine before school starts
Summer months usually mean a more flexible bedtime. Before school begins, start setting an earlier bedtime to make sure your child is used to a school schedule.

4. Have a contingency plan
Make a plan today for disasters and sick days. Who will take care of your child if he or she is ill?  Most schools require that a child be free of fever for 24 hours (without any fever reducing medicine) before they return to school.  Be sure to keep your contact information up to date so the school can contact you in an emergency.

5. Prepare the school
If your child has health issues (allergies, asthma, diabetes, etc.), it’s important to inform  the school, and to provide medications or supplies. You can help the school develop a plan for daily care and emergencies.

6. Get to know the school nurse
Ask if a school nurse is available full time, and onsite.  Federal and state laws exist to ensure that your child has access to safe and appropriate care.  Contact the National Association of School Nurses if you have a question, www.nasn.org.

7. Stay safe on the street
Develop and review safety instructions for walking to school or waiting for a bus, including reminders about what to do if approached by a stranger.

8. Eat for health and learning
Breakfast is the most important meal of the day.  Plan ahead to send a healthy lunch and snacks to school; review menu options to help guide healthy choices.  Make sure that your child has access to water throughout the day.

9. Keep it clean
Your child will be exposed to all sorts of germs and viruses while at school. Teach your child to wash his/her hands, especially after going to the bathroom and before eating. If hand washing isn’t an option, make sure your child has access to hand sanitizer.  Teach your child to cough or sneeze into a tissue or his/her elbow.

10. Shop for safe supplies
To avoid injuries to the back and neck, a backpack should never be more than 10 to 20 percent of your child’s weight. Consider a backpack with wheels, or make sure they have padded straps, and that your child uses both. Avoid school supplies with PVC plastics which can be toxic to your child. Information on safer alternatives for school supplies is available athttp://www.chej.org/publications/PVCGuide/PVCfree.pdf.

Source: ANA

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HHS Awards $40 Million in Grants to Sign Up Children for Health Coverage

The U.S. Department of Health and Human Services (HHS) recently announced $40 million in grants for efforts to identify and enroll children eligible for Medicaid and the Children’s Health Insurance Program (CHIP). Grants were awarded to 39 state agencies, community health centers, school-based organizations and non-profit groups in 23 states. The two-year grants are authorized under the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009.

“Today’s grants will help us identify and enroll children in Medicaid and the Children’s Health Insurance Program, ensuring that more children have the health care they need,” said HHS Secretary Kathleen Sebelius. “Keeping Americans healthy from a young age is the right thing to do, and it saves money by avoiding preventable diseases and conditions as they get older. The activities we are funding will help eligible children get covered, stay healthy and prepare them to succeed in school.” The grants will build on the Secretary’s Connecting Kids to Coverage Challenge to find and enroll all eligible children and support outreach strategies that have been shown to be successful.

Grants were made in five focus areas:

1. Using technology to facilitate enrollment and renewal (approximately $20 million to ten grantees)
2. Retaining eligible children in coverage (approximately $3 million to four grantees)
3. Engaging schools in outreach, enrollment and renewal activities (approximately $5 million to seven grantees)
4. Reaching children who are most likely to experience gaps in coverage (approximately $10 million to fourteen grantees)
5. Ensuring eligible teens are enrolled and stay covered (approximately $3 million to four grantees).
6. Grant amounts range from $200,000 to $2.5 million with the largest grants going to the technology focus area. For a list of grantees, please visit:http://www.insurekidsnow.gov/professionals/reports/chipra/CHIPRA-Cycle-II-Grant-Summaries.pdf

“We are making great progress enrolling eligible children in Medicaid and CHIP and the grants released today help keep these important efforts moving forward. They are a part of our commitment to help all eligible children get the health coverage they need,” said Cindy Mann, CMS deputy administrator and director of the Center for Medicaid, CHIP and Survey & Certification.

A new study just released by the Urban Institute and the Robert Wood Johnson Foundation found that, despite an increase in eligible children between 2008 and 2009, the total number of eligible but uninsured children declined from 4.7 million in 2008 to 4.3 million in 2009, in part due to outreach and enrollment efforts.

