The Pulse of ASNC


Policy, AIDS Connecticut (ACT) and a member of the ... Newsletter: Annette Sauerbrunn, [email protected]north-haven.k12.ct.us; Education: Karen Owen ...

The Pulse of ASNC

Association of School Nurses of Connecticut

Volume

Issue

Late Winter 2017

From the Desk of Sue Levasseur, President 2015-2017

Inside this issue:

Dear Colleagues, It is hard to believe that we are heading into spring and that well more than half of the school year is behind us. As the focus of ASNC last year was primarily the regional conference, this year we have buckled down and looked for initiatives that will not only improve your satisfaction as a member but increase the knowledge and skill you have as a professional school nurse. Our on-line webinar series has launched and I hope you have or will take part in our monthly offerings. We hope this will provide an easy and free way for our members to acquire needed contact hours as well as providing a diverse set of learning opportunities. As always we look for your feedback, good and otherwise. We know that our members also have a wealth of knowledge and expertise and would like to invite all to become involved by sharing that knowledge by providing your own webinar to our members. In addition our education committee is planning a “Summer Institute” on July 13th and 14th. Our initial plan is to use July 14th as a review for the national school nurse certification exam, which we encourage all members to take. Participants will be able to register for one or both days. More details to follow. Other behind the scenes work is focused on our legislative agenda. The legislative session is in full swing and we are closely monitoring all bills that may have an impact on school nursing, and we are providing testimony where necessary. It is a fast moving and constantly changing process that Board members Donna Kosiorowski and Mike Corjulo are working on with sometimes moment to moment changes. Please look for Donna’s article in this newsletter which will give you more information on this important matter. For those of you who may not know, Donna has been our legislative champion for years and I am echoing her sentiments that we have a powerful voice when we all work together in the legislative process. On a last note, this is a final call for recognitions which will be awarded at our spring dinner. Please use this opportunity to recognize your wonderful peers, school nurse advocates and nursing supervisors. It is a very easy process and all forms are available on the ASNC website. I would also like everyone to take note of our new logo in the left hand corner of this newsletter. We thought that our old logo needed a little facelift. A special thanks to all our dinner meeting participants who helped to vote on our new look. Happy Reading and as always thanks to Annette Sauerbrunn for her hard work on putting this newsletter together several times a year!

From the Desk of the President

1

We’ve Moved

2

ASNC Dinner Meeting

2-3

Implementation of Narcan

3

ASNC Continuing Educational Events Calendar

4

Cririal Issues In School Health

5-6

Food Allergy Survey

7

Legislative Updates

8-9

2017 Spring School Nurse Supervisory Conference

10

The Pulse of ASNC

Page 2

ASNC Dinner Meeting

We’ve Moved !

The contact information for ASNC has changed. Please note that we can be reached by US mail, email, phone or fax at the following: Association of School Nurses of CT C/O Graff-Wood Association Management Services 101 Oak St. Hartford, CT 06106 Phone: 860- 325- 7125 Fax 860- 727- 9863 Email: [email protected]

February 2, 2017 – Baci Grill, Cromwell By Annette Sauerbrunn MPH, RN

A delicious meal and very informative professional meeting was attended by many members from throughout the state on February 2. The topic of Naloxone (Narcan) use in schools was presented by Shawn Lang, B.A. Ms. Lang is the Deputy Director of Public Policy, AIDS Connecticut (ACT) and a member of the Community Advisory Board of the Center for Interdisciplinary Research on AIDS (CIRA). According to the ACT Naloxone (Narcan) Fact Sheet (www.aids.ct.org), Narcan can be a life-saving antidote to an opioid overdose. Between 2009- 2013, there were over 1,900 accidental and unintentional opioid deaths that occurred in 150 of CT’s 169 cities and towns. It is a very safe medication with little to no side effects. It can now be prescribed and dispensed in CT by specially trained pharmacists, and is covered by most insurances. It can be administered intravenously, subcutaneously, intramuscularly, and nasally. The question and answer session following the program was lively and interesting, with useful information for all school nurses. The following article chronicles one nursing supervisor’s account of the process she followed to implement standing orders for Narcan in the high schools within

ASNC Contacts: President: Suzanne Levasseur, [email protected]; Past President: Michael Corjulo, [email protected]; President Elect: Chlo-Anne Bobrowski, [email protected]; Recording Secretary: Joan Campbell, [email protected]; Corresponding Secretary: pending; Treasurer: Michael Corjulo, [email protected]; Director to NASN: Dr. Cheryl Resha, [email protected]; Membership: Verna Bernard-Jones, [email protected]; Newsletter: Annette Sauerbrunn, [email protected]; Education: Karen Owen [email protected]; Program (Co-Chair): Kathy Neelon, [email protected]; Program (Co-Chair): Lauren Young [email protected]; Government Relations: Donna Kosiorowski, [email protected]; NESNC Liaison: Chlo-Anne Bobrowski, [email protected] EMS– C: Trish Vayda; www.ctschoolnurses.org;

Member at Large: Mary Anne Porto, [email protected]

Page 3

her district. The members who attended also voted on a new logo for ASNC. It was felt that the time had come to update our look, replacing the old oil lamp with something more contemporary and reflective of our true practice, with children at the center. The winning logo is now featured on page 1 of this newsletter.

