Both Type 1 and Type 2 diabetes requires extremely careful management.  The process of counting carbs, monitoring blood sugar, and injecting insulin throughout the day can be complex and confusing.  As difficult as this is for adults, it can be exponentially harder for children – especially during the school day.

While the need is there – a recent CDC report details how both Type I and Type II diabetes are on the rise in youth populations – not every school has access to a qualified nurse on premises to assist children with their routine diabetes care.  In fact, only 39 percent of schools in the US employ a full-time school nurse and just 35 percent employ a part-time school nurse.  In rural areas, or communities struggling with healthcare staffing shortages due to the COVID-19 pandemic, those numbers can be much lower.

As school districts search for a viable solution to this worrying gap in care for young students, they can find an opportunity in telemedicine.

Virtual registered nurses offer a convenient and cost-effective way to provide experienced, high-quality care on demand. Telemedicine services allow nurses to supervise unlicensed assistive personnel (UAP) when conducting diabetes management tasks, such as insulin administration, providing support to school officials and bringing peace of mind to parents at home.

This strategy has been proven safe and effective for students and staff. In a study conducted in rural South Dakota between 2010 and 2013, virtual school nurses oversaw the administration of 5,568 doses of insulin. Out of those doses, only one error was recorded due to a carb counting discrepancy.

With the help of virtual nurses, UAPs were able to respond appropriately to episodes of both hypoglycemia and hyperglycemia.  While 70 percent of UAPs struggled with counting carbs on their own, virtual nurses provided education and oversight to ensure that students were consuming the right mix of foods.

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Parents of the participating students responded positively to the strategy, indicating increased confidence in the school’s ability to care for their children during follow-up surveys.  As a result of the study, South Dakota updated its rules around school-based diabetes care to integrate telemedicine more deeply into its strategies.

The complexity of diabetes care for children is an ideal use case to highlight the importance of virtual care in the absence of in-person providers.  There are enormous opportunities to expand the reach and utility of virtual nursing care in schools to help students manage their chronic conditions – and provide assistance for acute illnesses and injuries, when necessary, too.    

Virtual school nurses are a simple and highly effective way to close the access gap while supporting school staff members and parents in their shared mission to manage diabetes effectively and ensure a high quality of life for young people living with chronic disease.

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