Now in some cases, with the click of a mouse, a nurse can record and obtain a patient’s comprehensive medical history, then aggregate and analyze that information to make treatment plans and policies for an entire patient population. School nurses are leveraging the capabilities of EHRs to not only treat students when they come to see them on a one-on-one basis, but also to use that information to inform decisions about students’ overall health experience while at school. EHRs have been around since the early 2000s, but it wasn’t until recently that federal regulations prompted many hospital systems and ambulatory care facilities to implement EHRs. While some facilities and specialties have been faster than others to adopt an EHR system, studies show that nurses play a pivotal role in the success of EHRs. In fact, a survey of more than 16,000 nurses, conducted by the University of Pennsylvania School of Nursing in 2012, found that implementation of EHRs may result in improved and more efficient nursing care, as well as better care coordination and patient safety. These findings, among others, have helped encourage school nurses across the country to implement EHR systems in the school setting to help improve healthcare for students. Of those school systems, one of the first to implement an EHR system was the Waltham Public School district in Waltham, Mass.
“I was working as a school nurse in the early 2000s when I first heard about the possibility of an EHR system for schools,” said Marie DeSisto, RN, MSN, NCSN, director of nurses for Waltham Public Schools. “My colleagues and I began to search for the most appropriate EHR system and found one that was specifically designed for nurses.”
Since Waltham Public Schools implemented its EHR system, nurses across their district have been able to better track student injuries, illnesses and conditions, as well as help improve students’ overall health. According to DeSisto, data configured via the EHR system was especially crucial in a decision regarding the school district’s recess program.
“By using our EHR system, we were able to pull body mass index (BMI) data for students in each grade level. Our data showed us that 40 percent of students in our district were either overweight or obese,” said DeSisto. “We have always measured student height and weight, but our EHR system documented the problem and let us put that information to use.”
DeSisto and her colleagues then presented the alarming data to each of the principals in the district, as well as the superintendent, to showcase the need for students to continue with physical exercise every day. The data played a major role in their decision to reinstate health education programs and to not cut recess.
“That is just one example of how school nurses are using this data to better help their students,” said DeSisto. “Data is also being used to help other departments, such as physical education, athletic training, and guidance counseling, to develop their curriculums as well.”
According to DeSisto, EHR systems can take time to implement, but she welcomes and praises the enormous impact they can have on a school nurse’s day-to-day activity. “There is a learning curve at the very beginning of implementation, but a nurse has the ability to review data of hundreds of students in minutes, as opposed to the hours it would take with paper records,” said DeSisto. For those looking to implement an EHR system, DeSisto advises nurses to follow these helpful tips:
Before implementation, educate nurses about the program and the basics of how it works
The system needs to be user-friendly for nurses, including the ability to customize selections for nurses based on patient needs
Have a few nurses become experts in the program; then have them train, guide and assist other nurses in their learning process
Setting implementation goals and standards are good motivators for everyone
