2014 School Nurse Conference

Kathryn H McDaniel, BSN, RN, NCSN Health Services Supervisor, Public Schools of Robeson County [email protected] Kathy A Dail, BSN, RN, BC Lead School Nurse, Greene County Schools [email protected]

Learning Objectives  Discuss the current Scope and Standards of School  Nursing Practice  Identify how the professional standards are reflected  in the school nurse evaluation instrument  Describe how to implement the components of the  evaluation process

School Nursing: Scope & Standards of Practice 2011 (second edition) American Nurses Association www.nursesbooks.org National Association of School Nurses www.nasn.org

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2014 School Nurse Conference

Scope and Standards  Framework helps SNs channel energies into health  and academic achievement for all students  Authoritative statements of the accountability,  direction and evaluation of School Nurses  Written in measureable terms

Scope & Standards of Professional  School Nurse Practice  First Standards adopted in 1983  Modeled after generic nursing standards of ANA  Evolved to frame the unique role of SN  Updated 2011  Describe professional expectations

Tenets of SN Practice (2011)  Nursing practice is individualized  Nurses coordinate care – partnerships  Caring is central to practice  RNs use the nursing process to plan and provide care  Link between professional work environment and  quality care

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2014 School Nurse Conference

SN: Merges health and  educational goals Primary role is to support student learning:  Advocate  Liaison  Implement Coordinated School Health  Promote academic success  Serve entire school community

Composed of two sets:  Standards of Practice (1–6)  Reflect the 6 steps of the nursing process (assessment, 

diagnosis, outcomes identification,, planning,  implementation and evaluation) which is the  foundation for critical thinking of all registered nurses

 Standards of Professional Performance

(7‐17)  Describe the expected behaviors of the SN             

Local Protocols necessary  Policy and Procedures  Job Descriptions  Guidelines  Documents/Forms  Reflect federal and state regulations and

NC Nurse Practice Act

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2014 School Nurse Conference

Standards of Practice  Assessment

Implementation

 Diagnosis

a. Coordination

 Outcomes Identification b. Health teaching &  promotion  Planning  Implementation

c. Consultation

 Evaluation

Standards of Professional Performance 7‐Ethics 8‐Education 9‐Evidence Based Practice  and Research 10‐Quality of Practice 11‐Communication 12‐Leadership

13‐Collaboration 14‐Professional Practice  Evaluation 15‐Resource Utilization 16‐Environmental Health 17‐Program Management

Organization of Standards (NC)  Leadership  Safe, respectful environment  Use knowledge to enhance practice  Provide individualized care, using nursing process  Reflect on their practice

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2014 School Nurse Conference

DPI Instrument  Based on National Standards of Professional School  Nursing Practice  Standard is Broad Category of a school nurse’s  knowledge and skills  Paradigm shift from traditional performance  evaluation to professional growth  Shift in the way the ratings are traditionally viewed

(Proficient is good)

Purpose and Expected Outcome • Serves as a measurement of performance for  individual school nurses;

• Serves as a guide for school nurses as they reflect upon  and improve their effectiveness; • Serves as the basis for the improvement of  professional practice; • Focuses the goals and objectives of schools and  districts as they support, monitor, and evaluate  school nurses

Expected Outcome Cont’d  Guides professional development programs for  school nurses;

• Serves as a tool in developing coaching and  mentoring programs for school nurses; and • Informs higher education institutions as they  develop the content and requirements for school nurse training programs.

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2014 School Nurse Conference

Additional Info The North Carolina Standards for School Nurses are  provided as a guide for school nurses as they: continually improve their effectiveness.  It is incumbent upon the school nurse to provide  services as part of a comprehensive multidisciplinary  team with complementary knowledge, skills, and  experiences.

Resource:  NCDPI Standards for School Nurses  http://ncees.ncdpi.wikispaces.net/NCEES+Wiki  Support Staff (on left)  Scroll down to school nurse

(School Nurse Evaluation User’s Guide)

Evaluation Process  Review 3

1 Training

Professional  Development Plan Last Review Determine  7 Prof  Dev  needed for  next year. Summary  Evaluation  Conference End of Year

ORIENTATION

Self‐ Assessment

8 4

Less than 45 min Mini  or          “walk‐through”                Observations     during the year  (year 6 Post Observation  Conference No less than 10  days after  Observation

Pre‐ Observation  Conference

5 Atleast 45 min Observation (One required but can  do more.)

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2014 School Nurse Conference

Process: Training & Orientation  Webinar  http://ncees.ncdpi.wikispaces.net/support+staff  One hour training video and training presentation  power point

Process: Training and Orientation  Study the User’s Guide  Group Discussion of how to  implement  Know expectations/time lines of  supervisor/HR  Identify the Evaluator(s)  {Clinical practice – must be RN}

Standard:   Broad category of the school  nurse’s knowledge and skills. Elements  The sub‐categories of  performance embedded  within the performance  standard 

Descriptors  The specific performance  responsibilities  embedded within the  components of a  performance element 

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2014 School Nurse Conference

Ratings • Developing:  School nurse  demonstrated adequate  growth toward achieving  standard(s) during the period of performance, but  did not demonstrate  competence on  standard(s) of  performance.

