Current Issues In Utah Legislation

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Utah Schools in Health Care Crisis
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Children Have Complex Health Needs

  • Children are being released from hospitals and returning to school requiring nursing care during school hours.  Some procedures done in hospitals need to be done at school.
  • More complex medications and procedures are needed in Utah schools. For example, there are children that need:
    • Medications given through catheters which go directly into the heart
    • Emergency rectal medications to stop seizures
    • Insulin injections administered during the school day
    • Other complex medications and procedures during school hours (i.e. gastronomy tube feedings, urinary catheterizations, tracheostomy suctioning)

Children Need Safe Medical Care

  • Medical emergencies at school may be managed by a teacher, classroom aide, secretary, or custodian because a nurse is not available every day.
  • Staff and volunteers may be well intentioned, but may not have the competence, skills, or availability to handle the responsibility and complexity required to respond to complex medical conditions.  For example:
    • In Utah, a student self administered six times the prescribed dosage of her inhaler medication for an asthma attack.  She spent a week in the hospital and is still recovering.  There was no school nurse available that day.
  • Every day at least one school calls 911. 
    • 911 service is not available in all areas of the state
    • 911 response times vary from minutes to hours

Children’s Health Impacts Education

  • Healthy kids learn better.  A child who is sick or in pain may not be able to learn.
  • The dramatic increase in chronic illnesses such as diabetes, asthma, seizures, and severe food allergies may impede a child’s ability to learn if not properly supported at school.
  • Federal laws mandate that schools provide the services children need to access their education.
  • Utah has a responsibility to ensure all students receive quality health care at school as well as a quality education.
  • Health promotion and wellness activities, such as improved nutrition and physical activity, help all students perform better academically and promote the development of healthy lifestyles.

School Health Services

  • Utah’s forty public school districts have approximately 500,000 students being served by 129 full and part time school nurses.
    • There is approximately 1 nurse for every 6,127 students
    • Some nurses serve up to 14 schools each
    • Some nurses travel 3 hours one way to reach a school
  • Approximately 12,000 students attend charter schools in Utah.  Most charter schools provide no school nursing services.
  • The school nurse may be the only health care provider that some children see on a regular basis.

For more information, contact the Utah School Nurse Association

www.utsna.org

Where does a School Nurse spend her time each day?
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UNA Resolution
Whereas, even with the administration and dispensing of medications by highly skilled professionals (nurses, paramedics, pharmacists, physicians), medication errors cause at least one death every day, and injure approximately 1.3 million people annually in the United States. Thus, UNA believes this skill should not be further extended to lesser-educated individuals.

Whereas, it is requisite that a nurse spend hundreds of hours in clinical and classroom education to pass licensure and boards for the safe and appropriate administration of medications. Conversely, this legislation assumes that a minimally trained individual, who spends only 40 clinical hours and 40 theory hours, is enough education to safely pass hundreds of different medications and assess their impact on patients.

Whereas, the UNA believes there are no "routine" medications. All medications can have potentially dangerous side effects, especially in the elderly and compromised populations.  

Whereas, medication administration and dispensing are complex skills that involve a comprehensive understanding of pathophysiology, pharmacology, drug interactions, indications and contraindications. Moreover, the medication administration process must include consideration of accountability for the nurse and the institute authorizing the practice. Thus, critical assessment of a patient by the professional before, during, and after administration of medications is fundamental to prevent or minimize untoward effects.

Whereas, UNA recognizes that this legislation attempts to control a practice that already occurs in assisted-living facilities; we urge you to reconsider the appropriateness of this practice. Assistive living centers need to comply with the current rules of providing assistance to self-administered medication practices, and not have an assistant dispensing and administering medications. UNA believes that abolishing this practice altogether, not condoning an unsafe practice by attempting regulation, is clearly in the best interests of patient safety.

Whereas, one of the primary functions of the UNA is to ensure patient safety, we do not believe the proposed legislation provides for adequate educational preparation to administer medications. Moreover, it is inconceivable that any educational preparation below that of a Licensed Practical Nurse would be sufficient.

Whereas, HB 127 could have a catastrophic impact on patient safety, UNA would be willing to support and suggests the following alternatives to the legislation:

Therefore, be it resolved that Utah Nurses Association (UNA) actively opposes HB 127. It is the position of the UNA that Medication Aides (certified or not) pose a constant and direct safety threat to the patient population for which we advocate. We do not support the administration of medications by CMA's in any setting.

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