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School Nurses: Type I Diabetes for Full-Time Employed Public School Nurses
 
Course Description
    

This course is designed to refresh nursing knowledge in the basic care of students with type one diabetes. It introduces you to the basic pathophysiology of type one diabetes and gradually increase base knowledge to understanding carbohydrate counting, insulin therapy and insulin pump management. It allows easy understanding of blood sugar highs and lows while providing information on research and resources.

Throughout this course, you will, among other activities, create components of a Section 504 for a student with type one diabetes.

 
Course Syllabus
    

By the end of this course, participants will understand:

  • understand the pathophysiology of diabetes and review the causes of type one diabetes,
  • understand both state and federal laws which protect the student with diabetes,
  • recognize the difference in simple carbohydrates and complex carbohydrates and how they affect blood glucose levels,
  • help students make food choices based on the glycemic index,
  • assist the student count the number of carbohydrates for each meal,
  • understand the types of insulin as well as their peak and duration of action,
  • describe the difference between the Constant Carbohydrate Plan and Carbohydrate Counting Plan,
  • calculate the insulin required for a student using an insulin-to-carb ratio and a correction factor,
  • calculate the insulin required for a student using an insulin-to-carb ratio and a correction factor,
  • explain the difference between a basal rate of insulin and an insulin bolus of insulin,
  • have a basic understanding of insulin pumps on the market today,
  • explain the function of a continuous glucose monitor,
  • be able to define both hypoglycemia and hyperglycemia, list the causes, and treatments for these situations,
  • explain ketone testing and its importance,
  • complete a Diabetes Medical Management Plan (DMMP), 
  • identify some of the psychosocial issues students with type one diabetes may face,
  • ideas to arrange the classroom to support student learning, and
  • factors for supporting a positive classroom climate.
Course Organization

This course includes several different activity components, all of which are described below. During each session, you will participate in a unique collection of these activity components, depending on the particular focus of that session.


Read
When you see this icon you will be reading relevant articles, resources, and instructional materials that will help inform your online course development process.

Activities
When you see this icon you will be completing activity-based curriculum and inputting various components of your course content into course project.

Discuss
When you see this icon you will be using the online discussion board to share ideas, resources, and thoughtful conversation with your fellow course participants and facilitator.
Prerequisites

This professional development course is designed for school nurses in West Virginia public schools. Participants in this course will design and implement session projects throughout this course. Each session project will contain at least one activity related to a 504 plan. Participants are expected to have constant access to computers and be able to download and upload files. Although not a requirement, high speed Internet access definitely enhances the online experience. 

Microsoft Word is required in order to read, edit and/or create documents for this course. If you have a WVDE k12.wv.us email account, you have access to Word, Excel, PowerPoint, OneDrive, etc. as part of Microsoft Office 365. You should see your school/county technology support person if you need help in using/installing Word and/or other Office applications. 

If you do not have a k12.wv.us email account, Word must be acquired through other means.  One way to get access to Word Online at no charge is by Creating a Microsoft Outlook Account with Access to FREE Office Online

Format and Requirements

This workshop is divided into six one-week sessions which each include readings, activities, and an online discussion among workshop participants. The time necessary to complete each session is estimated to be 6.5 to 7 hours.

The outline for the workshop is as follows:

Session One What is Type One Diabetes?
Session Two Food Management and Type One Diabetes
Session Three Insulin Therapy
Session Four Insulin Pumps
Session Five The Highs and Lows
Session Six Everything Else; DMMP, Research, & Resources

Session One: Session One: What is Type One Diabetes
Diabetes is the most common endocrine disease in children.  According to JDRF, formerly the Juvenile Diabetes Research Foundation, type 1 diabetes (T1D) is an autoimmune disease in which a person’s pancreas stops producing insulin, a hormone people need to get energy from food. T1D strikes both children and adults at any age and suddenly. Its onset has nothing to do with diet or lifestyle. Though T1D’s causes are not yet entirely understood, scientists believe that both genetic factors and environmental triggers play a role. There is currently nothing you can do to prevent it, and there is no cure.

While insulin injections or infusion allow a person with T1D to stay alive, they do not cure the disease, nor do they necessarily prevent the possibility of the disease’s serious effects, which may include: kidney failure, blindness, nerve damage, heart attack, stroke, and pregnancy complications.

Session Two: Food Management and Type One Diabetes
Healthy eating for children with diabetes is the same as healthy eating for all children. Having a food plan is important for students with type one diabetes.  It is also important to remember that children with diabetes are children FIRST. Having type one diabetes doesn’t mean these students can’t eat the same foods as their friends, they can – it just takes a plan.

Any plan a student may use will involve some method of carbohydrate “carb” counting and insulin administration. Being able to help the student plan his or her meals, determine the total number of carbohydrates, and calculate the units of insulin will help control their blood glucose levels and manage their diabetes.

Session Three: Insulin Therapy
Students with diabetes require a balancing act of carbohydrate counting, physical activity, and insulin administration. Insulin is “life support” for children with diabetes. It is important for school nurses to be aware of the types of insulin available and the different plans used to determine insulin dosage.

