An Evaluation of Post-Concussion Return to School Guidelines: A Survey of Massachusetts School Nurses

2021 ◽  
pp. 105984052110322
Author(s):  
Jonathan Howland ◽  
Julia Campbell ◽  
Rebekah Thomas ◽  
Steven Smyth ◽  
Aynsley Chaneco ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Medical Center ◽  
School Personnel ◽  
School Nurses ◽  
Return To Play ◽  
Return To School ◽  
Care Providers ◽  
Sports Concussion ◽  
Return To Learn ◽  
Prevention Center

Although all states have legislation pertaining to youth sports concussion, most of these laws focus on return-to-play procedures; only a few address return-to-learn (RTL) accommodations for students who have experienced a concussion. To address this gap in the legislation, some states and nongovernmental organizations have developed RTL guidelines to advise school personnel, parents, and health care providers on best practices for accommodating students' postconcussion reintegration into academic activity. In 2018, the Massachusetts Department of Public Health (MDPH) developed RTL guidelines which were disseminated to school nurses (SNs) at all public and nonpublic middle and high schools in the state. In 2020, the MDPH engaged the Injury Prevention Center at Boston Medical Center to survey Massachusetts SNs to assess the usefulness of the guidelines. The response rate was 63%; 92% found the booklet extremely useful or moderately useful; and 70% endorsed that the booklet fostered collaboration among stakeholders.

scholarly journals Reducing Alcohol and Opioid Use Among Youth in Rural Counties: An Innovative Training Protocol for Primary Health Care Providers and School Personnel

10.2196/21015 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e21015
Author(s):  
Erica Francis ◽  
Kara Shifler Bowers ◽  
Glenn Buchberger ◽  
Sheryl Ryan ◽  
William Milchak ◽  
...  
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Health Care Providers ◽  
School Personnel ◽  
Primary Care Providers ◽  
School Nurses ◽  
Care Providers ◽  
Opioid Use

Background Given that youth alcohol use is more common in rural communities, such communities can play a key role in preventing alcohol use among adolescents. Guidelines recommend primary care providers incorporate screening, brief intervention, and referral to treatment (SBIRT) into routine care. Objective The aim is to train primary care providers and school nurses within a rural 10-county catchment area in Pennsylvania to use SBIRT and facilitate collaboration with community organizations to better coordinate substance use prevention efforts. Methods To build capacity to address underage drinking and opioid use among youth aged 9-20 years, this project uses telehealth, specifically Project ECHO (Extension for Community Healthcare Outcomes), to train primary care providers and school nurses to address substance use with SBIRT. Our project will provide 120 primary care providers and allied health professionals as well as 20 school nurses with SBIRT training. Community-based providers will participate in weekly virtual ECHO sessions with a multidisciplinary team from Penn State College of Medicine that will provide SBIRT training and facilitate case discussions among participants. Results To date, we have launched one SBIRT ECHO project with school personnel, enrolling 34 participants. ECHO participants are from both rural (n=17) and urban (n=17) counties and include school nurses (n=15), school counselors (n=8), teachers (n=5), administrators (n=3), and social workers (n=3). Before the study began, only 2/13 (15.5%) of schools were screening for alcohol use. Conclusions This project teaches primary care clinics and schools to use SBIRT to prevent the onset and reduce the progression of substance use disorders, reduce problems associated with substance use disorders, and strengthen communities’ prevention capacity. Ours is an innovative model to improve rural adolescent health by reducing alcohol and opioid use. International Registered Report Identifier (IRRID) DERR1-10.2196/21015

scholarly journals Experiences Among School Personnel and School Nurses on Educational Adaptations for Students With CFS/ME: A Qualitative Interview Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Wenche Ann Similä ◽  
Torstein Baade Rø ◽  
Torunn Hatlen Nøst
Keyword(s):  
Health Care Providers ◽  
Social Life ◽  
Interdisciplinary Collaboration ◽  
School Personnel ◽  
Chronic Fatigue ◽  
School Nurses ◽  
Care Providers ◽  
Teacher Student ◽  
School Absence ◽  
Qualitative Interview Study

