Creative Strategies Employed by the District of Columbia School Health Nursing Program to Enhance Access to Health Care for School-aged Children

Background Children are more likely to experience academic success if they are healthy. School Nurses promote health and wellness while actively collaborating with students, family members, school personnel and community based providers to ensure that the health needs of students are met. School Nurses remain on the frontline of providing health services to children and adolescents. In School Year 2009-2010 the District of Columbia School Health Nursing Program (DCSHNP) reported more than 190,000 visits for nursing services.

Need Although 96.8% of DC children aged 0-18 have either private insurance or managed care coverage, the actual rates of pediatric health care use among children enrolled in DC Managed Care Organizations are significantly low.

Methodology Recognizing that ensuring students' access to quality health care is significant to school nursing practice, and students' potential for academic success, DCSHNP implemented two key strategies to enhance school children's' access to health care: (1) An enhanced staffing plan was implemented to ensure full-time nursing coverage in DC public schools. Currently, 96.30% of public schools have full time nursing coverage. This professional coverage model allows for continuity of care while establishing partnerships with community-based health care providers; and (2)Nurse Case Managers were included in the staffing plan to support school nurses' delivery of comprehensive services. The Nurse Case Managers work collaboratively with health care providers to facilitate immunizations and the renewal of medication and treatment orders for students with chronic conditions.

Results The utilization of the enhanced staffing plan and the addition of Nurse Case Managers have contributed to better disease management, more comprehensive health care for students and an immunization compliance rate of 92.12%.

Learning Objectives 1. Demonstrate the challenges school-aged children have accessing health care. 2. Discuss strategies to enhance students' access to health care. 3. Evaluate strategies for positive healthy outcomes for school-aged children.