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Case Study

How Comal ISD Supports School Nurses Who Serve an Ever-Growing Number of Students

Director of Health Services Kelli Brooks oversees 39 nurses who serve over 27,000 students. At a time when demands on school nurses are rising, here’s how Frontline School Health Management helps them save time, avoid errors, and better care for students.

Comal ISD Hero Image

District Background

The 33 schools in Comal ISD — located about halfway between San Antonio and Austin, Texas — serve over 27,000 students each day. Thirty-nine school nurses administer medications and first aid, tend to ill students, and respond to thousands of requests each day. Kelli Brooks, the Director of Health Services, is there to support them: she manages the school health budget, oversees inventory, maps out hearing and vision screening schedules, calibrates audiometers, and a lot more.

With that many students, the district must be prepared for anything. Comal ISD was one of the first districts to have Control the Bleed kits at every campus, and now each school has multiple kits. Since some nurses have over one thousand students and can’t be everywhere at once, all employees are trained and have NARCAN® available at all locations as well, in case of an opioid overdose.

The job hasn’t gotten easier for school nurses. A resurgence of flu and RSV, and even more younger students who weren’t fully potty-trained during the pandemic means more visits to the nurse’s office. “The amount of office visits has gone up so incredibly much. It’s not uncommon for an elementary nurse to see 80 kids a day,” said Kelli — and that’s on top of distributing medications and working with kids who have special care needs like asthma or diabetes.

“The amount of office visits has gone up so incredibly much. It’s not uncommon for an elementary nurse to see 80 kids a day.”

Kelli Brooks
– Director of Health Services

Managing it all requires a system to keep track of the details.

Saying Goodbye to Cardstock

Comal ISD has been using Frontline School Health Management (formerly HealthOfficeAnywhere) for over 15 years. Prior to that, records were kept with paper and pencil. “We were documenting everything — immunization records, everything — on cardstock.”

Sometimes, Kelli said, it was hard to fit everything on one piece of paper. When a nurse looked at a student’s card, it was often difficult to read someone else’s handwriting. Recording required information was tedious and manual. And it was impossible to run reports in a quick, neat manner.

Reasons Comal ISD Chose Frontline

When asked why the district made the choice to use Frontline School Health Management, Kelli listed four primary reasons:

  • Saving time on state reporting
  • Immunization documentation makes it easy to see which students are noncompliant and send letters home to their parents or guardians
  • The ease of administering medications, since a to-do list auto-populates for school nurses
  • Medical alerts and other general alerts that appear whenever a student’s record is pulled up

Results

Time-savings for Nurses

“It has been a life saver to have this program,” Kelli said. Nurses — those 39 fearless souls caring for an ever-growing number of students — no longer must shuffle stacks of to-dos on notepads. Their dashboard populates with a list of things that must get done, and they can create reminders to ensure nothing gets missed.

The ability to quickly pull up students’ records makes it easier to navigate peak office visit times, with allergy warnings and medical alerts to help avoid mix-ups — something that comes in handy when the usual school nurse is out for the day. “That’s very crucial and beneficial for our substitutes too, so that they can log into the system and easily see anything that has to do with that student as well.”

Kelli said that when working with students who regularly receive medication, the system helps them move quickly, with each student’s profile easily accessible. “It helps maximize nurses’ time to be able to document everything in one single setting,” Kelli said. “Everything you could think of is right there.”

“It helps maximize nurses’ time to be able to document everything in one single setting.”

Kelli Brooks
– Director of Health Services

Comal ISD has also connected Frontline School Health Management to their student ID system. Whenever a student comes to the nurse’s office, the nurse uses a barcode scanner to quickly pull up the correct student record. This is useful for preventing medication errors, especially with elementary students who may not be able to answer questions correctly.

Running State Reports

Because Frontline School Health Management tracks everything in one system, it’s easy for Kelli and her team to run reports required by the state. “We use it for our immunization state report, since we have it all documented in there, it’ll pull up all the numbers that we need to show who’s compliant, who has exemption forms, and then we can submit that to the state as well as hearing and vision and scoliosis.”

Kelli can now complete that state immunization report in under 30 minutes — a task that previously would have meant hours of sifting through data. “State reporting is just such a time saver — immunization and documentation and being able to pull up easily who’s non-compliant and send those letters home,” Kelli said, in addition to all the other ways the system saves her staff time. “The ease of administering medications, having it all there on a to-do list, medical alerts and general alerts populating when you pull up a student… I could keep going on.”

“The ease of administering medications, having it all there on a to-do list, medical alerts and general alerts populating when you pull up a student… I could keep going on.”

Kelli Brooks
– Director of Health Services

Data to Support Planning

The Health Services Department also uses data captured in Frontline School Health Management to keep administrators and district leadership informed about what’s happening in each school. “Being able to show them the amount of office visits and the amount of medications that these nurses are giving has been really crucial.” They can even look at it by grade or day of the week. “I would pull the report and address it with the principal. ‘Okay, third grade is sending me double the amount of kids that kindergarten is,’ or, ‘Fridays are so much busier than Tuesdays.’”

And to keep an eye on trends in the student population that should be noted, such as whether more students coming to the office for first aid or for non-essential reasons, Kelli asks that nurses record every visit — even minor ones — because the data is so helpful.

“Being able to show [administrators] the amount of office visits and the amount of medications that these nurses are giving has been really crucial.”

Kelli Brooks
– Director of Health Services

Helping the Health Services Department Support School Nurses

Kelli looks at nurse’s offices are like mini urgent care centers, and said nurses often feel alone or without support. They often handle crises through their lunch breaks and pour themselves out for their students, but it can be a thankless job. Parents know when the school nurse calls, it’s usually unpleasant news about a sick or injured child — and don’t always respond with gratitude.

That’s why support from Comal ISD’s central health office is so important. Kelli and her team often visit campuses to lend support, help find substitute nurses, act as sounding boards, and even jump in to help when things get busy.

Because of the time they save using Frontline School Health Management — using the system to generate reports, add templates, add medications, and even do weekly inventory checks to provide accountability for controlled substances — Kelli said that they have more time to spend offering that support to nurses.

All in the Service of Education

And, of course, using the data in the system ultimately support’s Comal ISD’s mission to empower student learning. Not only are kids able to get back to class sooner because office visits don’t take as long, but it’s easy to see if a particular student is spending a lot of time in the nurse’s office, and the team can work with the teacher to plan how to prevent that.

“We want them in class. They’re in school to learn. And if they’re out of class for X amount of time because they’re in the nurse’s office all the time, then they could address that with the teachers. The statistical piece of it was something that I didn’t think that we would use as much, but we certainly are.”