Introduction: Chronic fatigue syndrome (CFS/ME) is a disabling disease severely impacting school attendance, education, and social life in young students. Uncertainties surrounding CFS/ME etiology may impact the interpretation of CFS/ME in schools. Thus, school personnel need information from health care providers to make adequate adaptations to education and social life at school for these students.Objectives: To explore teachers, counselors, and school nurses' experiences with adapting education for students with CFS/ME aged 13–19 in secondary and high schools.Design: A qualitative study with focus group interviews and individual interviews performed face-to-face or digitally between November 2020 and March 2021. Data were analyzed using Systematic text condensation.Participants: Six teachers, two counselors, and four school nurses in secondary and high school participated.Results: Adapting education for students with CFS/ME was challenging, especially before the students received a diagnosis. The challenges were related to identifying the students' adaptational needs, maintaining a teacher-student relationship due to school absence, difficulties in maintaining continuity of education, and uncertainty regarding the diagnosis. Successful adaptations were related to quickly reacting to school absence, early referral to educational, psychological services, a close collaboration with the school management, and the development of digital teaching for students with CFS/ME. Interdisciplinary collaboration and a clear, constructive plan with adaptive measures, including maintained teacher-student communication and educational and social adaptations, may be useful in preventing the losses, young people, with CFS/ME experience.Conclusion: Early interdisciplinary collaboration to adapt education and social life at school for students with CFS/ME, may support teachers, counselors, and school nurses in their efforts to adapt education and prevent losses related to academic and social development in students with CFS/ME.

School Nurses’ Management and Collaborative Practices for Student-Athletes Following Sport-Related Concussion

2018 ◽  
Vol 35 (5) ◽  
pp. 378-387 ◽  
Author(s):  
Michelle L. Weber ◽  
Cailee E. Welch Bacon ◽  
Tamara Valovich McLeod
Keyword(s):  
Secondary School ◽  
Health Care Providers ◽  
Student Athletes ◽  
Online Survey ◽  
School Nurses ◽  
Care Providers ◽  
Concussion Management ◽  
Management Plans ◽  
Return To Learn ◽  
Attitudes And Knowledge

The purpose of this study was to examine school nurses’ management and collaboration with health-care providers (HCPs) for student-athletes following a concussion. Secondary school nurses accessed an online survey titled the Beliefs, Attitudes, and Knowledge of Pediatric Athletes with Concussions (access rate = 15.6%; n = 1,246/8,000). Approximately 40% of schools where nurses were employed administered baseline and postinjury concussion assessments. No significant differences were found between employment model (single vs. multiple sites) in regard to conducting baseline ( p = .908) administration at their site; however, those employed at a single school more frequently offered postinjury assessments at their site than those at multiple sites ( p = .019). School nurses most frequently reported relationships with an athletic trainer (38.8%, n = 483/1,246) compared to other HCPs. A concussion management team, including school nurses, and other recommended members should develop comprehensive concussion management plans. Plans should comprise of multiple concussion assessments to aid in the return-to-learn/play processes.

scholarly journals Reducing Alcohol and Opioid Use Among Youth in Rural Counties: An Innovative Training Protocol for Primary Health Care Providers and School Personnel (Preprint)

2020 ◽  
Author(s):  
Erica Francis ◽  
Kara Shifler Bowers ◽  
Glenn Buchberger ◽  
Sheryl Ryan ◽  
William Milchak ◽  
...  
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Health Care Providers ◽  
School Personnel ◽  
Primary Care Providers ◽  
School Nurses ◽  
Care Providers ◽  
Opioid Use

BACKGROUND Given that youth alcohol use is more common in rural communities, such communities can play a key role in preventing alcohol use among adolescents. Guidelines recommend primary care providers incorporate screening, brief intervention, and referral to treatment (SBIRT) into routine care. OBJECTIVE The aim is to train primary care providers and school nurses within a rural 10-county catchment area in Pennsylvania to use SBIRT and facilitate collaboration with community organizations to better coordinate substance use prevention efforts. METHODS To build capacity to address underage drinking and opioid use among youth aged 9-20 years, this project uses telehealth, specifically Project ECHO (Extension for Community Healthcare Outcomes), to train primary care providers and school nurses to address substance use with SBIRT. Our project will provide 120 primary care providers and allied health professionals as well as 20 school nurses with SBIRT training. Community-based providers will participate in weekly virtual ECHO sessions with a multidisciplinary team from Penn State College of Medicine that will provide SBIRT training and facilitate case discussions among participants. RESULTS To date, we have launched one SBIRT ECHO project with school personnel, enrolling 34 participants. ECHO participants are from both rural (n=17) and urban (n=17) counties and include school nurses (n=15), school counselors (n=8), teachers (n=5), administrators (n=3), and social workers (n=3). Before the study began, only 2/13 (15.5%) of schools were screening for alcohol use. CONCLUSIONS This project teaches primary care clinics and schools to use SBIRT to prevent the onset and reduce the progression of substance use disorders, reduce problems associated with substance use disorders, and strengthen communities’ prevention capacity. Ours is an innovative model to improve rural adolescent health by reducing alcohol and opioid use. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/21015

