Standard 1 Aspect D

Standard 1. Evidence shows that by the time of the program completion, candidates exhibit knowledge, skills, and abilities of professional educators appropriate to their target credential or degree, including: Assessment of and for student learning, assessment and data literacy, and use of data to inform practice.  (Health Screening, Vision and Hearing Screen, Special Education assessments, Individual Health Care Plans, Immunizations)

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School Nurses use primary prevention strategies to promote health and prevent disease among school age children and adolescents. Mandated screenings and assessments include vision screening, hearing screening, First grade physical examinations, Special Education assessments as well as individual assessment for illness and injuries.  Assessment data is used to develop individualized health care plans, generate medical referrals, monitor student’s health status and/or implement other strategies to mitigate barriers to learning.  School nurses come to the program with a broad nursing background and multiple years of experience.  Proposed candidates take additional prerequisite coursework to facilitate their success in school nursing such as listed below.

Data Sources & Analysis:

DATA  Sources to be introduced:

• Preceptor Checklist of Skills and Competencies-Professional Management (Form P106/P206)
• Employer/Supervisor Survey of Program Effectiveness (Employer/Supervisor Survey)   
• Nursing 136 Health Appraisal Key Assignment: (Health Assessment demonstration)
• Program prerequisites: 
  
  • California School Audiometrist Certification
  • Special Education/Mainstreaming coursework 
  • Introduction to Counseling 
  • Bachelor degree and RN Licensure with multiple years of nursing experience

Data Source 1

Midterm and Final Semester Fieldwork Evaluation, Preceptor Checklist of Skills and Competencies (P106/206), Professional Management Skills
The first measure is the Fall semester (Elementary) and Spring semester (Secondary) fieldwork evaluation, Preceptor Checklist of Skills and Competencies-Professional Management Skills (P106/206) used by preceptors to evaluate candidates in their field work knowledge at two points.

Perspective: Preceptor

Items Using: 

Checklist areas include:

• Item 1: S39 “Candidate expresses understanding for what is involved in maintaining a comprehensive school health services program. (The school nurse provides vision, hearing, special education and mental health assessment to prepare the student to reach maximum performance.)” Example skills from the preceptor checklist:

• E2 through E19, School nurse competencies 1, Providing Health and Wellness Services, Primary Intervention. 

• Item 2: S40 “Candidates demonstrate a global understanding for the role of the school nurse as it relates to school and community.” (Checklist item, Spring semester only) A good assessment takes into account the entire environment, community characteristics and other extenuating factors.

Definition of Success:
Candidates are rated on a 5-point Likert scale, with 5 rated as “Excellent” to 1 “Poor”.  Our goal is that all program candidates achieve an Excellent or Very good rating.

• _{(SN Professional Management Means)}
• _{(SN Professional Management %)}

Summary of Findings

From 2017 to 2020:
S39 scores on Professional Management indicators demonstrated 99.5% of candidates achieved an Excellent or Very Good rating. One student received a Good rating and zero percent of students received a Fair or Poor rating.

S40 scores on the Professional Management indicator demonstrated 98% of candidates achieved an Excellent or Very Good rating.  Two students received a Good rating and zero percent of candidates received a Fair or Poor rating.

Mean scores in S39 ranged from 4.87 to 4.93 with an average of 4.88.  

S39 scores demonstrate growth from the Fall to Spring semester in assessment areas.

Mean scores in S40 ranged from 4.85 to 4.93 with an average of 4.89.

Analysis of Data:
Professional Management data demonstrates candidates consistently achieve high ratings in the ability to provide appropriate assessment of the health and well-being of students, staff, and families in the school community to promote learning in a comprehensive school health program.  Examples of school nurse assessment areas include: Health Screening, Vision, Hearing and Scoliosis Screenings, Special Education areas, Individualized Health Care Plans/504 Plans for students with disabilities, and Immunization compliance.

Data Source 2

Employer/Supervisor Survey of Program Effectiveness
The second measure is the Employer/Supervisor Survey of Program Effectiveness given at the end of the program to District Health Services Administrators who supervise program candidates. This is mailed one year after the candidates have graduated. 

Perspective: Employer/Supervisor of Program Completers

Elements of Data Source Using:

Items selected:

• Program Standard 4: Preparation to Promote Student Health and Wellness 
  “The program prepares candidates to integrate health and wellness concepts in the educational setting to allow students to be in school healthy, and ready to learn.  Candidates are knowledgeable about primary (disease prevention and health promotion), secondary (health screening, emergency, and acute care) and tertiary (rehabilitative or palliative care) levels of health care interventions as these relate to students and their families.” (Neuman Systems Model)
• Program Standard 6: Legal Aspects of School Nurse Practice
  “The program provides candidates with an understanding of the local, state and federal laws and regulations applicable to the practice of school nursing.  The program assists candidates to understand the practice of school nursing within a public educational system, including the structure and authority of school district administration, the scope and practice of school nursing as regulated by the California Board of Registered Nursing, application of the California Education Code, and/or other relevant local, state, and federal codes and regulations.”

