Wow! The school year is really winding down. I can't believe it has gone so fast. I have just a few things to share as we complete our school year and help our students and families with those last few health issues before we break for summer.

1. The annual conference was terrific! Great speakers, a nice location, and the conference committee did a wonderful job. If you missed it, you really missed out. A special thank you to Maureen Knowles and her Northwest committee for all they did and especially, the awesome entertainment. I don't think I saw anyone leave after the banquet. We had a full house to partake of the comedy event.

2. Statehouse advocacy day participation. OASN members participated in two statehouse days. ONA Nurse Day at the statehouse was on March 25th, and another school health advocacy day was on April 14th. I spoke on a panel at both and made very strong statements supporting our position on Children's Health and the Governor's budget bill. We also took those opportunities to meet with so many legislators that we had to divide up our group to make it to all of them.

3. Legislation. Substitute House Bill (HB) 1 was voted out of the House Finance and Appropriations Committee! Below is a brief summary of changes OASN has been working on:

-LPN language was removed from the bill. The removal of the language was a huge victory for school RNs, OASN and Ohio's students and we thank all of you who participated in some intense advocacy with members of the Ohio House to make this change happen. Because of your advocacy and these changes to the as-proposed HB 1, the House version does not include that a LPN is an acceptable level of service- delivery in Ohio's schools; however, the language does leave two definitions open to interpretation, including:
o Definition of the prescribed "district health professional"
o The qualifications of the school nurse and the school nurse wellness coordinator

-OASN will continue to advocate that the school nurse wellness coordinator qualifications are, at a minimum, a registered nurse. OASN will also work to bring clarity to the roles and minimum education levels required of school health services with continued advocacy in the Ohio Senate (please see below).

-The school medication administration changes we requested are in the House version and worded as OASN suggested. This means the law will continue as it has been in the past, except, that school employees designated by the administrator will need to "complete a drug administration training program" delivered by an RN to administer medication to Ohio's students. This change allows schools to provide high- quality care, maximize student safety as well as gives schools flexibility to meet the health needs of students.

UPCOMING WORK IN THE OHIO SENATE:
OASN is continuing its advocacy work in the Ohio Senate, as we are hoping to further clarify the definitions and roles in this bill as noted above. You should be receiving and will continue to receive alerts from OASN, as well as details regarding OASN formal testimony to the Ohio Senate Finance Committee.

OASN continues to be grateful to the grassroots advocacy of the membership! OASN members made a significant difference when they wrote letters, sent e- mails, and made phone calls. EVERY legislator that OASN leadership has worked with and visited with brought up how well OASN members advocated to their legislators. In short, they noticed!

There is still much work to be done and we are counting on all OASN members for their support, so watch for and follow directions on your alerts!

Thank you,

Deborah Strouse, RN, BSN, MEd, NCSN
President, Ohio Association of School Nurses

SUPPORTERS OF OASN!

The following organizations have given their written support to OASN's position on HB 1. Included are quotes from their letters.

American Lung Association - "For the health and well being of our children, there should be one full-time registered nurse in every school, every day. "- Tracie Ross, Executive Director The American Lung Association encompasses several national asthma organizations which were mentioned in the letter.

Columbus Education Association - The CEA Board of Governors unanimously passed a resolution on March 26th in support of the continued utilization of ODE licensed school nurses to meet the health care needs of the students of Columbus City Schools. The resolution was unanimously passed by the Legislative Assembly on April 2nd. A quote by CEA President, Rhonda Johnson, "Imagine if we replaced most of our classroom teachers with instructional assistants and in a downtown cubicle we had one teacher to supervise the instructional assistants. Our students would not receive high-quality instruction. Our students will not receive high-quality medical care if LPNs are allowed to replace licensed school nurses".

Frances Payne Bolton School of Nursing Alumni Association - "If there is one nursing professional full time in a school, that person should be the most qualified in that setting. Creating an additional license for a "school nurse wellness coordinator" (LPN) is misleading to the public and problematic in the school setting. It is cost effective and safer for school districts to hire RNs with a baccalaureate or higher degree in nursing with required specialty coursework for ODE licensure in School Nursing. At the recommended ratio of 1:750, a School Nurse making the same salary as a teacher, costs the school district only 38 cents per student per day. " Winifred J Walter, 2008-2009 President, Frances Payne Bolton School of Nursing Alumni Association.

