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 Many school districts have cut or reduced the hours
of school nurses in recent years, and nationwide less than half of
public schools have a full-time nurse, the authors of the report
note.
They say their results warrant “careful consideration” from
districts that are thinking of making such cuts in an effort to save
money.
“The findings of this study suggest that from a societal
perspective, the benefits of school nursing services may well exceed
the cost for those services,” Li Yan Wang told Reuters Health.
She led the research at the Centers for Disease Control and
Prevention’s Division of Adolescent and School Health in Atlanta,
Georgia.
To assess the Massachusetts program, the researchers compared money
spent putting full-time nurses in schools with money the program
saved by reducing doctors’ visits and keeping parents at work and
teachers in front of the classroom.
For the 22 types of procedures school nurses performed during the
study, from testing blood sugar to administering physical therapy,
the researchers calculated how much it would cost to go to a clinic
or hospital for the same care.
 To measure lost wages for parents, they determined the time parents
would have to take off work if children were dismissed early, as
well as how often they would have to come to school to help kids
take their prescription medications if no nurse was on site.
Finally, to assess teacher productivity, they referred to an earlier
study that found teachers spent 20 fewer minutes per day dealing
with student health issues once a nurse was assigned to their
school.
Massachusetts records showed that during the 2009-2010 school year,
about 477,000 students at 933 schools covered by the program
received school health services. Paying nurses to provide those
services cost $79 million.
The same care provided outside of school would have cost $20
million. In addition, with no school nurses parent productivity
losses would have totaled $28.1 million and teacher productivity
losses, $129.1 million.
Wang and her colleagues calculated that every dollar invested in the
school nurse program saved $2.20 overall, according to the findings
published Monday in JAMA Pediatrics.
Anne Sheetz said those savings are just a start.
“We haven’t looked at the number of emergency room visits saved, we
have not looked at the number of hospitalizations saved . . . we
have yet to look at the big savings,” she told Reuters Health. “This
is just a drop in the bucket.”
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Sheetz, the study’s senior author, retired last year as the Director
of School Health Services at the Massachusetts Department of Public
Health.
When she started the position, she said, “I could not believe the
amount of health care that was being done in schools and the
critical nature of it.”
School nurses, Sheetz said, see 60 to 70 kids each day. They have to
be ready to provide emergency care and mental health services and
help manage chronic conditions like diabetes. Nurses are also
charged with teaching other members of the school community about
issues such as life-threatening food allergies.
“The role of the school nurse has really expanded,” said Martha
Keehner Engelke, who has studied that topic at East Carolina
University in Greenville, North Carolina but wasn’t involved in the
new report.
“People think of it as doing vision screening and putting on
Band-Aids,” Engelke told Reuters Health. “Those things are there,
but that’s a really small part of what school nurses do.”
Two local doctors who have worked with the Massachusetts school
health services program, pediatric allergist Dr. Michael Pistiner of
Harvard Vanguard Medical Associates and endocrinologist Dr. Maryanne
Quinn of Boston Children’s Hospital, agreed that it has had a
considerable impact on kids’ health in both of their specialties.
“Cost has been a very real barrier,” Pistiner said.
The new study, he added, “may change these conversations. It may put
getting a full-time school nurse back on the priority list.”
SOURCE: http://bit.ly/1adWrco
JAMA Pediatrics, online May 19, 2014.
[© 2014 Thomson Reuters. All rights
reserved.] Copyright 2014 Reuters. All rights reserved. This material may not be published,
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