Evaluation of a school health program directed to children with history of high absence. A focus for nursing intervention

In recent years nursing personnel associated with a County Health Department have become involved in efforts to assess the effectiveness of their services, with particular emphasis on determining the benefits to the populations they serve. The present study was developed in response to questions concerning whether the skills of professional nurses were being utilized to best advantage within the school system. It was decided that identification of children with a past record of high absence would be a reasonable way of defining a group of children with a high risk of future episodes of illness and possibly a high prevalence of basic health problems. Since it was anticipated that children so defined could benefit from nursing service, it was concluded that high absence children constituted an appropriate risk group to which nursing services could be profitably directed. This group was therefore selected for the pilot program. The major objectives of the study were to consider the utility of directing nursing services to a defined risk group and to document the results of the experience in terms of patient outcomes, specifically, change in absence experience. The basic working hypothesis was that focused nursing attention would be positively associated with a reduction in days absent. From the perspective of the service agency some of the concomitant benefits from the study are: the methodology, using absence as an indicator, suggests a practical approach to identification of a high risk population; the school health program can be planned to further explore emphasis on prevention through selected priorities rather than continuing to be crisis oriented; and efforts can be directed toward development of improved documentation of nursing intervention not only to provide an improved data base for evaluation but also to meet the current demand for accountability. In addition to providing a meaningful experience in program evaluation for nursing staff within the health department, participation in the study promoted more effective communication between the school system and the health department which share joint responsibility for the school health program.