Unmet Needs of Children With Special Health Care Needs in a Specialized Day School Setting

Abstract

Children with Special Health Care Needs (CSHCN) represent a significant component of the pediatric population. They often present to schools with multiple and increasingly complex health issues, including medical technology dependency. Their daily variation in health status requires close monitoring and communication among caregivers. Limited research exists regarding parental concerns and communication between health providers, schools, and families. This study identifies the concerns of parents with CSHCN families, including satisfaction with communication between medical providers and schools. Parents completed a survey adapted from the American Academy of Pediatrics (AAP). Analysis of data indicated a high utilization of primary care services but highlighted persistent difficulty accessing services. This study demonstrates families have basic unmet needs in attaining services, including respite and palliative care; indicated an interest in improved communication and coordination of health information between schools and their primary health care providers; and expressed interest in augmenting school health services.

Meeting the Health Care Needs of Students With Severe Disabilities in the School Setting: Collaboration Between School Nurses and Special Education Teachers

“…A lack of close collaboration between the school nurse and the student's other educational team members may allow the student's medical needs to interfere with his or her success in learning (Aruda et al., ). Only 20% of participants indicated that they were “always” invited to participate in collaborative team activities.…”

“…Providing supports and accommodations for this unique population of students will continue to require “balancing complex health care needs and nursing interventions in the classroom setting… in coordination with educators who traditionally structure the classroom setting. The communication and mechanisms required for success in this coordination are still developing” (Aruda et al., , pp. 214–215).…”

“…This is consistent with existing literature (Roberts, 2006), yet does not comply with the suggested role of the school nurse in all aspects of the student's school life (AAP, 2008;NASN, 2011), including educationally related collaboration. A lack of close collaboration between the school nurse and the student's other educational team members may allow the student's medical needs to interfere with his or her success in learning (Aruda et al, 2011). Only 20% of participants indicated that they were "always" invited to participate in collaborative team activities.…”

“…Because health and education are so intricately intertwined, the school nurse plays an important role in both the health and education of students (American Academy of Pediatrics [AAP], ; NASN, ). As it pertains to students with SHCN, the school nurse has a particularly pivotal role, both in the daily management of care and in communicating with families and other stakeholders, thus offering opportunities for high‐quality health care for these students (Aruda et al., ). State laws and professional practice guidelines are clear about responsibilities that should be conducted solely by the school nurse:

Most of the health care procedures required to be done in public schools must be supervised or performed by state‐licensed health personnel such as a registered nurse.

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“…Most notably, given advances in technology that have led to increasingly mobile medical equipment, these children are no longer receiving their medical care via inpatient hospitalizations and, instead, receive much of their medical care through outpatient hospital support and in home and community settings (Perrin et al., ). Consequently, the number of students with special health care needs (SHCN) in public schools in the United States, many of whom are dependent on medical technology for survival, has been steadily increasing in recent years (Aruda, Kelly, & Newinsky, ; Best, Heller, & Bigge, ).…”