management of chronic diseases at school...
TRANSCRIPT
Management of chronic diseases at school settings
Lecture #10
CHS 485
Ms. Ghada M. AlSwayied
Role of schools in Asthma management
What is Asthma ?
- Asthma is a chronic lung disease that affects the airways.
- Children with asthma have airways that are inflamed.
- Inflamed airways are very sensitive, so they tend to react strongly
to things called “triggers.”
narrower
ess air getting through to the lungs
occasionally
all the time
●
●3.2 million or approximately 6
percent of children ages 5 to 17 had an asthma episode (attack) in the preceding year
● important role
Asthma
Why to be concerned about Asthma in School?
❏ Uncontrolled asthma can result in reduced performance for the child with asthma and disruptions for the entire classroom.
❏ Students with asthma can function to their maximum potential if their needs are met. The benefits to students include- better attendance- improved alertness- fewer symptoms- fewer restrictions on participation in physical activities & special events, such as field trips.
- fewer medical emergencies.
● A supportive learning environment for students with asthma.
● Reduced absences—students have fewer episodes and symptoms are treated earlier.
● Reduced disruption in the classroom— students have fewer symptoms when they adhere to their asthma action plan.
● Appropriate emergency care—school staff members know how to respond to emergencies.
● Full student participation in physical activities— physical education (PE) instructors and coaches know how to prevent exercise induced asthma.
What to expect from effective asthma management in school settings?
Develop an Asthma Management Program in Your School
A management program should contain:
•A confidential list of students who have asthma.
•School policies and procedures for administering medications, including protocols for emergency response to a severe asthma episode.
•Specific actions for staff members to perform in the asthma management program.
•A written action plan for every student with asthma.
•Education for staff and students about asthma.
Actions for the Principal or School Administrator
1.Help children with asthma and their families manage Asthma.
2.Teach staff, students, and families about Asthma.
3.Keep the environment clear of Asthma-provoking substances.
● Developing an indoor air quality (IAQ) management plan.
● Inspect the building regularly for signs of mold, moisture, leaks, or spills.
● Establish and follow a regular cleaning and maintenance schedule.
● Enforce smoking bans on school property.
● Schedule extensive building repairs, pesticide applications, renovations, or cleaning when the building is unoccupied to avoid exposing students to fumes, dust, and other irritants.
Keep the Environment Clear of Asthma-Provoking Substances by:
Actions for the School Nurse/ Health educator
•Identify students with asthma.
•Talk with teachers to help them become familiar with the needs of students who have asthma.
•Maintain an asthma action plan for every student with asthma.
•Suggest referral to their physician when needed.
•Communicate with parents or guardians and health care about acute episodes.
•Have an emergency backup plan.
•Use a peak flow meter to monitor daily management of asthma
What is a peak flow meter?
A peak flow meter is an inexpensive, portable, handheld device for those with asthma that is used to measure how well air moves out of your lungs.
Its works by measuring how fast air comes out of the lungs when you exhale forcefully after inhaling fully. This measure is called a "peak expiratory flow," or "PEF."
Keeping track of your PEF, is one way you can know if your symptoms of asthma are in control or worsening.
Actions for the Classroom Teacher
•Consult with your school nurse for managing students with chronic health conditions.
•Educate all students about lung health and asthma.
•Know your role.
•Be alert for signs of uncontrolled asthma.
•Plan field trips and other activities in a way that ensures students with asthma can fully participate.
•Alert school administrators, school nurses, and parent(s) or guardian(s) of changes in a student’s performance or behavior that might reflect trouble with asthma.
•Encourage the student with asthma to participate fully in physical activities.
Role of schools in Diabetes management
Diabetes Mellitus
Diabetes is one of the most common chronic diseases in school-aged children, affecting about 200,000 young people in the United States.
According to recent estimates, about 19,000 youths are diagnosed with type 1 and type 2 diabetes each year.
Diabetes is a serious chronic disease in which blood glucose levels are above normal due to defects in insulin production, insulin action, or both.
Although there is no cure, diabetes can be managed and complications can be delayed or prevented.
Diabetes must be managed 24 hours a day, 7 days a week. For students that means careful monitoring of their blood glucose levels throughout the school day and administering multiple doses of insulin by injection or with an insulin pump to control their blood glucose and minimize complications.
As a result, coordination and collaboration among members of the school health team and the student’s personal diabetes health care team are essential for helping students manage their diabetes in the school setting.
Diabetes Mellitus
What Is Effective Diabetes Management at School?
According to the US National Diabetes Education Program:
● Maintaining optimal blood glucose control.
● Assisting the student with performing diabetes care tasks.
● Designating trained diabetes personnel.
Maintaining optimal blood glucose control
The goal of effective diabetes management is to control blood glucose levels
by keeping them within a target range determined by the student’s personal
diabetes health care team.
Optimal blood glucose control helps to promote normal growth and
development, and to prevent the immediate dangers of glucose levels that
are too high or too low. Maintaining blood glucose levels within the target
range also can help prevent or delay the long-term complications of diabetes
such as: heart disease, stroke, blindness, kidney failure, gum disease, nerve disease, and
amputations of the foot or leg.