With the many new insulin analogs on the market, students with type one diabetes have more flexibility and choices in their diabetes management. Most children use a combination of rapid-acting and long-acting insulin therapy. Rarely do you see a student prescribed an intermediate-acting insulin – NPH.

Session Four: Insulin Pumps
Snacks (including on the bus, meal times, testing times and testing when blood sugars are high or low), Syringes, insulin pens, and insulin pumps all serve the same purpose: to deliver insulin to students with type one diabetes.  Which method of administration a student used depends upon many factors. These factors include the age of the student, the number of years since diagnosis, current blood glucose control, and insurance coverage. 

Students with diabetes must inject insulin many times a day. The exact number of injections varies from student to student. This task can be overwhelming for many students. Insulin pens and insulin pumps can make this task more manageable. Choosing an insulin delivery method is a personal decision to be made by the student, family, and physician.

Session Five: The Highs and Lows
The key to diabetes control is a careful balance between exercise, food, and insulin. It is not an easy task. There will be times, no matter how closely carbohydrates have been counted and insulin calculations have been made, the student with T1D will still experience high and low blood glucose levels. 

When a student faces a hypoglycemic or hyperglycemic episode, it is very important that the school nurse and the support staff know how to treat these situations. Again, it is important to remember that each student needs to be treated as an individual and to follow his or her Diabetes Medical Management Plan. 

Session Six: Everything Else; DMMP, Research and Resources 
Effective diabetes management in school takes a lot of work from everyone involved. The school nurse’s role in maintaining the safety and long-term health and success of the student with T1D is vital. The school nurse also must act as an advocate for the student with diabetes to ensure they have access to all of their needed supplies at all times. 

Assessment

Each session includes readings, activities, and a discussion assignment, which participants are required to complete weekly. This is a three-hour graduate level course and will require 45 hours to successfully complete the tasks. Participants should plan to spend 6.5 - 7 hours weekly to read assignments, complete activities including a session projects and participate actively in the weekly discussions.

Orientation Quiz: During the Orientation Session, participants are expected to complete the Orientation Quiz. The quiz may be completed as many times as necessary to score at least a 90% accuracy. 

Readings and Activities: Participants are expected to complete the required course readings and activities as posted in each of the session assignment pages. Optional readings may also be completed, but are not mandatory.

Session Projects: Each session of this course features one project. Project templates/instructions and rubrics are provided for every project as a part of the session content. Projects and/or supporting documents will be uploaded to the course dropbox during Sessions 1, 2, 3, 4, 5 and 6. Feedback will be provided in the dropbox for Sessions 1, 2, 3, 4, 5 and 6. To receive credit for the course all grades must be recorded as a "C.".

Copyright: Copyright guidelines are to be observed throughout the course project and all course activities. All work associated with the course project is to be the original work of the course participant. Fair use does not apply to the course project.

Discussion Forum: Participants will be evaluated weekly on the frequency and quality of their participation in the discussion forum. Participants are required to post a minimum of one substantial original posting each session in response to the discussion prompt for that session by Sunday evening. Participants are to respond thoughtfully to a minimum of two colleagues' original postings each session by Monday evening. They are to read all original messages by course participants and enough additional responses to make a total of 50% of the messages posted for that session by Tuesday evening. Postings will be evaluated on their relevance, demonstrated understanding of course concepts, examples cited and overall quality.

Read the Discussion Guidelines and the Checklist for Evaluating Discussion Postings. Your facilitator will follow these guidelines and the checklist when evaluating successful participation in the course Discussions. You will use peer-review rubrics to peer-review other participants' projects in the Discussions during Sessions One - Six. The Rubric Review Help Guide will assist you to complete this successfully.

Grades: All grades in the course gradebook must be a "C" for successful course completion. A grade of "C" indicates that all work has been completed and the work meets the expectations for that assignment.

 Pre and Post Workshop Surveys: Participants are expected to complete both surveys. The Orientation Survey is to be completed by Sunday during the Orientation Session and the Final Survey is to be completed by Sunday during Session Six. 

Certificate of Completion

Upon successful completion of this course participants will receive a Certificate of Completion documenting successful completion of the course requirements. Certificates are distributed to each qualifying participant via attachment to the Final Course Project Dropbox shortly after the completion of the course.

Graduate Credit Information

Participants in this course are eligible to receive non-degree graduate credits from either West Virginia University, Marshall University, West Virginia State University, or Concord University. Credits will be awarded at the end of the semester in which the course occurs. Additional information is available on the course News/Welcome Page.

Content and Technology Standards

This course will help participants meet the ISTE Educational Technology Standards and Performance Indicators for All Teachers (http://edtechleaders.org/documents/NETSAdminTeachers.pdf), especially Standards II, III, IV, and V. For more information about Technology Integration visit: http://www.iste.org

About this Course

This course was developed by the West Virginia Department of Education (http://wvde.state.wv.us).

Original design (before format modifications) by EdTech Leaders Online (http://www.edtechleaders.org), a project of Education Development Center, Inc, © 2007.  All rights reserved.