Download School health records

School Health Services
Activities to protect and promote
the health of the students
CHS 485
2nd lecture
School health services must be considered to be an important
component of the coordinated school health program.
Generally, the school health services programs include
numerous services that are designed to:
•Appraise the health status of the school children.
•Prevent and control communicable diseases.
•Providing care for school-children who
become sick or injured while at school.
MODEL FOR PROVIDING HEALTH
SERVICRS:
schoollinked
center
school
based
center
Objectives
Is to improve the student's access to primary care.
They are designed to overcome such barriers to obtaining
health care as time scheduling, lack of transportation,
and apprehension which often keep school-age children
from getting proper care during the school day.
The professional roles
The role :
The school nurse
 Can be a valuable help to the classroom teachers by
providing instructional support and serving as a recourse
persons
 Administering first aid instructions.
 Assessing student health complaints.
 Carrying out screening procedures.
Maintain school health records.
The role of the school nurse:
 Provides help to the child who becomes sick or injured
while at school.
 Managing the medical needs of the medically fragile child.
 Managing students' medications during the school day.
 Identifying and referring cases of child abuse and neglect,
and sexual abuse to the proper authorities.
The role of the school nurse:
 Participates in the activities which is designed to identify
children with medical problems and to be involved in the
development of educational programs for these individuals.
This often involves working with teachers, school
administrators, and child's parents to develop an
individualized educational plan.
Participates in developing the school health curriculum .
Works with the school administration to establish policy
for all matters relating to the health.
Effective and timely delivery of such services
is influenced by the number of nurses
available at the school site to respond to
the students’ needs.
The maximum ratio of nurse to student
should be: one school health nurse to no
more than 750 students in the general
school population.
classroom teacher:
The role
Using health service activities as an opportunity to
educate students.
Prepares the students for screening and appraising
activities through organized
instructional units.
The role of the classroom teacher:
As an advocate for child health, the classroom teacher can
play 4 roles:
Observation: Teachers can observe student's physical,
cognitive, social, emotional, and language performance in
comparison to age cohort peers. While a problem might not
be noticed when the child is alone, developmentally
consistence peers can provide an
a valuable frame of reference.
the role of the classroom teacher:
Referral: if the teachers suspect that a health problem
may be a learning impediment, their responsibility
extends to making an appropriate referral .
Gathering information: about the condition as
observed over a period of time.
Follow up the referrals: teachers must be patient and
persistent in their follow up activities. This includes
continuing observation and documentation to support
the work of intervention specialists who are working with
the child.
Health appraisal activities
Appraisal for the health status of an individual is important for
identifying deviations from normal, and conditions that may
have a negative effect on the learning and everyday
functioning .
The classroom teacher should use the various activities
involved in school health appraisal activities as an educational
motivation for students.
Health appraisal activities include:
 health examination: head, neck, chest, abdomen,
legs as well History of the health status
 screening programs which include:
 physical growth and development.
 vision screening.
 hearing screening.
 scoliosis screening.
 disease control and immunizations.
Health examination
School districts should adopt policies
requiring that children have health
examinations before enrolling in school for
first time.
The health examination should provide a
history of the health status of the child and
identify any health problems or allergies that
child might have.
Screening programs:
The health screening activities most
commonly carried out within the school are
inexpensive, can be conducted on a routine
basis, and provide important early information
about potential deviations from normal that
may needed medical attention.
The most commonly found screening
activities are height & weight, vision and
hearing screening, and screening for
scoliosis.
A ) Physical growth and development
Height and weight measurements are
helpful in ascertaining if the children are
experiencing appropriate physiological growth
and development patterns.
School programs enable a variety of growth
disorders to be identified i.e. malnutritionrelated problems, hypothyroidism.
Vision screening:
Poor vision can lead to various behavioral problems
that can have negative effects on academic
performance.
.
Visual defects/problems:
Inflammations , injuries, and refractive error, which is an
error in the focusing of light by the eye and frequent reasons
for reduced visual acuity.

The inflammations:
Conjunctivitis (pink eye):
An inflammation of the conjunctiva
caused by bacteria and viruses. It can
be easily transmitted to others by
rubbing the inflamed eye or by reusing a
washcloth or towel used by the infected
individual. There are effective antibiotic
ointments or drops for bacterial
infection.
Sty:
A red, swollen inflammation of the sebaceous gland on
the edge of the eyelid. Apply hot compresses , ointment
or surgery
Injuries to the eye:
•direct blows to the eyeball or penetration of the eye with
sharp foreign objects.
• chemical injuries by strong acids or alkalis
While prevention is the important factor, the teacher
must be familiar with appropriate emergency care
measures.
Refractive errors:
three basic types of refractive errors:
Nearsightedness(myopia).
Farsightedness (hyperopia)
Astigmatism.
