2 Objectives Define childhood chronic illness. Enlist the common chronic diseases in children. List the differences between acute and chronic conditions Understand the HAAD policy for school health. Explain the chronic care models. Describe how to prevent chronic illness. Enumerate the role of school nurse. 2
3 Outline Introduction Define chronic childhood illness. Effects of chronic illness on schooling. List common chronic illness in children. Difference between acute and chronic Conditions. Chronic care model. Policy of HAAD school health services. Teamwork is the key to success. Prevention of chronic illness. Screening for the children Conclusion
4 Introduction The links between health and education are well established. Healthy children are better able to learn, and strong health is highly associated with higher educational achievement. therefore work very closely with education and healthcare professionals to improve the health and learning outcomes for children and young people and make schools a healthy place to learn, work and play.
5 Introduction Chronic condition is an "umbrella" term. Children with chronicillnessesmaybeillorwellatanygiventime,but they are always living with their condition. Chronic illnesses affect at least 10 to 15 percent of American children. Responding to the needs of students with chronic conditions such as asthma, allergies, diabetes, and epilepsy (also known as seizure disorders
6 Continuation All children have different health problems during infancy and childhood, but for most children these problems are mild, they come and go, and they do not interfere with their daily life and development. For some children, however, chronic health conditions affect everyday life. Children with chronic illnesses attend school, and some of them struggle academically because of issues related to their health.
7 What is a chronic condition? Chronic illness is defined as an illness that is long term and is either not curable or has residual features that result in limitations in daily living requiring special assistance or adaptation in function (Jessup and Stein)
8 What is a chronic childhood illness? A chronic childhood illness can be defined as a medical condition that is long term or permanent, and is rarely able to be completely cured. A child with a chronic illness may be ill or well at any given time, but he is always living with the condition. Examples include asthma, epilepsy, diabetes, Crohn's diseaseand cystic fibrosis.
9 Continuation Such chronic illnesses affect the child's lifestyle, and parents will be required to deal with the child's health needs on a daily basis. Chronic illness usually requires regular medical treatment, and sometimes long hospital stays. Once the illness is routinely managed, most children can function well and live relatively normal lives.
10 Chronic Illness in America More than 125 million Americans suffer from one or more chronic illnesses and 40 million limited by them. Despite annual spending of well over $1 trillion and significant advances in care, one-half or more of patients still don t receive appropriate care. Gaps in quality care lead to thousands of avoidable deaths each year.. Patients and families increasingly recognize the defects in their care.
11 In a classroom of 30 children, 2 or more children are likely to have chronic illness
12 Common chronic childhood diseases Asthma (the most common) Diabetes Cerebral palsy Sickle cell anemia Cystic fibrosis Cancer. AIDS. Epilepsy. Spina bifida. Congenital heart problems.
13 How do kids adjust to and cope with chronic illnesses? Children reaction to diagnosis depends on several factors, which includes the child s personality, the specific illness, and their family. One big factor is the child s developmental stage. Children's understandings of illness and their coping strategies change as they grow older. Students with chronic health conditions can function to their maximum potential if their needs are met.
14 Effects of chronic illness on schooling When a child is away from school because they have been in hospital, or at home recovering, or going to medical appointments, they may find it difficult to: Complete learning activities or sit exams Maintain academic performance Take part in school activities such as sports or excursions Maintain school friendships Stay confident, positive and motivated
15 Effect on the Child The effect of chronic illness, on your child will depend on a number of things, which includes : type of illness what support you have child's age level of maturity, and individual temperament. How you as a family cope with the situation, and your attitude toward the illness, can make a big difference in helping your child to manage the emotional impact.
16 Differences Between Acute and Chronic Conditions ACUTE CHRONIC Beginning Rapid Gradual Cause Usually one Many Duration Short Indefinite Diagnosis Diagnostic tests Treatment Commonly accurate Often uncertain Often decisive Often limited value Cure common Cure rare
17 Differences Between Acute and Chronic Care Roles Role of Professional ACUTE Select and conduct therapy CHRONIC Teacher/coach and partner Role of Patient Follow orders Partner/ Daily manager
18 Necessary functions for chronic care Be organized by patient; not disease, but responsive to disease Populations contain data relevant to clinical practice Assist with internal and external performance reporting Guide clinical care first, measurement second!
19 Healthy Learner Model The Healthy Learner Model for Chronic Condition Management provides a framework to eliminate the disjointed approach to diabetes management at school, replacing it with a consistent, evidence-based approach. A diabetes resource nurse provides support for the school nurse and collaborates between the school, community, family, and health care providers.
