Frequent Flyers Nancy Nadel Sharon-rose Gargula Nadel and Gargula 2012.

Frequent Flyers Nancy Nadel

Sharon-rose Gargula

Nadel and Gargula 2012

The student will decrease unscheduled non-acute care visits to the nurse.


Unscheduled Non emergency Unnecessary No significant complaint


Chapped lips Invisible injuries Stomach aches just

before lunch Paper cut Frequent visits out

of the same class for vague complaints

Picking scab off healing cuts

Personal female care

Symptoms that just started 1 minute ago


Scheduled medication Scheduled treatment Asthma attack Chronic Illness care (diabetes, seizures) Fever Vomiting Chest Pain Injury requiring first aid Significant mental health crisis


Choose a group of students (between 10-150) that are at risk for frequent visits

Hint- the larger the group the better the outcome will be

Use eschool or DSC to determine who will be at risk

Past frequent flyer New student to the

building who has found their way to you


50% of the selected cohort will show improvement over a defined period of time with a minimum of 4 weeks.

If your cohort is 20, then a minimum of 10 students will have a decrease in their unscheduled office visits by at least one visit during the second time frame you have chosen to measure.


Any visit to the nurse

Include time of visit and length of visit

Chief complaints Is it vague or

specific? Is it medically

necessary?

Discuss with the student what the ultimate goal is for this visit (rest, pain free, go home)

Where is the student coming from or where is the student supposed to be going?


History, including onset of complaint

Care provided at home

If an injury, where did it happen?

Are parents aware of the illness/injury?

How is this interfering with outside activities?

Physical assessment

Staff conference: what is the teacher seeing in the classroom?

How often is the student leaving the classroom?

Is the teacher aware that the student has come to the health suite?


Choose 2 equal points in time Min 4 weeks max is school year Example Nov 1st-30th and April 1st-30th or 1st MP and

3MP

Compare the number of visits for the cohort (identified students)

Improvement can be by a single visit!


Identify the real reason for the visit. Look for patterns such as a common time Is there a substitute teacher? Is it the same teacher who is making

excessive referrals? Ensure medication availability and

compliance


Educate the student about acceptable reasons for visiting the nurse

Identify a motivator for staying in class which might include a reward system

Develop an IHP Teach student self care and facilitate a

means for this to happen Consider scheduling a time for an office

visit, just to check in


Is there a plan for the substitute teacher and what to do with students who are frequent flyers?

Educate teachers on proper referrals - decision tree

Make teacher aware of excessive referrals

Attend PLC’s Utilize support staff,

IST, guidance counselor

Speak with administration about support for teachers


Communicating concerns, genuine caring for student’s well being

Obtain a health history.

Set common goals with parent.

Conference with parents/teacher & nurse

Encourage parents to follow-up with PCP to rule out any physical cause for the student complaint.

Mental health issues if untreated can cause physical symptoms


Students showing improvement

___________________ Total number of

students Acceptable growth rate is 50% - unless you chose something else in agreement with your administrator


School nursing started with the premise that healthy children should be in the classroom and sick students should be at home.

By decreasing the frequency of non emergent visits we are supporting our teachers and helping students become successful.

The documentation for this indicator can lead to data for other indicators

We can combine this indicator with other indicators.


Frequent Flyers Nancy Nadel Sharon-rose Gargula Nadel and Gargula 2012.

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