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Health Services
The Tolland School Health Department eight member Tolland Nurses Association proudly demonstrates how we support the Educational Goals of Tolland School System by providing services to Tolland Public Schools students; K-12; in school; in class; and ready to learn. Laura Dolcelli RN and Lillian Byrne LPN at Birch Grove Primary School Michelle Povilonis RN and Linda Tofolowsky LPN at Tolland Intermediate School Christine Grulke RN and Susan Trimble LPN at Tolland Middle School Cindy Davidson RN and Kristen Boudreau LPN at Tolland High School  1. Curriculum and Instruction:
school year, 242 new students’ records (Pre-K, K-12, and transfer students) were screened for compliance with State of Connecticut Health Assessment Record Guidelines for physical exams and immunizations. o 100% Immunization compliance: Nov 2011 Mandatory State of Connecticut Department of Public Health Immunization Survey was completed by all schools o Immunization changes for school entry arrived March 15, 2011 from Department of Education regarding Hepatitis A; Influenza; pneumococcal; varicella; Measles/mumps/rubella, adolescent Tdap, and meningococcal vaccines. Birch Grove, THS and Tolland Middle School students greatest effected. Letters were sent home May 2012 and June 2012 to current 6th grade students who are non-compliant. o Kindergarten Orientation Evening for Parents: Health Services provided and requirements for Kindergarten entrance presented by Laura Dolcelli RN in March, including new State of Ct immunization requirements for incoming K students. o Preschool Immunization Survey for Influenza Compliance completed by Laura Educate students with chronic health conditions to manage their own care. Diabetes: Type 1: 13 students on insulin pumps: carbohydrate counting; insulin management; site changes; sick day management; pump suspension/resume Diabetes: Type 2: 2 students with Adult/maturity onset on oral medication regimen Laura Dolcelli, RN at BG, Michelle Povilonis RN at TIS and Chris Grulke RN at TMS, Cindy Davidson at THS met with parents, students, and class teachers at the beginning of the school year to develop Individual Health Care Plans and Emergency care for student with diagnosis of diabetes (13), students with active seizures, cardiac conditions and nutrition needs. Plans for meals, gym, music, art and fire drill made. . o Asthma: 649 ((up from 597) students with asthma; 179 with MD ordered inhalers/nebulizer: asthma action plans created by nursing staff. o Life threatening allergies: (food, nuts and bees) 159 (up from 101 students); 88 have epi pen in Nurses office; EHCP: Emergency Health Care Plan created for each student. o 250 Students with diagnosed ADHD: Connor’s Scale for assessment completed on request, 37 students have medications in the nurses office. o 4 students in wheel chairs: access, image, coping, independence, elimination o 25 students/2 staff with latex allergies: All schools continue to be latex free o 5/12 Department of Public Health “Annual Asthma Survey” was completed by o 4 students with nutritional needs including g-tube feedings and monitoring. Provide staff with strategies for promoting student health and safety in the classroom o Attending PPT’s and 504 : 14371 meetings were attended by nursing staff. o Food allergies/Allergic reactions/foreign body obstructed airway and Heimlich validation for 27 Department of Food services employees. Presented by Cindy Davidson RN, Michelle Povilonis RN, Christine Grulke RN, and Laura Dolcelli RN at respective schools. o 11 Preschool staff attended seizure precautions, interventions and choking management presented by Laura Dolcelli Birch Grove Sept 2011 o 26 paraprofessionals attended seizure precautions, interventions and choking management presented by Laura Dolcelli RN at Birch Grove; Michelle Povilonis at TIS and Chris Grulke RN at TMS o 2 Bus Paraprofessional trained for seizure/choking management by Chris o Personal Management Training (safe restraint training) recertification at THS o 89 staff members validated for epipen/inhaler and medication administration utilizing the new State of Connecticut Medication Administration Guidelines authored Ap 2011. o 21 FRC staff were epipen and medication administration validated by Laura Dolcelli RN Sept 2011 to meet the new State of Connecticut Medication Administration mandates as of April 2011. o Staff responsible for students who are diabetes were trained regarding recognition o Staffs responsible for students with active seizure activity within last two years were trained regarding recognition and treatment of seizure activity. o Laura Dolcelli RN and Cindy Davidson RN attended the “Critical Issues in School o AHA AED/CPR for Adult/infant/child was completed in March by CPR-o-Heart. 58 employees were validated: a minimum of 10/school o Bath Salts (A new, highly addictive designer drug labeled contains Mephedrone and MDPV (Methylenedioxypyrovalerone)) and Synthetic Marijuana Overdose at THS attended by Cindy Davidson RN; Kristen Boudreau LPN, Chris Grulke RN : THS nurses contacted Tolland Police regarding K Spice at local gas station being sold. o Sexual Harassment for Coordinators In Service by CIRMA attended by Chris o Sexual Harassment for Nursing Staff conducted by CIrma 4/12 attended by all o Cindy Davidson RN THS and Chris Grulke RN TMS met with parents/staff regarding student with new onset seizures. o “Post Concussive Syndrome in the Educational Setting” in-service provided by all school RN’s at each of the schools for staff to learn more about the student with concussion returning to school and accommodations needed and when a 504 plan is needed. o Concussion management reviewed with Paraprofessionals at BG at administration request. Two meetings conducted by Laura Dolcelli RN o “Optometrists and School Nurses: Working together to help children Learn” Newington HS attended by Laura Dolcelli RN 2/12 o “Individual Health Care Plans for Nurses” on line SERC program completed by on line SERC program completed by Laura Dolcelli RN  Student Assessment

SNAP: School Nurse Assistance Program updates allowed documentation to include
traditional Injury and Health visits but also non-visit and scheduled visits.
