Priority health interventions and preparedness: A novel school nurse clinic visit surveillance project in coastal Georgia

Background

The Syndromic Surveillance Program (SSP) of the Georgia Department of Public Health collects chief complaint data from hospitals to characterize health trends in near real time. These data were critical for situational awareness during the 2009 H1N1 pandemic. In 2012, SSP and the Effingham County Schools began a project to collect syndromic surveillance data from school clinics. These data may be used to inform interventions during a pandemic, guide school health programs, elucidate health priorities in school-age populations, and quantify nursing staff needs in schools.

Methods

Every day during Fall 2013, 12 nurses from 12 schools in Effingham County were to enter data into a web-based module for clinic visits that met the following syndrome definitions: Influenza-Like Illness, Rash/Fever, Gastrointestinal, Injury, Asthma, Diabetes, Oral, Mental Health, and Total Daily Visits.

Results

Nurses provided care in 36,067 total visits; 11,979 (33.2%) met at least one of the syndrome case definitions. Injury (3,168, 26.4%) was the most common chief complaint. Visits for asthma ranged from 11.6% of visits in Elementary Schools to 1.7% of visits in High Schools. Diabetes represented 16.1% of all visits, and 24.6% of all Middle School visits.

Conclusions

This project demonstrated that school clinics provide significant care to children and that clinic syndromic surveillance is valuable for preparedness and education programs. Baseline case load may be established, which can be used to identify outbreaks in the future. These data also show that priority targets for school and community programs include injury prevention, asthma, and diabetes control.

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Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Epidemiology
Other professions or practice related to public health

Learning Objectives:
Discuss the challenges in creating a school nurse surveillance system, including organizational and technical hurdles. Define case definitions of syndromes captured in school nurse clinic visit surveillance. Identify health issues affecting students in coastal Georgia. Compare chronic and infectious chief complaints as reported by nurses and how they affect children across elementary, middle, and high school in coastal Georgia.

Keyword(s): Surveillance, School-Based Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have an MPH in Epidemiology from Emory University and serve as the CDC/CSTE Applied Epidemiology Fellow for the Georgia Department of Public Health. I have performed multiple analysis/reports on infectious diseases from Tuberculosis and Trachoma to Rabies Surveillance. I have been working closely with this project and managing the data since July of 2013. I have worked directly with the nurses involved in the study and analyzed the data from the surveillance tool.
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.

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