Maintaining optimal blood glucose control
The key to maintaining optimal blood glucose control is to balance carefully
food intake, physical activity, insulin, and/or medication. As a general rule, food
makes blood glucose levels go up. Physical activity, insulin, and diabetes
medications make blood glucose levels go down. Several other factors, such
as growth and puberty, physical and emotional stress, illness, or injury, also can
affect blood glucose levels.
Maintaining optimal blood glucose control
Students with diabetes should check their blood glucose levels throughout
the day using a blood glucose meter and/or a sensor if prescribed.
The meter gives a reading of the level of glucose in the blood at the time it is
being monitored. When blood glucose levels are too low (hypoglycemia) or too
high (hyperglycemia), students need to take corrective actions.
Low blood glucose levels, which can be life threatening, present the greatest
immediate danger to people with diabetes.
Assisting the Student with Performing Diabetes Care Tasks
Many students will be able to handle all or almost all of their nonemergency
diabetes care tasks by themselves. Others, because of age, developmental
level, or inexperience, will need help from school personnel.
In addition to the routine care required to meet daily needs, diabetes
emergencies may happen at any time. School personnel need to be
prepared to provide diabetes care at school and at all school-sponsored
activities in which a student with diabetes participates.
The school nurse / health educator is the most appropriate person in the
school setting to provide care for a student with diabetes. Many schools,
however, do not have a full-time nurse, and sometimes a single nurse must
cover more than one school. Moreover, even when a nurse is assigned to a
school full time, she or he may not always be available during the school day,
during extracurricular activities, or on field trips.
The school nurse or qualified health care professional
plays a major role in selecting and training
appropriate staff and providing professional
supervision and consultation regarding routine and
emergency care of the student with diabetes.
Nonmedical school personnel — called “Trained Diabetes Personnel”— can be trained and supervised to perform diabetes care tasks safely in the school setting. Some schools may call these individuals unlicensed assistive personnel, assistive personnel, or trained nonmedical personnel. May include:
Designating Trained Diabetes Personnel
- Teachers- Physical education personnel- School principal- School secretary- Guidance counselor- Food service personnel
Care tasks performed by trained diabetes personnel may include blood glucose monitoring, insulin and glucagon administration, and urine or blood ketone testing. In addition to learning how to perform general diabetes care tasks, trained diabetes personnel should receive student-specific training and be supervised by the school nurse or another qualified health care professional.
Role of school nurse / Health education Specialist
•A diabetes-trained health care professional, such as a school nurse or a certified diabetes educator, develops and implements the training program, evaluates the ability of the trained diabetes personnel to perform the task, and establishes a plan for ongoing supervision throughout the school year.
Role of schools in Epilepsy management
Epilepsy
Epilepsy is a common disorder of the brain that causes recurring seizures. Epilepsy affects people of all ages, but children and older adults are more likely to have epilepsy. Seizures are the main sign of epilepsy and most people can control this with treatment.
Managing epilepsy while at school may involve:
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Seizure Action Plan
A Seizure Action Plan contains the essential information school staff may need to know in order to help a student who has seizures. It includes information on first aid, parent and health care provider contacts, and medications specifically for that child.
The information below should assist you if a seizure occurs during school hours.
* Personal info* Seizure Information (Type, length , frequency, ..)*Basic First Aid: Care & Comfort* Emergency Response* Treatment Protocol During School Hours (Medications)* Special Considerations and Precautions (regarding school activities, sports, trips.)
Basic Seizure First Aid:• Stay calm & track time • Keep child safe • Do not restrain • Do not put anything in mouth • Stay with child until fully conscious • Record seizure in log
A seizure is generally considered an emergency when: • Convulsive (tonic-clonic) seizure lasts longer than 5 minutes .• Student has repeated seizures without regaining consciousness .• Student is injured or has diabetes .• Student has a first-time seizure. • Student has breathing difficulties .• Student has a seizure in water.
* https://www.slideshare.net/missgrice/managing-chronic-health-conditons-at-school
References
• Telljohann, Susan Kay, Cynthia Wolford Symons, and Beth
Pateman. (2001) Health education: Elementary and middle school applications. New York: McGraw-Hill.
Chapter 2 and 3.
• (CDC):
https://www.cdc.gov/healthyyouth/hecat/pdf/HECAT_Ove
rview.pdf
• Journal of School Health.
* NDEP (National Diabetes Education Program):
http://www.ndep.nih.gov/publications/PublicationDetail.aspx?PubId=
97&redirect=true#main
Extra Shots Suggested Readings
*Seizures action plan:https://www.epilepsy.com/sites/core/files/atoms/files/seizure-action-plan-pdf_0.pdf
https://www.cdc.gov/healthyschools/npao/epilepsy.htm
* Managing food allergy in Schools: https://www.cdc.gov/healthyschools/foodallergies/index.htm
Good Luck Grads!
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