 Non-visits time utilized by the nurses for absentee management, new health Tolland Health Services Summary by visit
Total visits: 35691 as of June 2012
physicals documentation has increased as 229 fall sports physicals processed: 315 spring sports physical processed  Scheduled visits captured screenings for lice, vision, hearing and scoliosis. Provide services that increase school attendance by  Registered Nurse and part-time/full time LPN in each school cared for 48,639 K- 112 11/12 school year. (up from 38,867 students 10/11) StudentVisits to Nurse
School/year
its 15000
the Attendance Committee at their respective schools. Administer specialized services to students: Administration of Medications by School Personnel and Administration of Medication during Before- and After- School Programs and School Readiness Programs State of Connecticut Regulations Section 10-212a-1 through 10 were updated by the State Department of Education Spring of 2011. School nurses at each building now educating and validating “Qualified Personnel” including coaches, licensed athletic trainers, teachers, administrators, directors of before and after programs for documentation, administration on six aspects of medication administration to eligible students. New DVD utilized used as teaching tool in 11/12. Tolland Health Services: Medication Administration as
 Ambulance assistance was necessary for 5 students and 2 adults  Epi pen administered x2 to student (11/12 @TMS)  AED’s present in all schools not used in any schools Tolland Health Services
as of 6/12
attended New School Nurse Workshop offered through East Conn December 7 & 14, 2011.  CCMC Diabetes In-service Sept 2011 attended by Laura Dolcelli RN, Cindy Identify health concerns that may adversely impact learning: by providing mandated screening for Vision, Audiometric and Postural Screening Per Regulation Sec. 10-214.  Vision testing on all students grades K-6 and grade 9 (as well as special referrals from teachers, parents, and/or physicians. 1715 students were screened, failures re-screened. 192 referrals were sent out for students with altered vision that could adversely
impact their learning as they did not meet the State of Connecticut Mandated
Screening criteria. Hard to learn when you can not see the board.
 Audio-metric (hearing) testing on all students K-3, 5 and 8 (as well as special referrals from teachers, parents, and/or physicians.) Tympanograms were performed on all children who were referred by their physicians. 1232 students were screened, failures re-screened 8 referrals were sent out for students with altered hearing that could adversely
impact their learning as they did not meet the State of Connecticut Mandated
Screening criteria. It is hard to learn when you can not hear.
 Scoliosis Screening 5th - 9th grade, inclusive. 3 referrals were sent out for students who did not meet the 5 point criteria set
forth by the statutes.
