Page 100 - MMP-N-NJ CCN 21st Century School Nurse Leadership Book

5. Empower others to act on the vision.

Remove or alter systems or structures undermining the vision.
• For example, policy changes that include 12-Component Vision and Eye Health System of
Care: https://nationalcenter.preventblindness.org/sites/default/files/national/documents/
VSProgramEvaluationNHSAVersion.pdf
• Ask questions and include parents/guardians in understanding challenges and barriers
in taking their child to an eye care specialist. This will allow for tailoring school-specific
interventions that address the challenges.
• Collaborate with community partners (i.e. Lions Club, eye care specialists, VSP providers).
• Create interest/buy-in to acquire (purchase if necessary) evidence-based vision screening
tools that promote quality and efficient screening of students.
• Encourage classroom teachers and other school colleagues to let you know if a student
appears to have difficulty with vision (squinting, turning head to one side, etc.).
• Develop plan to create a list of parent/guardian helpers.

6. Plan for and create short-term wins.

Define and set a date for visible performance improvement. Recognize and reward those
involved in the improvements.
• Set a date early in the initiative that creates excitement. Example: This may be sending
an email to the principal and classroom teachers that lets them know screening has been
taking place, found that using parent escorts are making screening go much more smoothly
and efficiently. The fourth-grade students in Mr. A’s classroom made an amazing poster on
the importance of vision, brain activity and learning. Send a personal thank you note to the
parent/guardian escorts. Send a thank you note to the ABVI.

7. Consolidate improvements and produce more change.

Use your success and improvements (yes! this project is going to work and the guiding coalition
is behind the initiative) to further change systems, structures, etc.
• Evaluate and plan for changes/improvements for the following year.
• Address policy changes as needed for district vision screening.
• Obtain needed new equipment for vision screening. Evaluate funding sources and budget
limits. For example, purchasing a handheld autorefractor may involve checking with district
budgets, perhaps applying for grant monies, asking local businesses or organizations to
help. If yes, how will you show a return on investment.

8. Institutionalize new approaches.

Articulate connections between new behaviors and success of the program. Share the
successes and your results.
• For example, two months after implementing outside agency screening and school
nurse telephone follow-up, 45% of all vision referrals had been returned, three students
obtained necessary eyeglasses. By May 80% of all vision referrals had been returned.
This represents a large improvement from 25% for 4th grade and 11% for 6th grade. The
school art teacher would like to have a poster contest for the following school year with
vision as a theme. Funding for students that required financial assistance was obtained
through the Vision Service Provider (VSP) program and the local Lions Club. The local eye
care specialist thanked the school nurse for including her in the school initiative as she
had never been contacted by a school nurse in the past. A small grant was obtained to
purchase a handheld autorefractor to improve efficiency and quality of screening.
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