Robert D Murray, M.D. - "The area of school health is highly specialized. Registered nurses and LPNs are not equivalent in training and experience. They are not interchangeable any more than a primary care pediatrician can be substituted for a cardiologist." Dr. Murray is Chair of the Home and School Health Committee of the Ohio Chapter of the American Academy of Pediatrics

Ohio Dietetic Association - "We support OASN in its position that it is the registered nurse, not the LPN who is qualified to deal with these complex issues (referring to children with complex health issues)." Pat McKnight, MS, RD, LD State Policy Chair

The Ohio Federation of Teachers - The following resolutions were passed at the OFT convention on February 28, 2009 to support the rights of children: The Highly Qualified School Nurse; School Nurse's Role in School Health Clinics; Pathway for Paraprofessionals and School Related Personnel; and Expansion of the PSRP Title to Include School Healthcare Providers. "Children deserve the care of a highly qualified health care professional who is licensed as a registered nurse by the Ohio Board of Nursing and as a school nurse k12 by the Ohio Department of Education."

School nurses are asked to contact other supportive organizations or groups that may be willing to write a letter of support to send to legislators or ask them to contact the OASN office for further information. Please let OASN know to which legislators letters of support are sent and copy to the OASN office. We are hearing that legislators are receiving a lot of mail, so keep up the good work!

Renee C Besecker, RN, BSN, MS, NCSN
Executive Director
Ohio Association of School Nurses
PO Box 150
Tipp City, OH 45371
Phone 937-667-0850
Fax 937-667-3366
email: exdirector@oasn.org

The SWOSNA board meeting was on May 5, 2009 at the President, Judy Marrinan's home. A general meeting took place on May 7, 2009 with a CE event that followed on "Minors and the Law" by Shakyra Diaz of the ACLU Ohio. Crystal Thornton was inducted as the President, and Kathy Daffler as President-Elect. Juliet Kolde is the recipient of the 2009 Martha Carrick Scholarship and was recognized at the May 7th general membership meeting for her efforts to further her nursing education for the betterment of Ohio's children.

SWOSNA is currently seeking volunteers to chair the Ways & Means and Historian Committee. Anyone interested in these positions may contact Jeanie Bochenek at southwestrep@oasn.org .

OASN updates have been added to the SWOSNA members constant contact email. SWOSNA members were also encouraged to continue to write legislators regarding HB 1. SWOSNA donated $750 to OASN to help defray the costs of the recent and continual legislative efforts of the organization.

Respectfully Submitted,

Jeanie M. Bochenek, RN, MS, NCSN
Southwest Representative to OASN

Northwest's next meeting and CE event took place on May 6, 2009 at St. Luke's Hospital. In conjunction with Nurses' Day the topic focused on Taking Care of You- the Nurse. The general meeting followed the CE event.

Elections were held in February for the positions of President -Elect and Secretary. Two members nominated for these positions were running unopposed. The members elected Nancy Murdock as President - Elect and Erica Spychalski as Secretary. Treasurer, Alice Bruning, agreed to serve another term as there were no nominations for this position.

The newsletter chairs, Mary Martin and Mary Beth Durbin, are unable to continue in their positions. They have done a wonderful job for Northwest. Denise Kaufman and Laurie Gladieux will take on the responsibility of newsletter chairpersons.

Northwest hosted the State Conference at Sawmill Creek in Huron, Ohio in March. Maureen Knowles was the conference chair and coordinated with a wonderful committee to conduct an excellent conference. Attendees were entertained by the Around the Bend Players Improv Comedy Troupe through a generous donation by Northwest and OASN. The conference provided nurses with timely and engaging CE topics along with several opportunities to network and have fun.

With respect to House Bill 1, NWOASN members have been emailed the OASN alerts along with encouragement to write legislators when advised to do so. We have consistently reminded our school nurses of the importance of our organization and becoming and/or maintaining OASN membership. There is strength in numbers.

The next Northwest board meeting will be held sometime this summer.