 3. Staffing
Promote health habits among staff and students by  Maintain: Don’t Gain program for staff through “Bee Well”  Nutrition, exercise, and stress reduction methods throughout the school year.  TMS monitors 3 students hypotension weekly due to medications.  TMS monitors 2 adults weekly for blood pressure checks  67 (down from 99) Tolland School Employees received Seasonal Flu vaccines at the Flu Vaccine Clinic 11/22/11 Hosted by THS; Coordinated by Chris Grulke RN and Summit Health Clinic through CIGNA.  2012 EHHD Leadership Breakfast: “Strategic Planning for Active Communities" presented by Mark Fenton attended by Chris Grulke RN in January 2012  4. School Facilities
Prevent and control the spread of communicable disease Nursing Coordinator is a member of the Eastern Highlands Health District - Emergency Response Team. Nurses monitor student’s complaints for symptoms. Parent reporting drives the statistics. pox : one case. 2nd varicella booster required by the State of Connecticut to enter 7th grade as of March 2011. throat 168 cases; majority at BG and TIS Mononucleosis: 12 cases: Majority at THS: Reduced class schedule/rest periods planned to promote return to school disease: 1 case: Class/school notification for care of maternity Conjunctivitis: 23: Health teach hand washing LICE: 65 cases: Parent/student education on care, remediation and retreat : TIS and BG web pages have education for parents Concussions: 69 new onset and repeated concussions. Majority at TMS and THS. Classroom modifications made per MD; 4 students with 504 plans authored. Longest time accommodations needed has been 4 months. Flu: <10 cases per school reported: Students and staff continue to “sneeze in your sleeve” and “cover the cough”. Hand sanitizers continue to be prevalent. The DPH ruling 24 hours fever free without use of Advil/Tylenol helped as well.  September: Chris Grulke RN Reviewed Tolland School District Pandemic Influenza Response Plan for Tolland, CT utilizing the Eastern Highland Health District Pandemic Influenza Response Plan January 2008 Connecticut Department of Public Health: Community Mitigation Plan April 2007 as no new updates have been issued as of September 2010. Policy appropriate.  October: Tolland Public Schools BOE members flu clinic booked for November 16, 2011 at THS.: Nursing phone messages reflect DPH guidelines: students remain home until fever free for 24 hours without the use of Tylenol/Advil/Motrin Daily monitoring of absences, symptoms, treatment accomplished by the nursing staff as well as monthly review of CT DPH: Influenza Surveillance Update. Laura Dolcelli RN at BG drafted letter to 70 preschool parents regarding new requirements for flu vaccine. Laura also attended the Grade 2 Curriculum night as support/resource person for concerned parents due to case of viral meningitis at BG.  November: 67 employees received seasonal and H1N1 flu vaccine through Summit Health Clinic hosted at Tolland High School 11/22/11.  February <10 cases of flu/school reported Advocate for a healthy school environment ACHIEVE: Action Communities for Health Innovation and Environmental Change Chris Grulke is the liaison to this EHHD DPH committee working to reduce childhood obesity, improve childhood cardiovascular health and reduce tobacco use through policy changes. $75,000 was awarded to EHHD through the National Association of Chronic Disease Directors was completed in November 2011. Tolland was noted for five accomplishments. CTG: Community Transformation Grant awarded Nov 2011 to “Tolland County” this $102.6 Million dollar grand funded through the Affordable Care Acts will run for five years aimed to improve health of Nation by improving weight, nutrition, physical activity, tobacco use and emotional well-being and overall mental health. Tolland is one of 13 towns served by this grant. Chris Grulke RN serves as Tolland Public Schools Liaison under the “schools” coalition. Safety Committee: Chris Grulke RN is the Chairperson for this district wide committee that promotes safe access for all who attend our schools. Quarterly meetings conducted. Wellness Committee: Laura Dolcelli RN at BG is on the committee: Chris Grulke RN is liaison to committee through Safety Committee OSHA Training Session: All nurses presented OSHA training session on Blood Borne Pathogens and latex annual validation to all certified and non-certified staff and substitutes, at their respected schools Sept 2011 for 11/12 school year School Nurse Supervisor Conference attended by Chris Grulke RN 10/11 Nurses Meetings: All nurses attend monthly district wide nurses meeting x7.(one cancelled due to Storm Alfred) Attendance Committee Meeting: Attended by Cindy Davidson RN THS Tools for Schools: Indoor Air quality: Nurses are representatives on each of the
Tools for Schools Teams. Chris Grulke met with Dominique Fox and Cindy
Davidson at THS to jump start the THS TFS team in January 2012
Concussion Management: Head’s Up to Clinicians: Addressing concussion in
Sports Among Kids and Teens http://preventingconcussions.org/ advocated by
CDC and NFL viewed by nursing staff and sent to key coaches, physical education
teachers in school. TMS and THS web pages updated to include concussion signs
and symptoms and increase awareness and risk. “Post Concussive Treatment:
Returning to School” presentation made by all RN’s at respective schools to
teachers/administrators/guidance to update latest literature and treatment of
concussion.
TMS Breakfast Program discussed Abby Kassman-Harned, Chris Grulke RN
and Walter Willett Principal April and May 2012.
