Wellness Improves Learning for Youth (WILY) - Chronic Illness Management

Wellness Improves Learning for Youth (WILY) - Chronic Illness Management

Brief Description

Wellness Improves Learning for Youth (WILY) is a project supported in part by a five-year Centers for Disease Control and Prevention (CDC) grant to the Wisconsin Department of Health Services (DHS). Overall, the funds support state health department efforts to promote health and prevent and control chronic diseases and their risk factors. The focus of the work that will be carried out by DPI includes:

1. creating supportive nutrition environments in schools
2. implementing quality physical education and physical activity in K-12
3. implementing policies, processes, and protocols to meet the management and care needs of students with chronic health conditions (e.g. asthma, food allergies, diabetes, and obesity)

These slides provide information about all aspects of the project and how districts were selected. Slides 15 and 16 are specific to school nursing. (22 slides total)

The work of the DPI school nurse consultant for this project is to provide technical assistance and professional development to the participating school districts with a focus on assisting them to:

1. identify and track students with chronic conditions that may require daily or emergency management, e.g. asthma and food allergies,
2. develop protocols that ensure students identified with a chronic condition that may require daily or emergency management are enrolled into private, state or federally funded insurance programs if eligible, and
3. provide assessment, counseling, and referrals to community-based medical care providers for students with chronic conditions, including those that are activity, diet, and weight related.

Participating School Districts

The project activities are targeted to 16 school districts but the resources and some of the activities are available to all school districts.

Desired Project Outcomes

1. Decrease in absences for students identified with chronic conditions
2. Increase in percentage of students with chronic condition identified as having a medical home

Data Collection

Step Up Be Counted in 2016-2017
Grant school districts should plan to collect the data that is outlined in this year’s data collection tool on the DPI website. This data should be collected district-wide, with one lead nurse inputting the data into the DPI electronic system. For more information and the actual data collection format go to the school nurse data collection web page. All grant districts must complete this data collection tool by June 23, 2017.

Grant Updates

October 2016
August 2016
May 2016
March 2016
January 2016
December 2015
November 2015
September 2015
August 2015
January 2015
December 2014
October 2014
September 2014
August 2014
June 2014

Resources

General

• New Publication Highlights Opportunities to Incorporate Health and Wellness into School Improvement Plans
      The National Association of Chronic Disease Directors (NACDD) has released a new resource: A Guide to Incorporating Health and Wellness into School Improvement Plans. School improvement plans provide a systematic opportunity to address the needs of the whole child, incorporating physical, social, emotional and/or behavioral health priorities into schools. The guide is designed to provide public health agencies and other education partners an understanding of improvement plans and their purpose and role in schools and districts. It outlines opportunities to incorporate health and wellness-related goals and aligned activities into the improvement planning process, and highlights useful examples from a state, district and schools that have done it.
• See Wisconsin Department of Public Instruction’s information on chronic health conditions and management.
• eSchoolCare, an evidence-based online resource for school nurses is available by subscription. Content on chronic illnesses including asthma, allergies, and diabetes is presented by experts.
• Wisconsin Department of Public Instruction’s webcasts on medication administration by various routes.
• Wisconsin Public Health Association’s Wisconsin Improving School Health Services Project (WISHeS) page provides access to sample policies including those for asthma, diabetes, concussion, medication administration, medication disposal, and medication error.
• WISHeS sample procedures including those related to urinary, respiratory, digestive, endocrine, and cardiovascular conditions.
• Health insurance is an important factor in accessing health care for students with chronic health conditions. Covering Wisconsin connects residents with appropriate insurance coverage and other programs that support health, and promote effective use of these programs. Visit their web page for consumer resources: http://coveringwi.org/resources-and-links/materials.
• Wisconsin has five Regional Centers dedicated to supporting families with children and youth with special health care needs and the providers who serve them. The Centers are staffed by specialists who can help get answers, find services, and connect you to community resources. Their services are free and private.

Attendance

• The Healthy Schools Campaign released Addressing the Health-Related Causes of Chronic Absenteeism: A Toolkit for Action in May 2016. The Toolkit contains an overview and background on chronic absenteeism and students health and four “Taking Action” sections including (1) understanding student health needs (2) addressing the health related reasons students are absent (3) building effective partnerships to support student health and (4) building capacity.
• The National Association of Chronic Disease Directors (NACDD) has released a new 2016 resource: School Attendance, Chronic Health Conditions and Leveraging Data for Improvement: Recommendations for State Education and Health Departments to Address Student Absenteeism that highlights how state education and health departments can help lead the way in reducing absenteeism through a comprehensive approach that is inclusive of addressing chronic health conditions. This document emphasizes school nursing and the role of school nurses in data collection and use. It describes connections between school attendance and chronic health conditions, discusses challenges and opportunities for data collection and use, and promotes the integration of school health services, specifically nursing, into efforts to improve school attendance. The document provides recommendations for action and highlights successes within various states and communities. See additional NACDD resources and publications related to school health.