Respectfully submitted,
Marie Kraus, NW Rep

South East had their Spring Meeting on April 26th, 2009 at the Cherry Valley Lodge in Newark, prior to the Regional School Nurse Conference at 3:30 PM in the lobby. This report will serve as the minutes of the meeting and and as the newsletter report.

The meeting was opened by President Tammy Lorbach, followed by introductions of those present. There were 15 SEOASN members present. Membership forms and dues were collected. Vice President, Angie Lewis read the minutes from the Fall meeting.

There is currently $371.00 in the SEOASN account. There was a dispersement of $50.00 for the OASN basket and $25.00 for the Ohio School Board basket. Dues collected in the amount of $100.00

Fall & Spring meeting arrangements were discussed. It was suggested that the Fall meeting be changed to a date in November, possibly the week after the School Nurse Conference sponsored by Children's Hospital. Other suggestions were for CEU offerings, one half days or Saturdays. Locations suggested include, Athens, Gallipolis, and Jackson. At a prior meeting, it was discussed that Jackson would be the most central location for the spring meeting. Lori Moore and Tammy Lorbach will look into offering CEU at the meeting. It was also discussed that OU in Athens may be able to offer CEUs also.

NEW BUSINESS
1. Coordinated School Health Conference was discussed. There are two locations that school groups can participate in: Salt Fork and Deer Creek. A brochure was circulated at the meeting.

2. Discussion on increasing dues from $5.00/year to $10.00/year so we can be more effective in helping OASN in their legislative process and offer CEUs at future meetings. The motion also reflected that the SEOASN Constitution/Bylaws would have to be amended to reflect the change. It was motioned by Diana Chalfant and seconded by Marjorie Deck to accept the changes in dues and to amend the bylaws to reflect the change, motion passed. Those present at the meeting agreed to pay the extra $5.00 (Total $10.00) at the meeting and those not present can pay the additional $5.00 in the Fall.

3. DJFS funding reimbursement was discussed. The funding had stipulations for direct nursing care which states that the "skilled " Nurse services would have to be for "Medicaid eligible" students and involve skilled care that took at least 15 mins. If you were interested in more information, you may contact Tammy Lorbach at this email address: tlorbach@jcs.k12-oh.us .

4. School Issues: Several schools having problems with "Sexting", "the Choking Game", social issues, eraser burns, and "Wellness Committees" in schools where teams are not working as teams.

SE REP REPORT
· Annette attended the OASN Annual Conference, made and delivered the Regional Basket which was decorated with the conference theme. The theme for the conference is "Sowing the Seeds of Good Student Health". The 36th annual OASN conference was held on March 27th, 28th & 29th, 2009, at the Lodge at Saw Mill Creek in Huron, Ohio.

· OASN Survey - The survey is completed and there will be a detailed report later. It will be presented at the NASN Conference in Boston this summer. Annette has updated the email list based on the surveys of the region.

· HB 1 Update - The latest information received up to the meeting date included: The LPN language and section was removed from the bill according to the request of OASN. They also changed the medication law wording back to the original way it was written, except they added the stipulation of "an RN would have to teach the designated personnel proper medication administration". There still needs to be some clarification of the definition of terms "district health professional" and the qualifications of the school nurse and the school nurse wellness coordinator. These issues have passed through the OH House of Representatives and will now go through the Senate. Continue to write, e-mail or call your Legislators, it does work.

SEOASN Membership - Membership forms were sent to everyone via email, but had Annette's name on the bottom. Please complete the form and mail with your membership fee to our Treasurer: Rachel Klaiber, 4076 Haverhill Ohio Furnace Road, Ironton, OH 45638. (740) 533-1168.

Annette Scott, RN, BSN
SE representative to OASN

Sixty-four COASN members celebrated nurse's week on Tuesday, May 5th with a delicious dinner at Villa Milano Restaurant in Westerville in the Northeast section of Franklin County. It's always nice to have a relaxing dinner to catch up with our colleagues! We heard updates from our outgoing President Juanita Smith, our incoming President Carol Lynne O'Neil, and myself. We had a table labeled for those attending NASN conference in Boston this summer. Members are encouraged to email me if they are going to NASN and are looking for a roommate. Deb Strouse, OASN president was presented with flowers for all she does. She also urged us read our emails and to be vigilant with our emails to senators about House bill one. Our speakers next shared their informative one hour CE talk "Childhood Obesity Trends and Health Concern: Resources for School Nurses and Families".

