Emergency Management of Seizures in the School Setting

2007 ◽  
Vol 23 (3) ◽  
pp. 158-165 ◽  
Author(s):  
Christine O’Dell ◽  
Kathryn O’Hara ◽  
Sarah Kiel ◽  
Kathleen McCullough
Keyword(s):  
Emergency Treatment ◽  
Treatment Plan ◽  
School Setting ◽  
School Personnel ◽  
Critical Issue ◽  
Medication Administration ◽  
School Nurses ◽  
Emergency Department Visits ◽  
Rectal Medication ◽  
Treatment Plans

Effective seizure management in the school setting is a critical issue for students with seizures, as well as their parents, classmates, and school personnel. The unpredictable nature of seizures and the potential outcomes of experiencing a seizure in school are sources of anxiety for students with seizures. The ability to respond appropriately to a seizure is of concern to parents and school personnel. Implementation of a seizure emergency treatment plan empowers school personnel to quickly treat the child. Diazepam rectal gel is commonly used in seizure emergency treatment plans. It is safe and effective in terminating seizures and reduces the time to treatment and the need for emergency department visits when used in the school setting, and can be administered by medical and delegated to trained nonmedical personnel. School nurses should be aware of the laws and professional recommendations that pertain to rectal medication administration in schools for optimal emergency seizure management.

School Nurses’ Experience With Administration of Rectal Diazepam Gel for Seizures

2007 ◽  
Vol 23 (3) ◽  
pp. 166-169 ◽  
Author(s):  
Christine O’Dell ◽  
Kathryn O’Hara
Keyword(s):  
Early Intervention ◽  
School District ◽  
School Setting ◽  
Medication Administration ◽  
School Nurses ◽  
Scope Of Practice ◽  
Rectal Diazepam ◽  
State Practice ◽  
Acute Seizure ◽  
Rectal Medication

The purpose of this study was to determine school nurses’ knowledge of state and school district policies, their experience regarding the administration of rectal diazepam gel in the school, and the perceived benefits and barriers of providing this treatment. Four hundred nineteen nurses responded to a survey conducted during the National Association of School Nurses Annual Meeting. Seventy-one (18%) nurses surveyed had administered rectal diazepam gel in a school setting, while 54 (13%) nurses reported that either their state practice act or school district prohibited them from giving rectal medications in the school. Medication administration benefits, such as early intervention for treatment of acute seizure emergencies, were noted. Barriers were also identified, with lack of privacy as the most frequently listed. Scope of practice as it pertains to administering medication in the school and the extent to which delegation of duties can be used in the situation of administering rectal medication in a seizure emergency remain issues for school nurses.

Tooth Avulsion in the School Setting

2005 ◽  
Vol 21 (5) ◽  
pp. 279-282 ◽  
Author(s):  
Cheryl A. Krause-Parello
Keyword(s):  
Periodontal Ligament ◽  
School Setting ◽  
School Personnel ◽  
School Nurse ◽  
School Nurses ◽  
After School ◽  
Tooth Avulsion ◽  
Dental Emergency ◽  
Dental Injuries

Tooth avulsions occur when a tooth is displaced from its socket. Tooth avulsions are common dental injuries that may occur before, during, or after school. Therefore, it is essential that school nurses be well prepared to intervene when such a dental emergency arises. It is also imperative that school nurses and school personnel are fully equipped to manage a tooth avulsion. Time is of the essence when attempting to save an avulsed tooth. The goal is to successfully reinsert the avulsed tooth and to preserve the periodontal ligament. The school nurse is responsible for implementing the appropriate actions needed to save the avulsed tooth.

Developing a Nursing Protocol for Over-the-Counter Medications in High School

2003 ◽  
Vol 19 (1) ◽  
pp. 12-15 ◽  
Author(s):  
Lucinda Mejdell Awbrey ◽  
Sandra M. Juarez
Keyword(s):  
High School ◽  
School Districts ◽  
School Setting ◽  
School Personnel ◽  
School Nurses ◽  
Over The Counter ◽  
Nursing Knowledge ◽  
Development And Utilization ◽  
Ready To Learn ◽  
Legal Guidelines

Management of medications in school is one of the critical roles that school nurses carry out in the school setting. In recent years, parents have come to question the medication procedures that school districts follow. Parents question why a physician’s order is required for school personnel to provide over-the-counter (OTC) medications to their child at school. How do school districts balance the safety of students with the needs of parents wanting their children to have access to OTC medications at school? Following legal guidelines helps to reduce the risk for school nurses. Through the development and utilization of Nursing Standardized Protocols, high school nurses are able to provide nonprescription analgesics for specific common student complaints such as noninjury headaches and dysmenorrhea. On the basis of nursing knowledge and judgment, school nurses provide this service, which results in students returning to class quickly, feeling better, and being ready to learn.