5. Student Support Services

Encourage student participation in activities that promote healthy behaviors and
decrease high risk behaviors
o Wellness Committee: This district wide committee that encourages student participation in activities that promote healthy behaviors and decrease high risk behaviors and partner with families to enhance their child’s health habits. Laura Dolcelli RN at BG is on the committee; Chris Grulke RN at TMS is the liaison from the Safety Committee o CTG: Community Transformation Grant awarded Nov 2011 to “Tolland County” this $102.6 Million dollar grand funded through the Affordable Care Acts will run for five years aimed to improve health of Nation by improving weight, nutrition, physical activity, tobacco use and emotional well-being and overall mental health. o SHI: School Health Index: Self-Assessment and Planning Guide was completed K-12 school year 10/11 toward improving the Tolland Public Schools health promotion policies and practice. Health Education and School Counseling, Psychological, and Social Services fell below 80% and are targeted for improvement. Action Steps have been developed as part of the School Health Improvement Plan. Implementation began January 2011 and continue through 11/12 goals. Reassessment is triennial 13/14  6. Parents and Community

Nurses connect families to community service:
o CPR/AED training for district February 2012; o AED availability Per Connecticut General Statutes: 10-212d: 51 School o All nurses serve on SIT: Student Intervention Team (formally SWAT: Student Watch Assistance and Crisis Intervention teams. o Two THS Senior option students learned about school nursing at Birch Grove with Laura Dolcelli RN and Lilly Byrne LPN o HUSKY: 112 phone calls were made home to follow up on “no” or no answer regarding insurance coverage for Tolland Students; 10 packets were sent home to families identified and 2 families have no insurance; one was declined by HUSKY. o Chris Grulke RN and Laura Dolcelli RN work perdiem at Saint Francis Hospital Michelle Povilonis at TIS and Cindy Davidson at THS work perdiem as visiting nurses. o Referral to Tolland Human Services Department for Families in need as o Michelle Povilonis had parent meeting 4/12 regarding medical management of Partner with families to enhance their child’s healthy habits o Tools for School: Indoor Air Quality Teams include administrator, nurse, teacher, parent, custodian per Department of Health recommendations. o CTG: Community Transformation Grant awarded Nov 2011 to “Tolland County” this $102.6 Million dollar grand funded through the Affordable Care Acts will run for five years aimed to improve health of Nation by improving weight, nutrition, physical activity, tobacco use and emotional well-being and overall mental health. Tolland is one of 13 towns served by this grant. Chris Grulke RN serves as Tolland Public Schools Liaison under the “schools” o Kindergarten Registration Program presented by Laura Dolcelli RN, & Lillian Bonin LPN at Birch Grove Primary School 3/15/12. What is medically required for entrance to Kindergarten including the new State of Connecticut Immunization Laws released in March 2011. o AHA CPR/AED/First Aid: classes taught to Boy Scout Venture Crew leaders and  7. Goals for 2012-13 School Year

Goal achievement for 2011/2012:

1. School Health Services will promote asthma management education to students
and staff during the school year as recommended by School Health Index. Achieved 100%: SNAP template utilized 55 times for health teaching 3 signs/symptoms of asthma attack; and identifying 3 triggers of asthma attack and 3 self management skills.
2. School Health Services will integrate Connecticut State Statute: 10-212d AED in
public schools: Achieved 100%
a. 11 AED’s in district and 53 AHA AED/CPR Trained Responders accessible during school’s normal operational hours, during school-sponsored athletic practices and athletic events taking place on school ground and during school sponsored events not occurring during the normal operational hours of the school BG has 2 AED’s and 14 AHA AED/CPR Trained Responders TIS has 2 AED’s and 9 AHA AED/CPR Trained Responders TMS has 4 AED’s and16 AHA AED/CPR Trained Responders THS has 4 AED’s and 14 AHA AED/CPR Trained Responders 3. State of Connecticut: Department of Education Section 10-2121a 1-10:
Administration of Medication by School Personnel updates into Tolland Public
Schools practice: Achieved 100%:
Birch Grove: Laura Dolcelli RN validated FRC staff Fall 2011 Tolland High School: Cindy Davidson RN monitored needs at the Creative Nursery School at Tolland High School 4. School Health Services will health teach each student who visits the nurse the need for students to self-advocate for hand washing/sanitizing wipes prior to
snacks and lunch: Achieved 100%
a. 3,587 students washed hands with soap and water during a nurse b. 3,388 students had “health teaching” during a nurse visit Goals for 2012/2013 School Year
1. Support the Community Transformation Grant that has been
awarded to Tolland County through the Center for Disease Control and Prevention Initiative and EHHD DPH. Progress measurers include changes in weight, changes in proper nutrition and changes in physical activity. Schools to serve as assessors, identifying community needs and develop strategies. Support Tolland Public Schools: Department of Food Service initiative to
start a School Breakfast Program in one of the Tolland Schools as
measured by participation in meetings and developing strategies for
success.

Source: http://www.tolland.k12.ct.us/UserFiles/Servers/Server_891568/File/ARpt1112-Nurse.pdf