Rationale: These aspects look at how the program prepares students in health assessment areas to improve and support a student’s ability to learn. 

Definition of Success:
The SNSC program is rated on a 4-point Likert scale with 4 representing Excellent to 1 representing Poor.  Our goal is supervisors will rate the program a minimum of 3. 

EMPLOYER/SUPERVISOR SURVEY OF PROGRAM EFFECTIVENESS

Summary of Findings 
The Employer/Supervisor Survey of Program Effectiveness Standard 4 demonstrates that in 2016 and 2020 100% of candidates were prepared to meet program goals of appropriate integration of health and wellness to support student learning as perceived by supervisors of school nurses. All scores were in the Excellent or Good rating.  

The Employer/Supervisor Survey of Program Effectiveness Standard 6 demonstrates that in 2016 and 2020 100% of candidates were prepared to meet program goals of appropriate integration of health and wellness to support student learning as determined by health related local, state and federal law and regulations as perceived by supervisors of school nurses. 

Program ratings have increased since 2016 with recent rates indicating an increase from 44% to 85% on Standard 4 and from 55% to 85% on Standard 6, both excellent ratings.  Supervisors increased the rating of Standard 4 Excellent from 44% in 2016 to 85% in 2020.

Supervisors increased the rating of Standard 6 Excellent from 55% in 2016 to 85% in 2020.

Analysis of Data for Employer/Supervisor Survey:
The Employer/Supervisor Survey data demonstrates employers perceive the School Nurse Services Credential program has adequately prepared 100% of candidates in the ability to assess the health and learning needs of the school community, while integrating health and wellness to support student success and following all related local, state and federal laws and regulations.  Data reveals an increased number of supervisors, from 2016 to 2020, rated the program as Excellent in these areas.  This shows the SNSC Program has significantly improved its responsiveness from 2016 to 2020 in the application of health and wellness assessment of the school community including students, staff and families to improve learning outcomes.

Data Source 3

Nursing 136 Key Assignment: Health Assessment (N136 Key Assignment Health Appraisal)

Program candidates are licensed practicing Registered Nurses with a BSN, who have obtained Audiology certification from the State of California allowing them to provide hearing screening to students.  School Nurses are mandated by the State of California to conduct the following screenings: hearing, near and far vision, color vision and scoliosis.  Other assessments performed may include dental, neurological, nutritional, height/weight ratios, psycho/social, medication compliance, diabetic blood sugar and blood pressure readings.  Health Appraisal is key for school  nurses as they assess students for physical and mental barriers to learning; including assessing for all suspected illness or disability and sending medical referrals to obtain treatment.

Perspective: Program Faculty

Rationale for Using:
Although health appraisal is addressed in all school nurse coursework as it is essential to the practice of school nursing we will focus on Nursing 136.

A Course Description of N136 Health Appraisal states: “Integrates psychosocial and pathophysiological processes including techniques of history taking and health assessment in nursing practice and knowledge of normal findings as well as common deviation”.  

Course objectives include: 
Collect a comprehensive health history for clients, which reflect an understanding of factors such as heredity, culture, ethnicity, lifestyle and environment, which may influence the client’s state of health and potential for disease.

• Perform a systematic physical examination applying techniques of inspection, palpation, auscultation and percussion.
• Show a beginning ability to use specialized tools such as the otoscope, ophthalmoscope, and reflex hammer.
• Make appropriate adaptations in the data collection format based on the client’s age, degree of discomfort, and current state of health.
• Record the findings in the problem-oriented medical record format using appropriate medical terminology.
• Analyze a database for significant clues to alterations in health and/or presence of disease.
• Develop an initial plan for health maintenance, health promotion and disease prevention in collaboration with the client/family and/or other health care providers.

Definition of Success:
Candidates are expected to achieve a 3.00 GPA or higher to pass this course.

Grades in Health Appraisal  focusing on acquisition of knowledge of assessment.

Grades in Health Appraisal Case Study

In the table above, it is evident that candidates achieved high scores in health assessment with a combined mean of 3.99 over several cohorts.

Analysis of Standard 1d
Data demonstrating SNSC candidates’ ability to assess the health and learning needs of the school community indicates the School Nurse Services Credential program has adequately prepared 100% of candidates in the ability to assess the needs of students, staff and families in order to promote learning following all health related local, state and federal laws and regulation.  

Aspect E →