State Schools Nursing Service Supporting Transition, Inclusion and Improved Educational Outcomes for Students with Specialised Health Needs in Queensland State Schools Working Together Presented by Geraldine Dyer Helen McCullagh and Kim Bennett
State Schools Nursing Services Queensland s Department of Education and Training (DET) aims to ensure that every young person, including those with disabilities, chronic illness and/or specialised health needs, will be well prepared for life success through learning and education alongside their peers.
State Schools Registered Nurses State Schools -prep to year 12 Referral process Nursing assessment of student s health needs Care planning and implementation of Individual Health Plans (IHPs) 1. Impacts on learning 2. Impacts on camps and excursions 3. Whole of school planning (excursions, formal) Emergency Health Plans (EHPs) Training & ongoing support for school staff Evaluation and reviews
Principal Identifies student with a health need requiring a specialised health procedure Referral to State School Nursing Service Assessment IHP and EHP developed Staff training needs identified Emergency first aid response training and awareness required Specialised Health Procedure training is required School staff volunteer to be trained in procedure Principal identifies staff to complete training required e.g. asthma, epilepsy, diabetes Principal arranges training of school staff Parents may support staff training Yes Voluntary Undertaking Principal applies for supplementary Teacher Aide Funding No Principal and Regional office determine solution for student support Principal arranges refreshers as required
How do we deliver our services? Large groups Education sessions may be delivered to a large group such as the whole of school staff Asthma, Anaphylaxis, Diabetes, Epilepsy Theory and skills assessments Theory undertaken minimum of every 3 years Practical skills reassessed yearly
How do we deliver our services? One on One or Small Groups Student specific procedures: Gastrostomy Colostomy Urinary catheterisation Midazolam administration BGL and Insulin administration Tracheostomy management
Holistic approach and emotional wellbeing Steph Chronic illness linked with- Stigma and stereotypes Student mental health issues & feeling different /isolated Bullying Georgia and Hannah Epilepsy Top 1% of state
Participation in Education Nick Dravet Syndrome Inclusion in social events Inclusion, consideration and planning for needs in sporting carnivals, excursions and camps 8
Participation in Education Alissa - at school Work Experience Ayla- Hip Hop Classes 9
Participation in Education Attendance Inclusion Learning Natasha at Whitsunday Islands Camp with teachers aide Instils confidence Supports friendships Creates opportunities
Challenges to Service Delivery
Challenge of Distance Queensland - 1,852,642 km² Central Qld Region is more than 2.5 times size of Victoria
School staff turnaround Metropolitan 13% 41% Provincial city Rural 50 % of schools are in rural or remote areas 37% Remote highest transfer rates recruitment and retention of staff is difficult 9% limited subject specialist teachers
Metropolitan challenges Traffic Parking difficulties and costs
How do we get there? DIDO-Drive in drive out FIFO-Fly in fly out BIBO-Boat in boat out 15
How do we deliver our services to remote areas? Face to face Teleconferencing Online training (asthma, anaphylaxis) Virtual classrooms 16 DET s online learning centre Diabetes Australia Asthma Australia ASCIA Partner with medical personnel available in local community
Challenge of Weather Alternative transport methods May delay schools accessing assistance Planning/timing for visits around weather e.g. cyclone season Cost of service increases Electricity interruptions frequent in weather events- disruptions to phone or internet.
Population Boom and Bust Mining communities Transient Populations Grazing/farming communitiesdrought Economic pressures Family pressures Limited access to health care in remote settings Towns losing hospital, doctors and services Limited mental health services Poor or very expensive internet School may be the main support
Who do we train? Teacher aides do most of the specialised health procedures in schools Around half of working age Australians have Learning Literacy &Numeracy (LLN) problems State Schools Registered Nurses have Certificate IV in Training and Assessing which incorporates LL&N needs
Language barriers Australian census 2011 19% reported speaking a language other than English at home 2% speak only the other language at home Interpreters used rather than the student for discussions with parents re health issues English as an Additional Language or Dialect (EALD) advisory visiting teachers in schools
Cultural differences Multicultural society 3.6% of Queenslanders identify as Aboriginal or Torres Strait Islander Department of Education and Training Contacts Qld Indigenous Schooling Support Unit Community Education Counsellors Indigenous pathways coordinators Local contacts Indigenous health workers Cultural liaison officers Issues Consent trusting strangers, Face to face contact better Need to be flexible with time allocated for service provision
Health Service versus Dept. Education Regions DET Regions QLD HEALTH Regions
Working together with local health teams Health teams in many different locations Telehealth an option but takes extensive co-ordination to include SSRN
Staff unaware of impact of health issues
Technology issues Inconsistent access Equipment costs School bandwidth unable to keep up with demand Varying staff computer skills
Regional Office Ipswich
Service Delivery in Qld Home to 4.7 million people (March 2015) Second largest state 1,727,000 square kilometres. 1234 State Schools (Nov 2015) 524, 823 students 228,160 secondary school students 7 regions 34.1 (FTE) State Schools Registered Nurses 45 HC
Shaping a School Nursing Service I - Identify the needs, the customers & market the service accordingly N - Negotiate transporting the resource to all locations C - Connect collaborating with student/parents & staff L - Liaise & partnership with key health agencies A - Attendance and academic improvement S - Student and Staff wellbeing building a positive health culture S - Safe practices - promote acceptance, compliance with legislation
Hang in there! 29
Challenges to Service Delivery F Funding, data & allocation U Up skilling & professional development (MOU with Qld Health) T Trends across a broad range of conditions U Use evaluation to drive service quality R Research/evidence based practices E -Educational focus and nursing model
Working together 31
Success S - Select, induct & supervise U- Updated resources, policy / procedure C- Cross correlation of data C- Competency across range of health conditions E- Endeavour to meet rural & remote need S- Support innovative creative practice & knowledge sharing S -Resource development & culture
Using inventive ways to reach goals 33
Celebrating Success I must say, if it weren t for our school s SSRN, we wouldn t be at the stage that we could proudly say we give our Medically At Risk Students a competitive advantage of being able to attend school regularly, without the intervention of their illness. Many thanks to our SSRNs. (Kirwin State High School, Townsville Qld)
Look ahead to identify risks and issues for service delivery Be innovative and creative in your approach to schools 35..or the service will dry up and serve little purpose
Queensland State Schools Nursing Service Department of Education and Training