President Juanita Smith concluded the meeting with the annual Induction of incoming Board and Chair members. She graciously thanked her board members who are leaving the board after serving the past one or more years.

Those nurses include: Laurie Tufts- Treasurer, Fundraising Chairman- Chris Ungar, and Webmaster- Ginny Black. Also thanked were Deb Stoner who has been newsletter editor and will now be our Webmaster. Kate King who has been Legislative Chairman and will now be newsletter Editor. Carol Lynn O'Neil who has stepped up from president- elect to President.

2009-2010 COASN Board and Committee Chairs:

President - Carol Lynne O'Neil(Columbus City)
President Elect -Carolyn Bernard (Columbus City)
VP/Programs - Debra Judy (Columbus City)
Treasurer - Judy Carnevale (Olentangy Local)
Secretary - Liz Jones (Columbus City)
OASN Representative -Ann Underwood (Groveport- Madison)
Webmaster/PR - Debra Stoner (Hilliard City)
Research/Awards - Lynne DiLoreto (Urbana)
Hospitality - Nancy Lynskey (Columbus City)
Newsletter-Kate King (Columbus City)
Membership - Nancy Click (Columbus City)
Library/Historian - Sharon Clay (Columbus City)
Legislative - Juanita Smith (Columbus City)

Carol Lynne is seeking someone interested in the Fundraising Chairperson. Please contact me if interested so I can pass your name on to her. I know someone out there wants to help out our organization and donate a small amount of your time to help.

Respectfully submitted,
Ann Underwood, R.N. B.S.N.
COASN Rep. to OASN

NEOASN held their spring Annual Meeting on Saturday, May 9, 2009 at the Cuyahoga County Board of Health office in Parma. We enjoyed a breakfast of quiche, cut fruit, and spice cake while sharing stories with our colleagues. President, Amy Anter, welcomed us and opened the business meeting. Lisa Mason, treasurer, reported our October meeting cost $618.13 while bringing in $190.00, benefiting members who attended. We are in strong financial standing. Chris Bell gave her last membership report showing 80 active members and 20 lifetime-retired members at this time. Most of the meeting was then devoted to updating members on news from OASN and advocacy efforts: 1) OASN by- laws now allow electronic notifications and elections. 2) HB1 has moved into the Senate. Please continue to respond to the "OASN Alerts" and contact Senators. Our grassroots efforts educated legislators about health needs in Ohio schools, current levels of care, and the differences in the scope of practice between RNs, LPN's, and unlicensed assistive personnel. 3) OASN has had input into the proposed language governing medication administration in schools and continues to monitor progress. 4) Members have also testified regarding minimum requirements for a school nurse license. Additionally, the School Nurse Licensure Task Force presented their recommendations to ODE. 5) OASN has contracted with Baker Nonprofits, a lobbying group that is focused on healthcare legislation, particularly regarding children, and will assist us during this critical stage.

NEOASN members at this meeting voted to support the increased legislative efforts of OASN by sending a donation of $1000. Members also voted to send $100 to the OASN Education and Research Endowment Fund to honor Aurelia Barney who has been the Ohio School Nurse of the Year for 2008-09.

Elections were held and the new Board of Directors for 2009-2010 was installed:

President Debbie Weisbarth
President-Elect Chris Purdy
Co-Vice-Presidents Maureen Barrett and Rita Roth
Secretary Pat Kovac
Treasurer Lisa Mason
OASN Rep. Mary Massey
Past President Amy Anter

Susan Inscore will continue the newsletter and Mary Ellen Shannon will be the membership chair.

Following the meeting, our program was "Stress Management Update for School Nurses." Our presenter, Rosanne Radziewicz, RN, PMHCNS-BC, a psychiatric advanced practice nurse at MetroHealth Medical Center in Cleveland, covered the biochemistry of stress and discussed conventional and alternative techniques for coping to reduce the negative health impacts from stress. Two contact hours were approved

Mary Massey
NE Rep. to OASN

If you have ever attended an OASN conference, you can probably appreciate the amount of planning, recruiting, and volunteer hours that is involved.