Efforts to streamline Medicaid and CHIP enrollment and renewal practices, combined with robust outreach activities, have helped reduce the numbers of uninsured children. For example, Oregon, a previous CHIPRA outreach grantee, has cut its percentage of uninsured children in half, from 11.3 percent in 2009 to 5.6 percent in 2011. In the past two years, Oregon enrolled 94,000 eligible children in Medicaid and CHIP. In addition to its efforts in reducing paperwork for families and establishing a timely and cost-effective online application process, Oregon used its grant funding to provide direct one-on-one enrollment assistance to families and conduct vigorous outreach activities throughout the school system.

“We want to help others achieve what Oregon has accomplished and more,” said CMS Administrator Donald M. Berwick, M.D. “Simplifying enrollment and renewal systems and ensuring that signing up for health coverage is standard practice in schools and health centers are central to sustaining the progress we’ve made. The CHIPRA grants are designed to support these efforts that will have lasting effects.”

Today’s CHIPRA outreach grant announcement follows the August 12, 2011 release of a joint letter from HHS Secretary Kathleen Sebelius and Education Secretary Arne Duncan to the nation’s governors urging them to encourage schools to “undertake children’s health coverage outreach and enrollment activities when classes begin this fall.” The letter suggests promising strategies such as enlisting school athletic coaches to help promote enrollment. HHS is supporting such efforts by providing a strategy guide to states, schools, community groups, and other stakeholders as part of the “Get Covered, Get in the Game” initiative the agency conducted in 2010 with CHIPRA funding.

CHIPRA, together with the Affordable Care Act, allocates a total of $140 million for enrollment and renewal outreach, including $112 million in grants to states, community groups and health care providers, $14 million specifically for organizations serving American Indians and Alaska Natives (AI/AN), and $14 million reserved for national enrollment campaign activities. The first $40 million in grants, as well as $10 million in AI/AN grants, were awarded in 2009 and 2010, respectively.

Source: HHS

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Nurses on Front Lines for Preventing Teen Suicide

Faced with a stressful world, teens often feel overwhelmed and depressed and then consider ending their lives. Thousands of them die annually, making suicide the third leading cause of death for 15- to 24-year-olds, according to the Centers for Disease Control and Prevention. Many more youngsters attempt to take their lives but do not succeed. Nurses are making a difference with active prevention strategies.

“Suicide is a serious issue in the United States,” said Cathy Strunk, RN,  program coordinator for the  Surviving the Teens suicide prevention and depression awareness program at the division of psychiatry at Cincinnati Children’s Hospital Medical Center in Ohio.

“It’s important for nurses to look at the mental health of their patients,” Strunk said. “Nurses who work with teens are in a prime position to making a connection with them. The simple act of caring provides a safe environment for the teens to open up and express their personal problems.”

Strunk developed the hospital’s Surviving the Teens suicide prevention program with a grant from the J.E. & Z.B. Butler Foundation in 2001. Since then, she has educated approximately 6,000 middle and high school students in Ohio and Kentucky annually, as well as parents and school staff members about suicide, finding positive ways of coping with stressors, recognizing depression and suicidal behaviors, responding appropriately, using adaptive coping measures, and communicating well at home. Students also role play with Strunk how to help someone depressed or troubled.

The program includes Strunk’s “Steps to Last,” a tool nurses can use when talking with a depressed or troubled teen. They include listening and looking for signs of depression or suicide, asking questions, supporting the person, and telling an adult who can help or referring them to a mental health professional.

In September 2011, Strunk and co-authors published in the Journal of School Health results of a study they conducted indicating the effectiveness of the free, four-day Surviving the Teens program. They administered a survey to 1,030 students before the presentation, immediately afterward and to 416 of them three months later.

They found at the three-month follow up that the students were significantly less likely than at the pretest to be considering suicide, 1.5 percent down from 4.2 percent; to have a plan, 5.2 percent down from 9.9 percent; or to have attempted to end their lives, 1.7 percent down from 5.2 percent.

