Managing Pediatric Chronic Illness in the School Setting in Eastern North Carolina

Abstract

Chronic pediatric health conditions include “long-term physical, emotional, behavioral, mental, and developmental disorders that affect a child’s functional state and require prescription medications and medical or educational services” (National Association of School Nurses, 2012). Approximately twenty percent of the children and youth population in the United States are diagnosed with chronic illnesses (Rivkina, et al., 2014). These chronic illnesses create daily struggles not only for the children, but also their families, friends, and others with whom the children spend time. Since education is an integral part of childhood development, it is important to understand how chronic illnesses are managed in the school setting. Best case management practice involves individualized, goal-oriented interventions such as direct nursing care, teaching, and counseling, and is based upon input from the student, family, teachers, and school nurse. A program evaluation was conducted to assess the program and the barriers and facilitators for chronic illness case management in an elementary school in eastern North Carolina. Three key informants responded to a questionnaire, and a school nurse record review was conducted. Findings included the most common chronic illnesses managed at the school, as well as the most common barriers, underreporting and lack of communication. Neither the school policy nor the district policy included procedures for following up with unresponsive parents. Recommendations for these policies include providing the reporting and case management forms at “Meet the Teacher” night before school starts and at open house nights held during the year, sending forms home to be signed with report cards, and interdisciplinary follow-up.