Implementation of Narcan By Kathleen Neelon MS, BSN Nurse Coordinator, Wallingford Public Schools Three years ago I was approached by a parent in the supermarket asking me why we did not have Narcan available to nurses in our high schools. At the time I was a bit taken aback because I did not think it was a necessary item to have available to school nurses. I had heard about of a number of overdoses in the community but the ages of the individuals were early twenties and older. I did not think this was really an issue for our high schools. I began researching information and found that NASN had developed a position statement supporting the use the Narcan in schools. “It is the position of the National Association of School Nurses (NASN) that the safe and effective management of opioid pain reliever (OPR)-related overdose in schools be incorporated into the school emergency preparedness and response plan. The registered professional school nurse provides leadership in all phases of emergency preparedness and response. When emergencies happen, including drug-related emergencies, managing incidents at school is vital to positive outcomes. The school nurse is an essential part of the school team responsible for developing emergency response procedures. School nurses in this role should facilitate access to naloxone for the management of OPR-related overdose in the school setting.” During this same time period an organization was established in Wallingford called the Coalition for a Better Wallingford, in response to at least a few dozen or more young adult overdoses resulting in death over a period of a few years in Wallingford and Meriden. The Coalition's mission is “to engage the Wallingford CT community resources to produce healthy, caring, and responsible citizens by raising awareness and reducing substance abuse among our youth.” The members of the Coalition have become very vocal and helpful in working with the community, including schools, in raising awareness of opioid addiction.

After researching and digesting all this information I discussed with my medical advisor the idea of purchasing Narcan for our high school nurse to have available in the event it was needed. Over this past summer New Haven had 12 overdoses within a few days. After this incident I decided to stop dragging my feet and get Narcan into our high schools in the event we should ever need it. We have so many other emergency medications or devices such as Epi-pens, Glucagon and AEDs, so why not Narcan? Our medical advisor supported this effort and asked me to draft a protocol and standing orders for him to review. Our medical advisor discussed Narcan implementation at both high schools with our Superintendent, who supported our plan and informed our Board. I researched online examples of different protocols and standing order documents and drafted some documents for our district. After input from our medical advisor and a few school nurses, the documents were revised and approved by the medical advisor for use. We obtained our first Narcan free from a grant provided by the Clinton Foundation. We have since purchased another box for each high school so that we have some medication in our nurses’ medication boxes, and one for the school nurses’ “run kit” that they use to respond to any emergency in school. At this time we have not had to use the medication and hope that we will never have to use it. But if we do we are prepared and can now possibly save someone’s life.

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ASNC is pleased to announce an expansion of our education for school nurses. On January 24, 2017 we launched our first webinar on Self Injurious Behavior. It is now on our website for those of you who may want to listen to it with the PPT slides. It is a very exciting time for us to provide this additional option for our members to be kept updated on school nursing practice and be provided with a contact hour all online. Non-members have a fee for the contact hour. The calendar of events is listed below. We are also considering a clinical summer institute this summer. Please don’t hesitate to let us know what areas you would be interested in having at the summer institute. We heard some great suggestions at the Winter Dinner Meeting. Keep those suggestions coming! We are here for YOU, our members, and we want to meet your needs.

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There’s Still Time to Register….

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Page 7

Survey Data from the Task Force to Study Food Allergies in School Michael Corjulo APRN, CPNP, AE-C

This past fall, the Task Force to Study Food Allergies in School sent a survey to school nurses via ASNC and SDE to obtain data for use in their legislative report. Task Force members were amazed at your response rate. Here are some statistical highlights from the survey:       

We had 371 completed surveys, each representing a CT school, and a total of 7650 students with a known Life-Threatening Food Allergy (LTFA) 23% of schools reported administering at least one dose of epinephrine to treat anaphylaxis during the previous school year, with 8% of schools reporting that they administered 3 or more doses In 20% of schools less than half the students with LTFA had their own supply of epinephrine In 25% of schools less than half the students with LTFA had an IHCP In 70% of schools less than 10% of students with LTFA had a 504 Plan More than 40% of schools had a at least half their emergency allergy plans with orders to use Benadryl before epinephrine 12% of schools do not stock epinephrine, and 11% do not have a staff trained to recognize anaphylaxis and administer it if the nurse is not available

