262259 School nurses' role in asthma management, school absenteeism, and cost savings: A demonstration project

Monday, October 29, 2012 : 1:15 PM - 1:30 PM

Eunice Rodriguez, DrPH , Department of Pediatrics, Stanford University School of Medicine, Stanford University, Palo Alto, CA
Diana Austria Rivera, BA , Department of Pediatrics, Stanford University School of Medicine, Stanford University, Palo Alto, CA
Daniella Perlroth, MD , Department of Medicine - Primary Care Outcomes Research, Stanford University, Stanford, CA
Edmund R. Becker, PhD , Rollins School of Public Health, Department of Health Policy and Management, Emory University, Atlanta, GA
Nancy Ewen Wang, MD , Department of Surgery - Emergency Medicine, Stanford University, Stanford, CA
Melinda Landau, MS , Health and Family Support Programs, San Jose Unified School District, San Jose, CA
     
With increasing budget cuts to education and social services, rigorous evaluation is needed to document the impact of school nurses on student health/academic outcomes and district funding. In this study, a quasi-experimental design was developed in which four schools with added full-time nurses (demonstration) were compared with five schools with part-time nurses (comparison) in San Jose Unified School District (SJUSD). Student data and logistic regression models were analyzed to examine the predictors of absenteeism due to illness for the 2006-07 and 2008-09 academic years. Using SJUSD revenue limit data, we also calculated the aggregate and per student Average Daily Attendance (ADA) funding that was associated with the change in mean rates of absence due to illness from 2006-07 to 2008-09. Results suggest that children with asthma were more likely to be absent due to illness; however when a full-time nurse was added to demonstration schools, the number of absences due to illness dropped while increasing in the comparison schools and yielding an approximately half-day difference in mean absences due to illness by 2008-09. This reduction in mean absenteeism due to illness in the demonstration schools (and increase in comparison schools) equated to a savings of $48,518.62 in ADA funding for 6,081 students in 2008-09. These findings affirm the need to invest and prioritize school health services. Full-time school nurses play an important role in improving the management of asthma and other chronic conditions among students in underserved schools, which can impact school absenteeism due to illness and attendance-related district funding.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Provision of health care to the public
Public health or related nursing
Public health or related research

Learning Objectives:
1. Describe previous research on school nursing and nurse-to-student ratios in the context of diverse student populations with complex health needs. 2. Develop an evaluation model for measuring student outcomes linked to full-time school nurses. 3. Identify strategies to assess the economic impact of full-time school nurses.

Keywords: School Health, School-Based Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I worked closely with Professor Rodriguez the last four years to implement and conduct analysis for the evaluation of the full-time school nurse demonstration project in San Jose Unified School District, and also have past experience in implementing and evaluating other school-based programs. I am a graduate student at UC Berkeley pursuing a concurrent MSW/MPH degree focusing on program planning, evaluation, and advocacy of school-based health interventions and strengthening multi-sector community partnerships.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3267.0: School Health Services: Chronic disease management