We need your help! We are looking for school nurses (retired nurses, family members, etc.) and no experience is necessary......we will train!

Please contact Kathy O'Dell at vicepresident@oasn.org

On February 28th in Columbus, the Ohio Federation of Teachers passed resolutions supporting the rights of children. Teachers support that children have the right and deserve the care of a highly qualified health care professional, the registered nurse, licensed by the Department of Education. Pat Gunter, School Nurse and Executive Board Member of the Cleveland Teachers' Union, and member of the American Federation of Teachers' Healthcare, along with the Union Conference Committee, Aurelia Barney, Susie Rice, Darlene Hernandez, Nancy Ponish and Director of Cleveland's Health Care Providers, Janice Maund, believe school health care providers must stay in the forefront of health care reform. We must continue to address the children with chronic disease and guide them through the system of health care. We support teachers in the classroom so the can teach and we can continue to provide the necessary health care that supports academic success for all of Ohio's children.

Submitted by Patricia Forrai-Gunter

At the February 17th meeting of the ONA Summit, Kimberly J Friedman, JD, described a new program known as the Nurse-Family Partnership. The program, whose national office is based in Denver, CO, is an evidence-based, community health program that helps transform the lives of vulnerable mothers pregnant with their first child. Each mother is partnered with a registered nurse early in her pregnancy and receives ongoing nurse home visits that continue through her child's second birthday.

Independent research proves that communities benefit from this relationship. Every dollar invested in a Nurse-Family Partnership can yield more than five dollars in return. The Nurse-Family Partnership is a growing program, only recently becoming based in Columbus, Ohio. Some examples of outcomes from a trial of the program included a:

48% reduction in child abuse & neglect
56% reduction in ER visits for accidents & poisonings
59% reduction in arrests in teens
67% reduction in behavioral and intellectual problems in children
72% fewer convictions of teenage mothers

For further information on the program, please contact:
Kimberly J Friedman, JD, Program Developer, Midwest Region.
kimberly.friedman@ nursefamilypartnership.org
Direct line phone # 303 865-8402

A recent question was submitted to the ODH about the recommended contents for the first aid kits in art rooms and science rooms.

Doug Pollitt of the ODH Environmental Health program, recommends that the following items should be included in the first aid and spill kits for science and art rooms:

This list is not all-inclusive, but recommended supplies include:
-assorted bandages, cotton balls, splints, and cold packs
-tongue blades, face mask or shield, and disposable gloves
-isopropyl alcohol
-containers of diatomaceous earth for general spills. (Diatomaceous earth may be spread to absorb neutralized chemicals, then swept and disposed of properly.)
-spilled acids are best neutralized with powdered sodium hydrogen carbonate ( sodium bicarbonate/baking soda) and bases with vinegar (5 percent acetic acid solution).

Submitted by Ann Underwood, RN

Along with emerging diseases and infections, nurses need to be aware of the return of an old nemesis: bed bugs. Remember your parents saying "Sleep tight, don't let the bed bugs bite" when they tucked you into bed at night? While most of us growing up in the United States had never seen a bed bug, that is no longer true today. With the banning of certain pesticides, insecticide resistance and frequent international travel, bed bugs have returned to the United States and the state of Ohio. Have you heard about bed bugs in your schools or community? If you haven't yet, chances are you will soon.

Bed bugs are about the size of an apple seed-1/4 to 3/8 inch long. They are flat, oval, fast and may look like a young, small roach. They may be colorless to reddish- brown/brown depending on when they have fed last. The adult female may lay up to 500 eggs in her lifecycle; she glues them in place until they hatch into nymphs in 6- 17 days. Nymphs need a meal of human blood to develop and grow through different stages. The adult can live 12- 18 months and can survive for months without a blood meal as they can enter a hibernation state. Bed bugs cannot fly or jump, but move very fast and are able to cling tightly to surfaces. Unlike head lice, bed bugs only feed on human blood and then retreat from the human body to hide in the environment. They usually hide during the day in dark, protected areas and prefer fabric, wood and paper surfaces where they leave tell-tale black fecal spots. They hide behind electrical outlets, switch plates, baseboards or edges of peeling wallpaper; these areas need to be inspected if an infestation is suspected. Their presence does not indicate a lack of cleanliness or low socioeconomic status, although treatment of bed bug infestation in the home can be expensive. Bed bugs are excellent "hitch hikers" and may travel from one place to another in luggage (including backpacks), books and furniture.