Attention Deficit Hyperactivity Disorder (ADHD)

• Read Baltimore (MD) County’s ADHD Identification and Management Guide (2012 Edition) for schools.

Food Allergies/Anaphylaxis

• The National Association of Schools Boards developed Safe at School and Ready to Learn: A Comprehensive Policy Guide for Protecting Students with Life-Threatening Food Allergies for school board members and their districts. The guide addresses the health challenges students with food allergies face and the need to prevent and effectively respond to health emergencies in school.
• Food Allergy Research & Education (FARE, formerly Food Allergy and Anaphylaxis Network). Overall, one-stop site with accurate and specific information for schools including tools, resources and templates.
• The National Association of School Nurses (NASN) Toolkit for Food Allergies includes Clinical Conversations for the School Nurse-Food Allergy Management in the School Setting and Saving Lives at School: Anaphylaxis and Epinephrine as well as algorithms, forms, templates, checklists, and other documents.
• Food Allergies at School: Individualized Health Care Plans vs. Section 504 Plans (56 minutes). Webinar produced by Kids with Food Allergies presented January 14, 2014.
• CDC developed Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs in response to the FDA Food Safety Modernization Act. The guidelines were published in 2013 and consist of 4 sections with extensive information for families, a wide variety of school staff, health care professionals, and early childhood program staff.
• The Tool Kit for Managing Food Allergies in Schools was developed by CDC to help schools in implementing the Voluntary Guidelines for Managing Food Allergies in School and Early Care and Education Programs. The easy-to-use tool kit includes tip sheets, training presentations, and podcasts highlighting resources and action steps specific for a diverse audience of school staff:
  • School superintendents
  • Administrators
  • Teachers and paraeducators
  • School nutrition professionals
  • School transportation staff
  • School mental health professionals
• Food Allergies: Managing and Preventing Acute Reactions in the School Setting The best practice guidelines provide school administrators, school nurses and staff with information, recommended policies, procedures and resources to ensure that students diagnosed with anaphylactic food allergies have a safe learning environment. The best practice guideline recommendations provide recommended action steps for schools and school districts.

Asthma

• The following materials were developed at a National Asthma Summit in October, 2015:
      AAAAI Announces the School-based Asthma Management Program (SAMPRO™)
  Improving health and school-related outcomes for children with asthma requires integrated care coordination amongst families, clinicians and school nurses. To facilitate this, the AAAAI is now home to the School-based Asthma Management Program (SAMPRO™). SAMPRO™ standardizes recommendations for school-based asthma and provides useful resources for the care of asthmatic children in schools.
  Developed in collaboration with a variety of stakeholders, SAMPRO™ is detailed in the September issue of The Journal of Allergy and Clinical Immunology (JACI), and is endorsed by: Allergy and Asthma Network; American Academy of Pediatrics; American College of Allergy, Asthma & Immunology; American Thoracic Society; and National Association of School Nurses.
  The toolkit includes materials and resources for school nurses. It is free and easy to access once you register.
• The National Asthma Education and Prevention Program Managing Asthma—A Guide for Schools is a 44 page guide intended to provide school personnel with practical ways to help students with asthma come to school each day healthy and ready to learn.
• The Guidelines for the Diagnosis and Management of Asthma is the source for the most recent Expert Panel Report which establishes the best practice recommendations for asthma treatment.
• Wisconsin Asthma Coalition is committed to improving asthma management for children and adults. Their website includes documents, tools, resources, and access to webinars.
• Asthma Friendly Schools Initiative: School Nurse Asthma Toolkit. Download all or sections of this kit from the American Lung Association website.
• School Nurse Asthma Care Checklist provides a summary of best practices for the care of students with asthma in school and is available at no cost on NASN's website.
• See the Wisconsin Asthma Program: Guide to Asthma-Friendly Schools. Created by the Wisconsin Department of Health Services Asthma Program, the guide’s purpose is to provide guidance to Wisconsin schools on ways to help students better manage their asthma. It includes information about the impact of asthma in Wisconsin and sections on the 3 key steps to asthma friendly schools: (1) self-management and education, (2) asthma trigger reduction and (3) collaboration with families, students, staff, and health care providers. The guide includes various guides, handouts, sample letters, and posters.