Myopia
 objects at a distance appear to be fuzzy and blurry ,
 but nearby objects are clear .
In this case, the light rays are bent so that they meet short
of the retina,
This may be caused by an eyeball that is too longer or by a
sharply curved cornea.
 It can be corrected by wearing prescription glasses or
contacts lenses.
 corrected by
concave lenses
Hyperopia
 The eyeball may be shorter from front to back and
the light rays cannot be bent enough to focus on the
retina,
 It may also be caused by an insufficiently curved
cornea. The hyperopic individual has difficulty seeing
objects that are nearby clearly.
 corrected by
convex lenses
Astigmatism :
 in this case there is an imperfectly shape cornea, the
light rays focus at different points short of the retina. As a
result , there are various forms of blurring or misshapes.
This error often accompanies myopia or hyperopia.
Corrected by cylindrical lenses
School vision screening
procedures:
 Visual
acuity refers to how well an
individual sees an object at a specific
distance (20 feet = 6 meters). What is
meant by VA 6/18 (Distance /the
smallest size of the letter read).
 The screening environment should
be in a quiet room with normal light
without glare or shadows.
 The Snellen eye chart is the most
commonly used, the least expensive
and the easiest screening test to
perform.
With this procedure , the eye chart
should be placed at eye level at a
distance of 20 feet from where the
individual is standing or sitting. The
student is then asked to identify the
line on the chart at which the
student can read at least 50% of
the letters correctly. Both eyes
should be checked individually.
The acuteness of vision is
reported in the form of a fraction
in which the denominator
indicates the smallest letters, or
symbols, that the individual being
tested can see. The numerator
indicates the distance at which
the test was giving . for example ,
for a reporting of 20/40 ,the 20
indicates that the individual was
tested at 20 feet from the chart
and the 40 indicates the value of
the smallest line of the letters that
could be read. A child with the
reading of less than 20/25 should
be referred to the physician.
Screening for Eye muscle imbalance
involves having the student look at a small target object
held about 15 inches from the face . the individual giving the
test moves the object alternately from eye to eye about ten
times. The screener watches the eye for horizontal and
vertical movement.
Screening for color deficiency :
 the individual being tested must identify a number or
figure made of colored dots within a background of other
colors.
Hearing screening:
Hearing is important during all stages of life, but has particular
impact during the elementary school years when speech
patterns are developing and adaptations first occur outside
the home, Hearing loss can interfere with normal speech and
language development .
What are the indicators for hearing loss problems?
Failure to hear questions posed by the teacher, inattention,
excessive loudness by the child when talking and responding
to others, and turning the head to one side to hear.
Distortion in children's speech is another important early
observation clue for hearing problems.
School hearing loss problems and screening procedures:
They are subjective, unscientific appraisal
procedures but they do assist first hand
hearing screening.
There is two types of hearing loss:
1) A sensorineural loss:
Results from damage to the sensory cells in the cochlea or
the neural pathway between the cochlea and the brain, it is
most likely permanent.
2) A conductive hearing loss :
 it may be the result of a buildup of ear wax in the ear
canal or the presence of a foreign body in the ear canal.
Otitis media, a common cause of conductive hearing loss.
It is usually correctable.
Scoliosis screening:
Scoliosis is a sidewise (lateral) curvature of the spine
that usually begins in the pre-pubertal and adolescent
growth years.
In some cases, the cause may be congenital or the
result of trauma, but in most instance the cause is
unknown.
There are two different types of scoliosis:
Postural and structural.
Postural scoliosis: In this type the spine is structurally
normal, but looks curved because of another condition
such as differing leg length or muscle spasm in the back
muscles. The curve is usually mild and it changes or goes
away when the person bends sideways or forwards.
Structural scoliosis cannot be
corrected actively by individual,
if left untreated it can become
extremely severe and can result
in permanent disability.
Disease control – immunizations
•Seven major childhood infectious diseases that in some
cases could cause permanent disability or death have
been significantly reduced or eliminate today. All of these
diseases are preventable by immunization with safe and
effective vaccines. Today , immunization is required by
law for admission to school in the world.
•The required immunizations prior enrollment in school
include: diphtheria, pertussis, tetanus, polio, measles,
rubella and mumps.
Emergency care for sick and injured students
 Acute onset medical conditions such as asthmatic attack,
diabetic coma, or epileptic seizures, often occurs unexpectedly,
as do unintentional injuries.
School districts should develop written policies that indicate
the specific measures to be taken in such circumstances so
that school personnel know what actions to take to assist their
students. In order for this to occur, school staff members must
be educated about the policies and understand their
responsibilities.
School health records:
There should be a school health record on
a file for every elementary and middle level
schoolchild. These records should be kept in
an appropriate location that assure
confidentiality & makes them accessible to
those who need access to them.
The record should be large enough to
provide space for health history information,
immunization records, the student's
measurements during the school years.
Thank you