To mark this year’s National Nurses Week, we not only praise all nurses for their caregiving and dedication, but also highlight those who are committed to the specialty practice of school nursing. In fact, one of the most important programs we operate at the Health Care District of Palm Beach County is our school health program.

For background, the Health Care District is a public health care system in Florida established by Palm Beach County’s voters 26 years ago as a special taxing district. It provides adult and pediatric care at its primary care clinics, health coverage programs for eligible uninsured residents, pharmacy services, a nationally-recognized trauma system, short and long-term skilled nursing, and acute care at Lakeside Medical Center – the county’s only public hospital.

Why School Nurses?

Our School Health Program assigns more than 200 full-time registered nurses at 168 public schools in Palm Beach County. For many students, the School Nurse is the only health care professional that they see all year.

These nurses provide ongoing health services to students allowing them to maximize time in school and be healthy and ready to learn. The program is costly, yet the anecdotal thinking has always been about the benefit of this program to the students and parents.

But last year, JAMA Pediatrics published a CDC study that puts a dollar amount on the cost-benefit of having full-time registered nurses in schools. The key point was that for every dollar spent on a school nurse program, the community receives back $2.20 of benefits.

The “Cost-Benefit Study of School Nursing Services” study is based on information gathered from the Massachusetts Essential School Health Services Program.

By the Numbers – Massachusetts and Palm Beach County

The Massachusetts school nurse program is a large, state-wide program encompassing all 78 school districts in the state. It has a total of 1,157 full-time registered nurses in 933 schools.

By contrast, the Health Care District program is about one-sixth the size, with 205 registered nurses spread over 168 schools.

Over one year, the nurses in Massachusetts reported 4,946,757 health visits by students and 99,903 visits from staff.  By contrast, Health Care District nurses reported a total of 678,300 student visits during the 2013-2014 school year.

Nurses in both programs performed medical procedures such as glucose testing, blood pressure monitoring and medication administration.

After being seen by the nurse, 93.8 percent of students in Massachusetts were able to return to class.

The financial analysis of the cost-benefit of the Massachusetts program incorporated several factors:

  • cost of the procedures that the nurses performed (costs were assigned using Medicaid fee schedules)
  • value of time saved by teachers and school personnel who did not have to provide care for students who were ill
  • cost savings related to parents that did not have to lose time from work because such a high percentage of students were able to return to the classroom

Nurses’ Impact is Clear

When all these costs and savings were combined, researchers found there was a net positive effect: “For every dollar invested in the program, society would gain $2.20.”

As the Health Care District examines programs of value to the community, the benefit of full-time registered nurses in schools is clear from this study.  

What’s more, bringing additional services into school health, such as those provided by the Health Care District’s C. L. Brumback Primary Care Clinics, will increase the value of the program to the community.