We work with school nurses every day and we heard from many of them that they had a desire for information and resources about independent school health services, but the research simply didn't exist. So we set out to change that. Together with a panel of six independent school health professionals, we developed the 2013-14 Annual Research Questionnaire of Independent School Health Services. And now, we're happy to report, the results are in, analyzed, and available to you in the 2013-14 Annual Report of Independent School Health Services.
It's a great read, but let's face it, 32 pages is a lot of info. So, I've distilled it here so you can have a bird's-eye view of the information in 10 minutes or less. Read the short version here for surface details, and download the full version to read when you have a few more minutes on-hand.
Our research covered seven main areas:
Boarding and day schools of all sizes are represented in the data gathered. Of the 151 schools represented, 78.2% are day schools, and 21.9% are boarding schools. All schools are under 2,000 students, with the average enrollment at 511 students.
The majority of schools (85.4%) are co-ed while boys-only and girls-only represent small percentages, each at 7.3%. Each school was asked to indicate the percentage of the student body with chronic health conditions. Asthma is the most common reported condition at 8.4%, followed by severe food allergies at 4.7%, seizures at 1.2%, and diabetes at 0.4%.
2. Staffing and Facilities
NASN recommends a ratio of 1 school nurse to 750 students. Research respondents indicate their ideal ratio is 1 nurse to 344 students. However, in reality, the actual average ratio is 1 nurse to 426 students. So, reality is better than the recommended ratio, but still not ideal.
Schools also indicated their health center budget, not including salaries. The majority of schools (70.2%) work with a health center budget of $10,000 or less. On the other hand, 5.3% of schools work with a budget of $100,001-$275,000.
Respondents were asked questions aimed at identifying the responsibilities of healthcare providers, as well as how their time is divided amongst various tasks. Questions covered daily responsibilities, such as caring for students and teachers, administrative tasks, and yearly duties including screenings and other school personnel.
On a typical day, 33.8% of respondents handle 1-10 student visits for injuries and illnesses, 28.5% handle 11-20 visits, 27.2% handle 21-40 visits, and 10.6% handle more than 40 visits each day.
Over the course of the year, an average of 64.2% of healthcare providers' time is spent on clinical tasks, 30% is spent on administrative tasks, and 5.6% is spent on miscellaneous tasks.
4. Information Management
The method of information collection and management can impact the amount of time dedicated to administrative tasks (see above that these tasks consume just over 30% of respondents’ time annually). Seventy respondents indicated that they use software to collect records, while 63 stated they still use paper. When it comes to managing those records, 85 schools use software while 42 schools are paper-based. While more schools are utilizing software to collect and manage health information, a considerable number are still using paper, which can contribute to increased time spent on administrative tasks.
5. Parent Compliance
Respondents were asked if their school requires health information to be submitted prior to the student attending class, traveling off-campus, or participating in sports. They were then asked if those policies are enforced and students are truly prohibited from participating in any school activity on or off campus until all required health information is submitted. The answers were different.
Of the respondents, 78.2% said yes, their school does require health information to be submitted before attending class, 88.1% said yes prior to traveling off-campus, and 84.8% said yes prior to participating in sports. However, only 39.1% of schools truly enforce these policies and prohibit students from participating in any school activity prior to submitting all required health information.
6. Policies and Procedures
For this section, questions were aimed at determining if schools have written and published policies on a number of topics, including prescription and OTC medications, immunizations, absences, child abuse, allergies, concussions, contagious disease, head lice, asthma, and many more. Respondents then noted if all health center staff are required to complete training on new or revised health policies and procedures. At 67.6%, most schools do require training. Respondents also noted if health center staff are required to complete an annual performance review - 56.3% said yes.
7. Support and Professional Development
Networking with peers can be invaluable to improving practices and finding guidance. We asked respondents to select the networking activities in which they are able to participate. One-on-one networking is the most common with 78 respondents. Local/regional email listservs are a close second with 77 respondents.