In the past year there have been increasing numbers of reports of bed bug infestations in hotels, apartments, homes and dormitories in Ohio; there have also been questions about what to do if children bring bed bugs to school in their belongings. The Hamilton County Public Health and Cincinnati Health Department were the first in the state to develop bed bug resources in response to these questions. The Central Ohio Bed Bug Task Force (COBBTF) was formed in Franklin County in November, 2008 and now has an informational Web site (see Resources). COBBTF developed and piloted bed bug awareness training for school personnel. Check with your local health department to see if a bed bug task force is being formed in your area.

Health care professionals may be seeing bed bug bites for the first time in their careers. Bed bug bites are often seen as three bites in a line on exposed areas of the body such as the neck, hands, arms, feet (not palms or soles). However, there is no way to tell a bed bug bite from another insect bite. As with mosquito bites, some people may find the bites irritating; bites may become infected from scratching that causes a break in the skin and introduces microbes. Regular insect bite management is encouraged to reduce irritation prevent infection: keep the site clean, cover any break in the skin and wash hands frequently. At this time there is no evidence that bed bugs themselves spread disease.

Bed bugs may come to school in the belongings of students. If you find an insect on a student or his/her belongings that you suspect is a bed bug, the child does NOT need to be sent home or excluded from school. Treat the child with dignity and notify the family of the suspected problem. Discreetly remove the child from the classroom long enough to see if a specimen can be obtained for identification (see Resources). Care should be taken not to crush the specimen, and it may aid in the insect identification if multiple bugs are submitted.

If an insect is positively identified as a bed bug, the school district should contact their pest control provider to ask about their experience with bed bugs. You may check your company on the Ohio Department of Agriculture Web site to see if it is licensed to apply pesticides (see Resources). "Bug bombs," DEET, and hot and cold weather extremes are not effective for exterminating bed bugs.

If your school is infested with bed bugs, it will require school custodial and teaching staff to be trained about bed bug characteristics since most people have not dealt with them before. Regular integrated pest management will need to be on-going. Any bed bugs found at schools must be placed in a sealed plastic bag before disposal. Any affected areas of the school building should be vacuumed daily and the vacuum bag disposed of daily by sealing it tightly in a plastic garbage bag. Vacuuming alone will not treat the infestation.

A sample parent notification letter to notify for a bed bug infestation at your school is on the COBBTF web site (see Resources). The site also has pictures to help identify infestations, school guidelines, a PowerPoint presentation with information about bed bugs and links to other bed bug resources. Some suggestions to help the family and school deal with bed bugs are to:

• Send only essential items to school. Inspect items coming from home upon arrival at school. It is best to keep non-essential items at the school to help prevent transfer of bugs from home to school.
• Keep school items sealed in a plastic bag or tote and off the floor at home and limit items taken back and forth from home to school until the home infestation is treated.
• Request the family send a set of clothes to school that are freshly laundered, dried on high heat and sealed in a plastic bag. The child may change into the clothes at school and place the other clothes in a sealed plastic bag to send home. It may be necessary to store and launder a student's clothes at school.

Resources

Central Ohio Bed Bug Task Force. http://centralohiobedbugs.org/ From the home page select "target areas," then "schools" to download the letter and view all the resources available.

Ohio Department of Agriculture. http://www.agri.ohio.gov/ To find information on pest control companies, click on "pesticide regulation", then "online services," then either "licensed company search" or "licensed people search".

Bed bug identification: The specimen(s) may be sent to the Ohio Department of Health (free service for Ohio residents): http://www.odh.ohio.gov/odhPrograms/dis/zoonoses/v bd p/vb_dref.aspx or for a small fee, The Ohio State University: http://ppdc.osu.edu/ for proper identification.

Janet Hyme-Householder RN, BSN, MPH
School Nurse Consultant - Emergency Preparedness
Ohio Department of Health
School & Adolescent Health
School Nurse Program
246 North High St.
Columbus, OH 43215
614-995-7075
fax #: 614-644-9850
janet.householder@odh.ohio.gov