Diabetes

• The American Diabetes Association published an update to their position statement on Diabetes Care in the School Setting in October 2015. The six-page document is very comprehensive and includes sections on (1) the laws protecting students with diabetes, (2) care in school, (3) general guidelines, (4) responsibilities of the parent/guardian, student and school, (5) special considerations, (6) other settings such as preschool and post-secondary.
• The American Diabetes Association Safe at School is a comprehensive guide providing information about legal protections for students with diabetes, position statements, resources for care at school, strategies for resolving challenges, staff training materials, and sample written care plans.
• The Juvenile Diabetes Resource Foundation School Advisory Tool Kit (11 pages) provides information from the parent perspective about how parents of children with diabetes and schools can work together to provide a safe, caring, and positive learning environment for the child/student.
• The National Association of Chronic Disease Directors Diabetes School Health Resources site provides links to a variety of diabetes resources grouped by legislative information, educational materials for children and families, sample individual health plans, and a substantial number of resources from specific states.
• Students with Diabetes: A Resource Guide for Wisconsin Schools and Families. Revised March 2010.
• NASN Helping to Administer to the Needs of the Students with Diabetes in Schools (H.A.N.D.S.) program is a continuing education full day program for school nurses.
• NASN Position Statement on Diabetes Management in the School Setting. Adopted January 2012.
• This comprehensive resource, Helping the Student with Diabetes Succeed: A Guideline for School Personnel, from the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK), was released in September 2016 and is intended to provide guidance to school personnel to ensure a safe learning environment for students with diabetes.
• The American Academy of Pediatrics and the National Association of Chronic Disease Directors co-hosted the excellent webinar “Enhancing Diabetes Management in Schools: Policy, Protocol and Collaboration ” in May 2014. View the presentation and the slides.
• The American Diabetes Association Diabetes Care Tasks at School: What Key Personnel Need to Know is two-part training curriculum consisting of 13 PowerPoints with corresponding video segments.
• The Massachusetts Department of Elementary and Secondary Education published the 96 page Massachusetts Guide for Managing Diabetes in Schools in 2011. The guide includes sample forms and plans for school nurses.
• DPI School Nurse Summer Institute 2016—Managing Diabetes Safely in the School Setting: A framework for collaborative care. Resources include FAQ, Recorded Presentations, and White Paper.
• The pediatric diabetes specialists at American Family Children's Hospital present these resources for patients and families with Type 1 diabetes.

Obesity

• NASN Position Statement on Overweight and Obesity in Youth in Schools—The Role of the School Nurse, Revised June 2013.
• The School Nurse Childhood Obesity Toolkit, published by NASN, 2013. This provides the framework and resources that identify the role of the school nurse in the intervention and management of overweight and obese youth.
• Centers for Disease Control and Prevention (CDC) About BMI for Children and Teens includes a link to the BMI calculator.
• The American Academy of Pediatrics (AAP) Expert Committee Recommendations Regarding the Prevention, Assessment and Treatment of Child and Adolescent Overweight and Obesity; Summary Report includes a brief section on "The Roles of the School and the Community."
• AAP Executive Summary BMI Measurement in Schools summarizes expert panel review of articles, position statements, and current state legislation related to BMI programs.

Seizures

• The CDC Healthy Schools website has added new materials on their Epilepsy page. The four tabs provide an overview of epilepsy in schools, epilepsy facts, seizure first aid and training, and professional development resources.
• The Epilepsy Foundation has affiliates in most states (including Wisconsin) that are great supports for schools and school districts dealing with issues around students with epilepsy. The national Epilepsy Foundation has funding from the CDC that also supports work in this area. The Epilepsy Foundation also funds a 24/7 helpline that can answer questions from professionals or the general public.
• Epilepsy Foundation Managing Students with Seizures is a three module continuing education program to assist school nurses to effectively manage students with seizures in the school setting. Users set up an account (no cost) and can receive continuing education contact hours from the CDC.
• View the procedures for Administration of Buccal Seizure Medication and Administration of Intranasal Seizure Medication on the DPI Medication Administration page.
• See the Epilepsy Foundation’s Seizure Action Plan

Transition

• Visit the Transition Improvement Grant website for information about effective, targeted, and low cost professional development to Wisconsin youth, parents, educators and all stakeholders in the area of postsecondary transition to improve strategies that will positively affect the post school outcomes of students with disabilities. Every 14-year-old child with an IEP has transition planning to smooth the move from the high school to postsecondary setting. Students with chronic health conditions may also be students with disabilities.
• The national Got Transition website includes resources for health care professionals and families to assist in the transition from pediatric to adult health care.
• The Wisconsin Transition Planning Guide includes a Transition Health Care Checklist called Preparing for Life as an Adult. See page 14 of the guide for the Transition Checklist form.
• Children’s Hospital of Wisconsin has developed a six page Transition Checklist covering Health Care, Adult Services, Financial, Education, Employment, Transportation, and Recreation.