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The School Nurse as a Coordinator of Health Services for Handicapped Students: A School Record Analysis
Authors:Cathy L Crossland  EdD    Gordon H DeFriese  PhD    Michael F Durfee  MD    Wendy L Sanchez  MEd    Jane S Stein  MS  Don W Badger  MSW
Institution:Coordinator, Graduate Program in Special Education, and Director of the Diagnostic Teaching Clinic, School of Education, North Carolina State University at Raleigh;Professor of Social Medicine, and Director of the Health Services Research Center, University of North Carolina at Chapel Hill;Associate Professor of Medicine, Department of Pediatrics, the University of North Carolina at Chapel Hill, and Medical Director of Wake Teen Medical Services;Coordinator of the Diagnostic Teaching Clinic, School of Education, North Carolina State University at Raleigh;Associate Director for Data Management, Health Services Research Center, the University of North Carolina at Chapel Hill;Director of Adolescent Services, Wake Teen Medical Services
Abstract:Data from a study of linkages between the public schools and private medical practitioners in the care of handicapped children in the elementary grades were used to study the extent to which school nurses act, through screening and referral, as coordinators of health care services for these children. Cumulative school records for a population of 785 students with one or more learning-related handicapping conditions in a single school district were examined. Findings indicated that (1) classroom teachers refer nearly 40 percent of students with handicapping conditions to the school nurse; (2) approximately 33 percent of these students are subsequently referred to physicians for additional medical care (diagnosis and treatment); (3) there are important differences in the likelihood of parental follow-through with nurse referrals for physician care depending on the nature of the child's condition; and (4) where the school and the private medical care system have interacted, parental follow-through with a school nurse referral is more likely. The study suggests that school nurses might play a significant role in assuring continuity of care for children whose physical health is an important factor in determining educational progress.
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