• Proficient: School nurse  demonstrated basic competence on  standard(s) of  performance

Ratings Cont’d  Accomplished:  School nurse exceeded  basic competence on  standard(s) of  performance most of  the time. (Seen over time.)

 Distinguished: School nurse  consistently and  significantly exceeded  basic competence on standard(s) of  performance. (Seen over time.)

Ratings Cont’d  Not Demonstrated: 

School nurse did not demonstrate competence or  adequate growth on achieving standard(s) of performance.  (Note: If the “Not Demonstrated” rating is used, the  Evaluator must comment about why it was used.)

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2014 School Nurse Conference

Artifacts • Artifact–A product resulting from a school nurse’s  work. Artifacts are natural by‐products of a  school nurse’s work and are not created for the  purpose of satisfying evaluation requirements. • Artifacts may be used when the evaluator and school  nurse disagree on the final rating. The school nurse  may use them as exemplars of their work.

Self‐Assessment . . .  SN uses rubric to complete self‐assessment early  in school year; revisit throughout school year  May be used as basis for discussions with  evaluator in order to clarify performance,  expectations, set goals, plan professional  development and program changes, or provide  input to the final, end‐of‐year ratings

Nurses Must Know their Standards School Nurse Responsibilities: • Know and understand the North Carolina Professional  School Nursing Standards. • Understand the North Carolina School Nurse Evaluation  Process. • Prepare for, and fully participate in, each component of the  evaluation process. • Gather data, artifacts, evidence to support performance in  relation to standards and progress in attaining goals. • Develop and implement strategies to improve personal  performance and attain goals in areas individually or  collaboratively identified.

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2014 School Nurse Conference

Scoring Rubric  Review scoring rubric in manual – pages 17 – 20.  A rating is determined based on the last column  farthest to the right that has all items checked.  The

heading above the info indicates the rating per  element. Begin with the left‐hand column moving to the right and mark each descriptor  that describes the performance of the school nurse during the period for which  he or she is being evaluated.  If the rater is not able to mark any of the  descriptors for an element, then the “Not Demonstrated” column is used.

Conclusion End of Year Conference  & PDP  Observation(s) discussed  Artifacts provided if desired  Discuss progress made throughout year  PDP discussed—completion of goals.  Both sign off.  Evaluation Summary form

completed and signed by nurse and supervisor.

Summary Evaluation • During the summary evaluation conference, the

evaluator and school nurse shall discuss the evaluator’s  assessment of the school nurse’s performance over the course of the school year, the school nurse’s self‐ assessment, the most recent Professional Development Plan, the components of the North Carolina  School Nurse Evaluation Process completed during the year, observations, artifacts submitted or  collected during the evaluation process, and other evidence of the school nurse’s performance.

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2014 School Nurse Conference

Action Plans  Action Plan–A plan developed by a  principal/supervisor/lead nurse with input from  the school nurse for the purpose of articulating  specific actions and outcomes needed in order to  improve the school nurse performance.   Action plans are developed and administrated under  guidelines provided by each LEA.

GOAL SETTING Important Factors:

What are SMART Goals?

• Goal setting is a critical step in  creating professional development  plans. SMART Goal setting is a  researched process that makes  success attainable. 

 Specific and Strategic

• Goal— WHAT will be accomplished   • ACTIONS needed to make it happen • Expectations/Outcome at the end: What can I expect from my actions • Resources—materials, labor, data    needed to accomplish goal • Time Bound = Completion Date (end of current school year)

 Results Oriented

 Measurable 

(increase/decrease)  Attainable and Achievable  Time Bound

Intended Purpose  (Review) Use of the North Carolina Standards for School Nurses  will: • Guide professional development as school nurses  move forward in the 21st century so that school nurses  can attain the skills and knowledge needed; • Provide the focus for schools and districts as they  support, monitor and evaluate their school nurses; and • Assist higher education programs in the development  of content and requirements of school nurse  education curricula.

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2014 School Nurse Conference

Resources  www.snanc.org Policy & Advocacy tab, “Our Positions”  NC School Health Program Manual (2010). NC Division of 

Public Health – Children and Youth Branch – School  Health Unit. Raleigh, NC  National Association of School Nurses (2002). Care of  Students with Special Needs in Schools. Praeger, Zickler,  Mosca. Scarborough, ME.    American Nurses Association (2011) School Nursing: Scope  & Standards of Practice, second edition.  Silver Spring,  Maryland. (and 2005 version)

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