Guidelines for the Administration of Medication in School

PEDIATRICS ◽  
1993 ◽  
Vol 92 (3) ◽  
pp. 499-500
Author(s):  
Keyword(s):  
School Board ◽  
Treatment Plan ◽  
School Setting ◽  
School Personnel ◽  
Regular School ◽  
School Superintendent ◽  
Individual School ◽  
Life Threatening ◽  
Medical Advisory Committee ◽  
Complex Disability

Many children and adolescents are able to attend school because of the effectiveness of their medication. The health circumstances requiring medication are diverse. Medication may be essential for continued functioning, either as a component of an elaborate treatment plan for the student with a complex disability or as the only treatment necessary for a student to maintain or regain control of his/her chronic illness. In rare instances medications may be necessary for life-threatening emergencies. For most students, the use of medication will be a convenient benefit to control acute minor or major illnesses, allowing a timely return to the classroom with minimal interference to the student and to others. A student may also symptomatically benefit from nonprescription medications. SCHOOL POLICY The school board and the school superintendent, in conjunction with other school personnel and in collaboration with the physician or medical advisory committee for each school (district), should develop a policy for the administration of medication in the school setting. The guidelines should indicate what age and/or class levels are included, such as kindergarten through grade 12 or, alternatively, separate guidelines for different grades. Individual school districts also should seek the advice of counsel as they assume the responsibility for giving medication during school hours. Liability coverage should be provided for the staff, including nurses, teachers, athletic staff, principals, superintendents, and members of the school board. Any student who must take medication during regular school hours should do so in compliance with the school's regulations. The American Academy of Pediatrics recommends that each school include or consider the following sections in its medication policy.

School Nurses’ Experiences With Medication Administration

2003 ◽  
Vol 19 (5) ◽  
pp. 281-287 ◽  
Author(s):  
Michael W. Kelly ◽  
Ann Marie McCarthy ◽  
Matthew J. Mordhorst
Keyword(s):  
Focus Groups ◽  
Comparative Method ◽  
School Setting ◽  
Medication Administration ◽  
School Nurses ◽  
Self Administration ◽  
Local School ◽  
Written Comments ◽  
Medication Administration Errors ◽  
Constant Comparative Method

This article reports school nurses’ experiences with medication administration through qualitative analyses of a written survey and focus groups. From a random sample of 1,000 members of the National Association of School Nurses, 649 (64.9%) school nurses completed the survey. The quantitative data from the survey were presented previously. However, 470 respondents provided written comments on the survey. Comments on the eight items that had the most written comments were qualitatively analyzed. In addition, to clarify information obtained from the surveys, two focus groups with local school nurses were conducted. A constant comparative method of analysis was used, and results were combined from the two data sources. The combined analyses resulted in six final categories of concern: (a) delegation of medication administration, (b) comfort with delegation, (c) self-administration of medication, (d) medication administration errors, (e) storage of medication, and (f) administration policies. The findings suggest that school nurses across the country have similar concerns regarding the administration of medications in the school setting.

scholarly journals Outcomes associated with a negotiated asthma treatment plan

2012 ◽  
Vol 9 (3) ◽  
pp. 175-182 ◽  
Author(s):  
Noreen M Clark ◽  
Yi-An Ko ◽  
Z Molly Gong ◽  
Timothy R Johnson
Keyword(s):  
Health Care ◽  
Treatment Plan ◽  
Symptom Control ◽  
Emergency Department Visits ◽  
Health Care Use ◽  
Oral Steroid ◽  
Oral Steroids ◽  
Treatment Plans ◽  
Asthma Outcomes

Negotiated treatment plans are increasingly recommended in asthma clinical care. However, limited data are available to indicate whether this more patient-engaged process results in improved health outcomes. The aim of this study was to determine the associations between the presence of a negotiated treatment plan and the outcomes related to adherence to the medical regimen, symptom control, and health care use. The focus of the study was on women, the subgroup of adult patients, who are most vulnerable for negative asthma outcomes. Data were collected by telephone interview and medical record review from 808 women diagnosed with asthma at baseline, first year, and second year follow-up. Associations were examined between the presence of a negotiated treatment plan at baseline and subsequent asthma outcomes. Women with a negotiated treatment plan reported more adherent to prescribed asthma medicines (odds ratio (OR) = 2.41, 95% confidence interval (CI) = (1.82, 3.19)) and those with a plan and using oral steroids at baseline had less oral steroid use at follow-up (OR = 0.21, 95% CI = (0.05, 0.93)). Women with a negotiated plan also had more days (17%, 95% CI = (8, 27)) and nights (31%, 95% CI = (16, 48)) with symptoms than those without such a plan. No differences in hospitalizations, emergency department visits, or urgent physician office visits were noted between the groups. Patients with higher education levels were more likely to have a negotiated treatment plan. Negotiated treatment plans appear to have achieved greater adherence to prescribed asthma medicines and less need for oral steroids but were not related to fewer symptoms of asthma or reductions in urgent health care use. Additional strategies may be needed to reduce symptom and health services utilization outcomes.