A Scoping Review and Content Analysis of Common Depressive Symptoms of Young People

2021 ◽  
pp. 105984052110126
Author(s):  
Jia-Wen Guo ◽  
Brooks R. Keeshin ◽  
Mike Conway ◽  
Wendy W. Chapman ◽  
Katherine A. Sward
Keyword(s):  
Content Analysis ◽  
Depressive Symptoms ◽  
Young People ◽  
Health Care Providers ◽  
Scoping Review ◽  
School Nurses ◽  
Future Research ◽  
Depression Symptom ◽  
Care Providers ◽  
Five Dimensions

School nurses are the most accessible health care providers for many young people including adolescents and young adults. Early identification of depression results in improved outcomes, but little information is available comprehensively describing depressive symptoms specific to this population. The aim of this study was to develop a taxonomy of depressive symptoms that were manifested and described by young people based on a scoping review and content analysis. Twenty-five journal articles that included narrative descriptions of depressive symptoms in young people were included. A total of 60 depressive symptoms were identified and categorized into five dimensions: behavioral ( n = 8), cognitive ( n = 14), emotional ( n = 15), interpersonal ( n = 13), and somatic ( n = 10). This comprehensive depression symptom taxonomy can help school nurses to identify young people who may experience depression and will support future research to better screen for depression.

Application of Components of the Massachusetts’ Sports Concussion Regulations to All Students With Concussion: A Survey of School Nurses

2018 ◽  
Vol 36 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Holly Hackman ◽  
Jonathan Howland ◽  
Alyssa Taylor ◽  
Linda Brown ◽  
Mary Ann Gapinski ◽  
...  
Keyword(s):  
High School ◽  
Confidence Interval ◽  
Focus Groups ◽  
Odds Ratio ◽  
School Nurses ◽  
Sports Concussion ◽  
Medical Clearance ◽  
Return To Learn ◽  
Two Measures ◽  
Academic Implications

Appropriate management by schools of all students with a concussion, regardless of the cause, has not received the same attention as sports-related concussions. Focus groups conducted with Massachusetts School Nurses in 2015 found that some had applied protocols required in the state’s sports concussion regulations to all students with concussion, not just student athletes. We surveyed high school nurses in Massachusetts to examine (1) the extent of this practice and (2) the extent to which protocols for all students with concussion are included in school policies. Of 168 (74%) responding, 94% applied the return-to-learn and play, and medical clearance requirements to all students with concussion, regardless of how or where the concussion occurred and 77% reported their school’s policy required these protocols for all students with concussion. A significant association (odds ratio: 13.3, 95% confidence interval [2.4, 72.8], p <.01) existed between the two measures. These findings have important clinical and academic implications.

Abstract 2197: Telestroke: Optimizing Access to Emergency Interventions in Acute Stroke Care

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Rayetta Johnson
Keyword(s):  
Quality Improvement ◽  
Acute Stroke ◽  
Health Care Providers ◽  
Positive Impact ◽  
Medical Center ◽  
Stroke Care ◽  
Nurse Specialist ◽  
Care Providers ◽  
Acute Stroke Care ◽  
Evidenced Based

Background and Issues: The burden of stroke in North Carolina is one of the highest in the nation (approximately 28,000 stroke hospitalizations from 2003-2007). The number and high costs of stroke have made it incumbent to improve the numbers of patients receiving effective treatment. There are two major barriers for treatment of acute stroke: time and access. The utilization of telestroke in community hospitals aids in decreasing these barriers by providing immediate access to a stroke neurologist. In order for telestroke to be successful, awareness and education regarding acute stroke care must be provided for health care providers as well as the communities. Thus, the development of a telestroke system requires nursing and medical expertise. The Primary Stroke Center Team at Wake Forest Baptist Medical Center in Winston-Salem, N.C. implemented a telestroke network system (Intouch's Health's RP-7 Robotic system) in January of 2010 to provide 24/7 access to the medical center's acute stroke experts and the latest advancements in stroke interventions. There are eight hospitals in the network at the present time. Methods: Our team identified that many of the network hospital's staff are not experienced in taking care of a stroke patient and that a “roadmap” is useful to guide them in these steps.The stroke nurse specialist developed a quality improvement plan for the network hospitals which included: an evidence-based algorithm for patient care; stroke education, in particular, neurological assessment and tPA administration classes for the ED staff; quarterly meetings to provide outcome and feedback data with each network hospital; stroke awareness events for the community. Mock telestroke consults were also performed prior to “going live” with telestroke for each of the network hospitals. Of utmost importance is the early involvement and education of the EMS system in the respective county of the network hospital. The buy-in of EMS was found to be a key component in the success of the network. Finally, attention to customized quality improvement efforts for each of the facilities are required to accomplish integration into the telestroke network. Results: The data has been analyzed, and thus far, a 24% rate of tPA administration has been seen with our network hospitals (an increase from the 3.6% national average). Comparisons between each of the eight network hospitals' rates of administration of tPA prior to and after joining the network show a trend of increase (10%-40%). The effectiveness of the algorithm has also been explored by analysis of feedback and initial results have shown a positive impact. Conclusion: A combination of improving access to stroke neurologists in conjunction with a focus on improving the level of care via evidenced based stroke care teaching and implementation of algorithms at a network hospital is required for implementing and building a successful telestroke network.

