Abstracts

Rationale: Social determinants of health have a direct impact on health outcomes and equity within a community. Having a safe and supportive environment, direct access to school nursing and other health services along with disease specific education has shown to improve health and academic outcomes. Students with epilepsy were reported as more likely to miss 11 or more days of school in a year and had activity limitations when participating in sports/clubs as compared to students with other medical conditions.¹



To address the needs of students with epilepsy, the Epilepsy Foundation (EF) launched the Seizure Safe Schools (S3) legislative initiative, currently enacted in 23 states. The model bill has 5 elements and mandates a student’s Seizure Action Plan be available to personnel who interact with the student, and FDA-approved prescribed medication be available for administration.

The aim of this survey was to gain insights on nurses’ knowledge of S3 legislation, challenges associated with implementation and identification of training and support needed.






Methods: Leveraging insights from previously reported surveys, the National Association of School Nurses (NASN), Students with Epilepsy Guideline (2018) and the S3 model legislation, a 50-question survey was developed. It focused on 5 areas: seizure recognition, seizure response, implementation of S3 legislation, delegation of authority to treat seizures in the school setting, and training. A survey was sent to a convenient sample of 10,932 school nurses who opted in for information from a pharmaceutical company.


Results: The sample represented a diverse group of experienced nurses with 48% aware of S3 legislation.

When a seizure occurs, 62% indicated they provide seizure first aid, and then administer rescue medication. If the latter, 37% are required to call 911 following a seizure. Over 80% of school nurses felt very or extremely comfortable with delegating the authority to administer seizure rescue medication while only 66% had the authority to do so. The ability to assess students’ response to medication and symptoms and/or other school personnel not willing to administer hinders delegation of authority to others.

Preparedness to address S3 requirements varied. The respondents look to EF (82%) or NASN (54%) for training and education.




Conclusions: While there is a push for greater health equity in schools shown through the S3 legislation advancement across the US, the data collected from the survey indicates more education and support is needed to address S3 requirements and ensure equitable health outcomes. The ability of staff other than nurses to administer rescue medication is a barrier to equitable treatment. Specific needs and opportunities for training programs varied by region emphasizing targeted awareness efforts and improved support systems will be required.



¹Pastor PN, Reuben CA, Kobau R, Helmers SL, Lukacs S. Functional difficulties and school limitations of children with epilepsy: findings from the 2009–2010 National Survey of Children with Special Health Care Needs. Disabil Health J. 2015. DOI: 10.1016/j.dhjo.2014.09.002.








Funding: Survey supported by Neurelis, Inc.