Wednesday, August 18, 2021

Concussions in the School Setting


Concussions and The School Nurse


What is a concussion?

It won't take long before a student enters your school nurse office and notifies you they have been diagnosed with a concussion. It is important that your student understands what this diagnosis means and as a school nurse you have the opportunity to educate your student.  A textbook definition from the Centers for Disease Control and Prevention is: 

"A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells." (CDC, 2021)

However, that is a very technical and medical definition- will your student understand what that actual means?  It is OK to give an actual medical definition, but then follow it up with easy to use words and terms that your student will understand. This will depend on the grade level, age, and compression level of your student. 




What are common symptoms of a concussion?

Although school nurses are not allowed to diagnose a concussion, they should be able to recognize and refer for signs and symptoms of a potential concussion caused by a recent head injury. As a school nurse you'll want to know your school district's protocol when dealing with a student who has suffered a head injury at school or comes to school with a concussion diagnosis.  Do you know what signs and symptoms to look for?  For a review of signs and symptoms related to a concussion read this CDC article titled Concussion Signs and Symptoms

Are concussions serious?

Although concussions might not be life threatening, the side effects can be serious. Many students recovery within a few weeks, but others might need a few months or even longer to make a complete recovery!

                                     

What classroom accommodations can be made to support a student with a concussion?

There are many appropriate and suggested classroom accommodations that can be made when a student is diagnosed with a concussion. Sometimes the physician or athletic trainer might even provide you or the classroom teachers with accommodations when they provide the diagnosis. Other times the school nurse will only receive the written diagnosis. When this happens, what are you accepted to do?  Is the school nurse supposed to notify the student's classroom teacher/s or the student's school counselor?  Each school or school district should have a written concussion protocol to follow in this situation. 

A brief concussion protocol example might be something like this:
  1. School Nurse receives documentation that student has been diagnosed with a concussion
  2. School Nurse notifies classroom teachers and school counselor that the "concussion protocol" has been started
  3. School Nurse asks for or receives updates from students, parents, classroom teachers, and/or school counselor as needed
  4. School Nurse might need to inform athletic trainer or physician of received updates
  5. School Nurse receives documentation the Return To Learn is complete
  6. School Nurse notifies classroom teachers and school counselor that the "return to learn" has been completed
  7. School Nurse asks for or receives updates from students, parents, classroom teachers, and/or school counselor as needed
  8. School Nurse might need to inform athletic trainer or physician of received updates
  9. School Nurse receives documentation the Return To Play is complete
  10. School Nurse notifies classroom teachers and school counselor that the "return to play" has been completed
  11. School Nurse asks for or receives updates from students, parents, classroom teachers, and/or school counselor as needed
  12. School Nurse might need to inform athletic trainer or physician of received updates
The above are only brief suggestions ... as a school nurse you'll want to check on your school district's specific policies and procedures regarding concussion.  If your district doesn't have one, then you might want to work on creating one to use at your school when needed.

+This post contains affiliate links which means The School Nurse 
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NEED HELP CREATING A CONCUSSION PROTOCOL / POLICY / PROCEDURE? 

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THREE CONCUSSION PROTOCOL / CLASSROOM SUGGESTION SLIDES

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  • 3 fully editable slides for the following concussion situations:
    • Concussion Protocol Starting
    • Return To Learn
    • Return To Play
  • Edit to make each slide specific to your school / students
  • Save as PNG or JPG in order to insert into the body of an email







School Nurse Concussion Resources:






Sunday, August 8, 2021

Digital Student Health History Form

 

Digital Health History Form for Students

+ this post contains affiliate links+


Helpful School Nurse Tips: Knowing the health conditions of your students will prepare you to be able to provide appropriate care for all of your students. In addition, you can use this information to calculate the % of your students who have chronic health conditions, create Individualized Healthcare Plans, and other health related Action Plans.

Health History Purpose

The purpose of this digital student health history form is to provide an easier, yet formal way, for the school nurse to gather (collect data) on medical conditions for current students. Although this digital form is 100% editable, it currently offers parents a way to inform the nurse of the following:

  • Current health concerns
  • Explanation of the health concern
  • Description of how the health concerns impacts the student's school day
  • Requested accommodations the might benefit the student throughout the school day
  • Doctor contact information

As you can see, this digital health history form provides parents a chance to subjectively provide the school nurse with an overview of their child's current health conditions. The school nurse can then ask for needed / required follow up information from the student's parents and/or physician.