scholarly journals An Integrative Review of the Influences on Decision-Making of Young People About Human Papillomavirus Vaccine

2018 ◽  
Vol 35 (1) ◽  
pp. 39-50
Author(s):  
Helen Sisson ◽  
Yvonne Wilkinson
Keyword(s):  
Decision Making ◽  
Human Papillomavirus ◽  
Parental Involvement ◽  
Health Care Providers ◽  
Hpv Vaccine ◽  
Hpv Infection ◽  
School Nurses ◽  
Human Papillomavirus Vaccine ◽  
Care Providers ◽  
To Receive

The human papillomavirus (HPV) vaccine is a key intervention in the prevention of HPV infection and associated cancers. This review emphasizes the importance of understanding what influences decision-making about this vaccine. Guided by the work of Whittemore and Knafl, and Pluye and Hong, we identified 25 studies, from which four prominent themes emerged: fear and risk, pain, parental involvement, and involvement of others. Fear of cervical cancer was a strong motivation to receive the vaccine, and the extent of parental involvement also had an impact on decision-making. Recommendations to receive the vaccine by health-care providers were also an important influence. School nurses are fundamental to the promotion and delivery of the HPV vaccine and should stress the significant role that it plays in the prevention of cancer. Additionally, school nurses should ensure that discussions about HPV infection and vaccine include parents where appropriate and should distinctly recommend vaccination to those eligible.

scholarly journals Knowledge of Surgical Informed Consent and Associated Factors among Patients Undergone Obstetric and Gynecologic Surgery at Jimma Medical Center, Jimma, Oromia Region, Ethiopia, 2020. An Institutional Based Cross-Sectional Study.

2021 ◽  
Author(s):  
Belete Fenta Kebede ◽  
Tsegaw Biazin Tesfaye ◽  
Aynalem Yetwale Hiwot
Keyword(s):  
Informed Consent ◽  
Health Care Providers ◽  
Associated Factors ◽  
Medical Center ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Outcome Variable ◽  
Gynecologic Surgery ◽  
Care Providers ◽  
Cross Sectional

Abstract Introduction: The practice of informed consent before any surgical procedure should form the fundamental element that serves to protect both patient and surgeon from prosecution. Several factors can affect the process of surgical informed consent. Knowledge towards surgical informed consent is one important factor. It is worth mentioning that patients’ understanding of the information provided in the consent form is a prerequisite for obtaining valid informed consent, otherwise, it will be only symbolic. The study aimed to assess knowledge of surgical informed consent and associated factors among patients who undergone obstetric and gynecologic surgery at Jimma Medical Center, Jimma, Oromia Region, EthiopiaMethodology: Institutional based crossectional study was conducted among systematically selected women undergo obstetrics and gynecologic surgery in Jimmy medical center from April 1 to May 30, 2020. The collected data were coded, entered into Epi data version 3.1, and analyzed using SPSS version 25. Bivariate and multivariate regression was carried out to determine the association between an outcome variable and an independent variable. Tables, pie -charts, and texts were used to report the result.Results: This study revealed that the mean age of the respondents was 29.5 ±3.5 years and the majority of them (83.3%) were married. The respondents had significantly poor overall knowledge of surgical informed consent 77.2 %( 95%CI: 72.8-81.2).Patient educational status (AOR: 1.22 (95%CI: 1.1-2.47), satisfaction level (AOR: 1.823(95%CI: 1.061-3.134).and patient- provider relation-ship (AOR: 0.472(95%CI: 0.271-0.822) were associated with knowledge of surgical informed consent.Conclusion: in this study, the overall level of knowledge regarding surgical informed consent was significantly poor than the other national and international figures. Patient Education, satisfaction, and patient-provider relation-ship were associated with knowledge of surgical informed consent. Health care providers should provide adequate information before surgery to improve patients’ knowledge regarding surgical informed consent and provide adequate input on ways to improve the consent process to make it better suited to fit the needs of all patients.

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