Pharmacology Update: School Nurse Role and Emergency Medications for Treatment of Anaphylaxis

2021 ◽  
pp. 1942602X2110219
Author(s):  
Theresa A. Bingemann ◽  
Anil Nanda ◽  
Anne F. Russell
Keyword(s):  
Side Effects ◽  
School Personnel ◽  
Local Environment ◽  
School Nurses ◽  
First Line ◽  
Onset Of Action ◽  
Epinephrine Administration ◽  
Prompt Treatment ◽  
Nurse Role ◽  
Life Threatening

Anaphylaxis is a rapidly occurring allergic reaction that is potentially life threatening. Recognition of the early signs and prompt treatment of anaphylaxis is critical. School nurses are tasked with educating nonmedical school personnel on the recognition and treatment of anaphylaxis and emphasizing that epinephrine is the first line of treatment for anaphylaxis. Fortunately, there is now availability of multiple epinephrine administration devices. However, this also means that there are more devices that school nurses and nonmedical assistive personnel need to learn about to be able to administer in an emergency. Once epinephrine is administered, emergency medical services must be activated. Education regarding what to expect after the administration of epinephrine with respect to side effects and onset of action is also necessary. Though adjunctive medicines, such as antihistamines and inhalers, may also be administered after the injection of epinephrine, they should not be solely relied on in anaphylaxis. School nurses are uniquely situated for this role, as they understand the local environment in a school and can assess and reassess the needs of the faculty and staff.

scholarly journals The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

scholarly journals Multicriterial CNN based beam generation for robotic radiosurgery of the prostate

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Stefan Gerlach ◽  
Christoph Fürweger ◽  
Theresa Hofmann ◽  
Alexander Schlaefer
Keyword(s):  
Deep Learning ◽  
Treatment Planning ◽  
Treatment Plan ◽  
Plan Quality ◽  
New Approach ◽  
Beam Generation ◽  
Radiological Features ◽  
Improve Treatment ◽  
Robotic Radiosurgery ◽  
Treatment Plans

AbstractAlthough robotic radiosurgery offers a flexible arrangement of treatment beams, generating treatment plans is computationally challenging and a time consuming process for the planner. Furthermore, different clinical goals have to be considered during planning and generally different sets of beams correspond to different clinical goals. Typically, candidate beams sampled from a randomized heuristic form the basis for treatment planning. We propose a new approach to generate candidate beams based on deep learning using radiological features as well as the desired constraints. We demonstrate that candidate beams generated for specific clinical goals can improve treatment plan quality. Furthermore, we compare two approaches to include information about constraints in the prediction. Our results show that CNN generated beams can improve treatment plan quality for different clinical goals, increasing coverage from 91.2 to 96.8% for 3,000 candidate beams on average. When including the clinical goal in the training, coverage is improved by 1.1% points.

scholarly journals Outcomes of Peer Review for Radiotherapy Treatment Plans With Palliative Intent

2018 ◽  
Vol 14 (12) ◽  
pp. e794-e800
Author(s):  
Dina Thompson ◽  
Kimberly Cox ◽  
James Loudon ◽  
Ivan Yeung ◽  
Woodrow Wells
Keyword(s):  
Peer Review ◽  
Treatment Plan ◽  
Palliative Radiotherapy ◽  
Cancer Center ◽  
Palliative Intent ◽  
Treatment Plans ◽  
Important Quality ◽  
Radiation Medicine ◽  
Radiotherapy Treatment

Purpose: Peer review of a proposed treatment plan is increasingly recognized as an important quality activity in radiation medicine. Although peer review has been emphasized in the curative setting, applying peer review for treatment plans that have palliative intent is receiving increased attention. This study reports peer review outcomes for a regional cancer center that applied routine interprofessional peer review as a standard practice for palliative radiotherapy. Methods and Materials: Peer review outcomes for palliative radiotherapy plans were recorded prospectively for patients who began radiotherapy between October 1, 2015, and September 30, 2017. Recommended and implemented changes were recorded. The content of detailed discussions was recorded to gain insight into the complexities of palliative treatment plans considered during peer review. Results: Peer review outcomes were reviewed for 1,413 treatment plans with palliative intent. The proportions of detailed discussions and changes recommended were found to be 139 (9.8%) and 29 (2.1%), respectively. The content of detailed discussions and changes recommended was categorized. Major changes represented 75.9% of recommended changes, of which 84.2% were implemented clinically. Conclusion: Many complexities exist that are specific to palliative radiotherapy. Interprofessional peer review provides a forum for these complexities to be openly discussed and is an important activity to optimize the quality of care for patients with treatment plans that have palliative intent.

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