The survey also requested comments about challenges and best practices. By far the most common reply to both questions addressed the use of food for celebrations and rewards, especially in the classroom setting. A separate survey was also sent to school superintendents with a 41% reply rate. Of note was the question: What specific strategies/protocols do you use to protect students with food allergies in your district? Only 53% of the respondents answered that the district-wide food allergy plan is published on their public website; 32% publish the plan on their internal websites, and 45.6% provide annual notice of the plan to parents and guardians. Of great concern to the Task Force was that each year superintendents are required to attest in writing to the CSDE that they are complying with the law that requires these aspects of food allergy management in school. Here is the link to the web page for the Task Force, included the Final Report for anyone interested in reading more about this initiative, the list of legislative recommendations, and the rest of the survey data that was collected: http://www.cga.ct.gov/ed/taskforce.asp?TF=20150702_Life-Threatening%20Food%20Allergies%20in%20Schools When thinking about the progress we’ve made as the health professionals working to promote safety and inclusion for all students, with any health condition, there are two scenarios, exemplified by these recommendations that keep coming to mind: Every day students with LTFA go to school and have plans in place to ensure their safety and inclusion during their educational experience; and every day students the same age with the same allergies go to other schools where the practices do not adequately address safety and inclusion. This is not a matter of finances or resources. It is about knowledge, leadership, and advocacy. An elementary school student has an anaphylactic reaction on the bus. The driver pulls over, calls dispatch, who calls 911. He stands over the child as her airway narrows and her BP falls. If he had some basic training, he could administer her Epipen. Without the training, he, and everyone else, has to hope the ambulance gets there in time. This is not delegation, this is public health, like grabbing the AED off the wall and pressing the power button. It only needs to happen once, and we can prevent it.

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Legislative Updates

By Donna Kosiorowski MS, RN, NCSN Editor’s note: The following are some of the proposed bills before the CT Legislature. ASNC has been monitoring those with the potential to impact school nurses and/or the children they care for. The right-hand column states ASNC’s position on these proposals. If you’d like to discuss any legislation, please contact us at [email protected], or by phone: 860- 325- 7125.

To track bills: Go to and set up your account: http://www.cga.ct.gov/aspx/cgabilltracking/ CGABillTrack_Register.aspx Once you register you will be taken to: http://www.cga.ct.gov/aspx/cgabilltracking/CGABillTracking.aspx Once you are there, you can choose how often and how you will receive notifications, what bills you want to track (by introducer, co-sponsor or Bill number). HB = House Bill; SB= Senate Bill. You will automatically receive periodic updates on your chosen bills. Always read the bill in its entirety since language changes and language that may be unrelated to the title of the bill can be added up until the final hour. To find your legislators: Go to: http://www.cga.ct.gov/asp/menu/cgafindleg.asp You will be asked for your address and gain access to your legislators (state and national)

Bills currently being watched by ASNC appear on page 9

Page 9

HB-6034 An Act Concerning the Overall Safety Management and Social Emotional Well Being of Students with Life Threatening Food Allergies Support Elimination of the ability for a parent or guardian to prohibit the administration of epinephrine to a student. HB- 7200 An Act Concerning Life Threatening Food Allergies in Schools

Recommendations from Life Threatening Food and Allergy Task Force. Includes education, care planning, school bus drivers, school climate etc.

Needs amending

SB-902 An Act Concerning Recommendations of the School Nurse Advisory Council (SNAC)

1. In addition to professional development requirements specified by CGS 10-212-a (10 hours every 2 years), all new Connecticut school nurses should complete 12 hours of training using a curriculum approved by CSDE in collaboration with the Association of School Nurses (ASNC) and Connecticut Nurses’ Association (CNA) within one year of hire. 2. That all districts participate in the CSDE’s annual School Health Services Program Information Survey. 3. Representative from ASNC not be limited to a private or parochial nurse. HB-6494 An Act Permitting the Delegation of Medication Administration by a Registered Nurse to

EMT’s. Allow a registered nurse to delegate the administration of medication to an emergency medical technician who has received training in the administration of medication.

Support

Oppose- nurses accountable for delegation; different scope of practice; potential for EMT’s to replace school nurses

HB-6689 An Act Concerning Immunity from Liability for School Bus Drivers Who Administer Epinephrine to A Student Permits school bus drivers to administer epinephrine to a student and to include school bus

Oppose

drivers in the list of persons protected from liability for administering epinephrine. HB-6701 An Act Concerning The Administration of Glucagon in Schools

Remove the requirement that a qualified school employee voluntarily agrees to administer glu-

Oppose

cagon to a student with diabetes. HB-7048 An Act Protecting Youth and Student Athletes From Concussions Neutral For purposes of this section, "licensed health care professional" means a physician licensed pursuant to chapter 370, a physician assistant licensed pursuant to chapter 370, an advanced practice registered nurse licensed pursuant to chapter 378, [or] an athletic trainer licensed pursuant to chapter 375a or a chiropractor licensed pursuant to chapter 372.

Adds chiropractors to clear a student post concussion

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