How To Collect A Student Health History

Have you ever had a parent call you with an update or have a child give you a verbal update? Those are great, but usually you prefer to have something is writing too. This digital student health history is a great initial data collection tool. Use this form within a follow up email - just make sure your Google settings are set so you receive notification when the form is completed. Follow up emails give you a chance to recap information from the conversation, review discussed accommodations, ask permission to share information with staff on a need to know basis, and ask any questions that you might have thought of since the conversation.

Why A Health History Is Important

Accurate student health histories are great!
Knowing what to do with the information from those health histories is even better! 


Digital Health Records-  Many schools use some sort of digital school management software; such as Skyward, SASI, PowerSchool etc. What program does your school us? IS there is a way to incorporate health history information into your school management software system?  If so, use it :)  It might seems time consuming at the moment, but you will save time in the long run. 


Health Conditions Lists- Many moons ago, I used to create Excel Health Concern lists- this was my only option at the time and so it worked for me. I would create a column filled spreadsheet and sort and organize as needed! Thankfully now, I can use my school's school management software (Skyward) to organize this same information! Skyward allows the ability to add  health concern information as a "Health Condition". Then, "Health Condition" reports can be created by grade level, graduation year, teacher, etc. These reports also provide an overall school summary including the number of students with each health condition. This information is very valuable for your end of the year (EOY) report for your school administration, school board, and/or supervisor.


Healthcare PlansUse the gathered health history information to create individualized healthcare plans for your students. There are many FREE and paid examples of healthcare plans all over the Internet- just Google what you are looking for. Maybe you don't think you have enough time to create a healthcare plan for every student who might need one- that is OKAY! You can always create a generic plan to put in place for specific health conditions- asthma, seizures, food allergies etc. Then, you can decide which students need their own specific emergency action plans from their private physicians and use your time to encourage parents to provide those completed emergency plans to you.


Emergency Action PlansEmergency Action Plans (EAP) are needed for students with known acute or chronic health conditions which have the potential to turn into a medical emergency while attending school or a school sponsored even and/or the health condition has the potential to negatively impact the student's learning process.  There are many free and paid examples available online- again, just search what you are looking for many examples should appear.


Medication FormsKnowing what medications a student is prescribed is nice to know. This knowledge can help you see the "bigger" picture. Many times students only take medication at home, but sometimes at school too. If medication is needed during school hours, then most districts require a physician's order and sometimes even have a specific form that needs to be completed. You can view medication form examples HERE. If a specific medication is included on an EAP then a separate medication form is typically not required.


Procedure FormsAs you filter through your student health history forms, you might find that a student requires a nursing procedure completed during school hours. These procedures might consist of: dressing change, g-tube feed, suctioning, catheterization, etc. Just like a doctor's order is required to administer medications in the school setting, a doctor's order should be on file in order for the nurse to complete any sort of nursing procedure in the school setting. Years ago in Illinois there was a "yellow manual" full of nursing procedures that may need to be completed in the school setting. I don't remember who published the manual and I don't have it available at the moment, but I will update this blog post if I find it! In the meantime complete an Internet search and I'm certain many examples will be available.


                               

ILLINOIS SCHOOL NURSE REFERENCES:

Illinois General Assembly (Full Article)
Illinois General Assembly Codes (Child Health Examination Code, 77 Ill. Adm. Code 665) https://www.ilga.gov/.../admincode/077/07700665sections.html
Illinois State Board of Education: Health Requirements
Each state has rules listing the minimum health requirements students must meet in order to attend school. 
Try searching your state + school health requirements to locate your specific state school health requirements.

OTHER SCHOOL NURSE REFERENCES:

2015 DOASN Lillian Wald Blog Post: http://diaryofaschoolnurse.blogspot.com/search...
Complete List of Department of State Health Websites: https://www.cdc.gov/.../healthdire.../healthdepartments.html
Lillian Wald - Henry Street Settlement https://www.henrystreet.org/about/our-history/lillian-wald/
NCSL State Vaccination Policies: Requirements and Exemptions for Entering School https://www.ncsl.org/.../state-vaccination-policies...
Schools & Health: Our Nation's Investment https://www.ncbi.nlm.nih.gov/books/NBK232693/
State School Nurse Associations

                                 Sixth, Seventh, Eighth, Ninth, Tenth, Eleventh, Twelfth, Homeschooler, Staff, Not Grade Specific - TeachersPayTeachers.com
            

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