20 The Care Model Community Resources and Policies Health System Health Care Organization Self- Management Support Delivery System Design Decision Support Clinical Information Systems Informed, Empowered Patient Productive Interactions Prepared, Proactive Practice Team You are here Improved Outcomes
21 Chronic Care Model Community Resources and Policies Self- Management Support Health System Health Care Organization Delivery System Design Decision Support Clinical Information Systems Informed, Activated Patient Productive Interactions Prepared, Proactive Practice Team Improved Outcomes
22 Self-management Support Emphasize the patient's central role. Use effective self-management support strategies that include assessment, goal-setting, action planning, problem-solving and follow-up Organize resources to provide support
23 Delivery System Design Define roles and distribute tasks amongst team members. Use planned interactions to support evidencebased care. Provide clinical case management services. Ensure regular follow-up. Give care that patients understand and that fits their culture
24 Features of case management Regularly assess disease control, adherence, and self-management status Either adjust treatment or communicate need to primary care immediately Provide self-management support Provide more intense follow-up Provide navigation through the health care process
25 Decision Support Embed evidence-based guidelines into daily clinical practice. Integrate specialist expertise and primary care. Use proven provider education methods. Share guidelines and information with patients.
26 Clinical Information System Provide reminders for providers and patients. Identify relevant patient subpopulations for proactive care. Facilitate individual patient care planning. Share information with providers and patients. Monitor performance of team and system.
27 Health Care Organization Visibly support improvement at all levels, starting with senior leaders. Promote effective improvement strategies aimed at comprehensive system change. Encourage open and systematic handling of problems. Provide incentives based on quality of care. Develop agreements for care coordination.
28 Community Resources and Policies Encourage patients to participate in effective programs. Form partnerships with community organizations to support or develop programs. Advocate for policies to improve care.
30 Teamwork is the key to success Student Parents SCHOOL NURSE Medical Care Classroom teacher, PE teacher, coach, principal, after-school staff
31 Teamwork is the key to success children and their families adapt well to chronic illnesses over time (Lewis & Vitulano, 2003). However, frequent hospitalizations, fatigue, anxiety, pain, and other symptoms can put children at risk for academic problems and health complications, particularly when they are first diagnosed. interventions play an important role in ensuring that students with chronic illness have the same educational opportunities as other students.
32 Continuation particularly school nurses, must partner with parents and health care providers to help children to manage their illness and participate fully in academic and extracurricular activities. They can implement strategies that reduce disruption to the school day, ensuring the school environment is safe, and providing case management when indicated (Special Report, 2003).
33 Policy of HAAD school health services Promote the health & well-being of children and adolescents; Improve access to appropriate school health services; and Enable children and adolescents develop healthy behaviors to prepare them for all life stages.
34 Role of School nurse School nurses do more than just sticking a Band-Aid. They serve as someone special when kids becomes ill and things get tough. "It's almost like being in an ER; you never know what's going to come in," Gloria Reynolds said. Screening is conducted by the School Nurse at the school on a annual basis.medical History, Body Mass Index (BMI percentile), Vision Screening (Eyesight test).
35 Role of School nurse The glue and the liaison between the family, hospital and school. Help educate staff, students and others about the child s health care needs. Monitor blood sugars, medication administration, peak flow meters and rest time during the school day.
36 Continuation Maintains the screening details in BMI & Waist Circumference, History, Measurements, Sensory Screening, Physical Examination( HAAD School Health) Ensure the planning of potential emergencies or special circumstances in advance
37 Prevention The latest global school surveys conducted by WHO show that a third of the adolescent population (11 to 13 years old), across the emirate of Abu Dhabi are either overweight, or are border line overweight. conduct screening for all students from Grade 1-12 are required to receive the following screening tests on an annual basis Medical History, Body Mass Index (BMI percentile), Vision Screening (Eyesight test).
38 Continuation can identify carriers of SCD and genetic counseling can help to make couples at risk aware of the disease., education, prevention and early intervention in childhood help reduce the risk of death from complications of SCD. These aims the prevention from diseases
39 Prevention Ensure early and comprehensive prenatal nutrition & health care. Encourage healthy eating habits beginning at an early age. Incorporate physical activity into daily to prevent the sedentary lifestyle associated with obesity. Enable early diagnosis of developmental delays or mental illness to improve access to programs designed to help children with these conditions. Importance of regular medical care
40 Together we can make a difference Disease -friendly policies and procedures Healthy school environment Chronic illness education for students and staff(eg. Asthma ) Open communication (school, parent, health care provider)
41 Conclusion Coordination of care for children with special healthcare needs can be realized using existing resources. Using cystic fibrosis as an example, implementation methods within pediatric primary care practices are presented and discussed. Prevention better than cure, School health nurse is a role model for caring children with childhood illness.
42 References Arnold M, Silkworth C(1999) The school nurse source book of individualized health care plans: Volume 2 (Sunrise River, Northfield, MN).
43 Continuation Fleitas, J. [a] Band-Aides and Blackboards: Health Education Resources. Isaacs, D., & Sewell, J. R. (2003). Children with chronic conditions. Medical Journal of Australia, 179, The Journal of School Nursing, , first published on December 28, pdf
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