In addition, the young people were more likely after the program to indicate an intent to seek help and to know an adult at school with whom they felt they could discuss their problems.

Strunk plans to develop a train-the-trainer program, so the program can expand across the nation, with mental health professionals and school nurses conducting the sessions.

Nurses already play a major role in identifying and helping depressed and suicidal teens.

“School nurses are often the first contact children have,” said Linda Davis-Alldritt, MA, BSN, RN, FNASN, FASHA, president of the National Association of School Nurses. “It is estimated that about one-third of the students that come into a school nurse’s office come in with a mental-health problem. There are very few resources in most communities for teen mental health. The school nurse is a safe haven.”

Linda Davis-Alldritt, MA, BSN, RN, FNASN, FASHA, said teens will often confide in the school nurse about their feelings of depression and thoughts of suicide.

Davis-Alldritt reports many of those students may have been bullied or had a traumatic stress situation at home and school.

“In the course of conversation, it’s okay to ask if they are considering suicide,” Davis-Alldritt said. “Research has clearly shown that talking about suicide in a caring way does not cause suicidal thoughts.”

Nurses can then link the children and parents with school and community services.

“The school nurse is a valuable resource for the child to initially talk to and to follow up and get the family the help they need,” Davis-Alldritt said.

Nurses and mental health professionals in the community also are addressing this issue. Boseung Halliwell, APRN, PMHNP-BC, at the Community Health Services of Lamoille Valley in Morrisville, Vt., works with psychiatrist Linda Zamvil, M.D., counseling depressed youth. She asks them about their environment, how they feel about their lives, and their relationships with family and friends.

“Medication helps dramatically, but trying to process their feelings is very important to me,” Halliwell said. “Teens don’t have the skills to deal with their emotions, and that can lead to suicide.”

Zamvil, an advisory board member for Families for Depression Awareness, helped develop a webinar for the organization to call attention to the issue of depression in young people. Untreated, Zamvil said, it can lead to substance abuse, academic failure, bullying, eating disorders and suicide. Biology, including genetics, as well as abuse and stressful life experiences contribute to depression.

“There is a lot of hope and help for kids, but there is a stigma attached to it,” Zamvil said. “People don’t seek help or seek it too late.”

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ANA Recognizes Emergency Nursing as Specialty Practice


The American Nurses Association (ANA) has formally recognized emergency nursing as a specialty practice.

Emergency nursing is the care of individuals across the lifespan with perceived or actual physical or emotional alterations of health that are undiagnosed or require further interventions. Emergency nursing care is episodic, primary, typically short-term, and occurs in a variety of settings.

ANA also approved the Emergency Nursing Association’s (ENA) scope of practice statement and acknowledged the standards of practice for emergency nursing. These documents, written by the ENA, form the foundation of emergency nursing and outline the expectations of the professional role within which emergency nurses must practice.

“The criteria for attaining specialty status are rigorous, so the recognition of emergency nursing as a specialty is a significant achievement,” said ANA President Karen Daley, PhD, MPH, RN, FAAN. “ANA’s role in this process is to protect patients by ensuring high quality in nursing practice and performance. This recognition tells the public that emergency nurses are dedicated to meeting high standards of care and patient safety.”

ENA President AnnMarie Papa, DNP, RN, CEN, NE-BC, FAEN, said the recognition acknowledges the unique aspects of emergency nursing, and gives emergency nurses a stronger voice in health care policy debates.

“It allows other health professionals and health care consumers to have a clear understanding of the range of emergency nursing practice and gives a better understanding of the roles emergency nurses fill,” Papa said.

Papa added that the designation establishes a common language and understanding within the emergency care field, strengthens the case for ongoing research to apply best practices at stretcher-side, and reinforces “the need of the emergency nurse to embrace career advancement in leadership, education and advanced practice nursing.”

By consensus of specialty nursing groups, ANA became the neutral reviewing body of scope of practice statements and standards of practice for nursing specialties in the late 1990s. Specialty nursing practices must meet certain criteria to gain recognition, a review process intended to ensure consistency in nursing practice.

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