Emergency Medication Access and Administration in Schools: A Focus on Epinephrine, Albuterol Inhalers, and Glucagon

Access to emergency medications is a growing concern, particularly regarding the availability, safety, and use of these medications in schools. The purpose of this article is to report results not previously published from a national survey, specifically regarding the emergency use of epinephrine, albuterol inhalers, and glucagon. A nonexperimental, cross-sectional design was utilized for this descriptive study. An online survey was distributed to school nurses in 2015, and data from 6,298 school nurse respondents are presented in the analysis. Findings related to stock and student-specific emergency medication use and storage, epinephrine usage data, and delegation of emergency medication administration to unlicensed assistive personnel are presented in this article. Further development of policies and procedures regarding emergency medication administration in schools is needed. School nurses are a valuable resource for obtaining knowledge in this area and keeping students safe at school.

Increasing colorectal cancer screening orders using unlicensed assistive personnel

BackgroundColorectal cancer (CRC) is among the leading cancer diagnoses affecting both men and women worldwide. Prevention and early detection of CRC is possible by increasing access to and utilisation of screening tests. Although CRC screening is highly recommended, screening rates remain suboptimal in the USA, particularly among underserved populations. Our project site, an urban federally qualified health centre, was not meeting the national screening target of 80% of eligible adults.ObjectiveThe aim of this quality improvement project was to increase the number of orders for CRC screening to eligible patients by using unlicensed assistive personnel and automated telephone outreach calls to offer 100 patients CRC screening during an 8-week period.Methods40 patients received outreach calls from care coordinators (CC). 40 patients received automated telephone call reminders to call a CC to obtain an order for CRC screening. 20 patients were offered CRC screening by a medical assistant (MA) as part of their scheduled office visits. We used two plan-do-study-act (PDSA) cycles to deliver these three screening interventions.ResultsA total of 100 patients received one of the interventions. Ten of those patients received an order for either colonoscopy or faecal immunochemical testing by the conclusion of the second PDSA cycle. The MA-offered screening resulted in the highest percentage of patients accepting CRC screenings and patients preferred this outreach approach compared with CC outreach or automated voice messages. CC outreach yielded a lower rate of accepted screenings. None of the patients who received the automated calls followed up to obtain a screening order.ConclusionOur project demonstrates that unlicensed assistive personnel have the potential to increase patient access to CRC screening.

A Descriptive Study of Differing School Health Delivery Models

The purpose of this exploratory qualitative study was to identify and describe emerging models of school health services. Participants ( N = 11) provided information regarding their models in semistructured phone interviews. Results identified a variety of funding sources as well as different staffing configurations and supervision. Strengths of the new models included an increase in school nurses and improved communication between schools, public health agencies, and health providers. Challenges for nurses practicing in the new models included not feeling connected to the school and unclear roles of unlicensed assistive personnel. Additional research is recommended to determine the effectiveness of new models. This continued study can provide insight and guidance to schools struggling to meet student health concerns.