Hawaii Keiki: Healthy & Ready to Learn Designated as an American Academy of Nursing Edge Runner

University of Hawaii at Manoa Nursing (UHM) and the Hawaii State Department of Education (HIDOE) are pleased to announce that the Hawaii Keiki: Healthy & Ready to Learn (Hawaii Keiki) Program has been designated as an Edge Runner by the American Academy of Nursing (Academy). Edge Runners are evidence-based, nurse-designed models that demonstrate significant clinical, financial, community, and policy outcomes with proven sustainability and replicability. Each of these programs highlights nurses’ ingenuity and collaboration in developing new methods to provide care and promote health equity.

Nurse on the Big Island listening to a student's heart

“This national recognition is a testament to the dedication of our nurses and so many people behind the scenes who are committed to ensuring that public school students in Hawaii have equitable access to health care,” said Deborah Mattheus, PhD, APRN-Rx, CPNP, FAAN, senior practice director and dental sealant program director for Hawaii Keiki. “Studies show that students succeed academically when they come to school healthy and ready to learn. Our program puts health care right into the schools. Hawaii Keiki makes sure every child who needs health care, receives it at no-cost and regardless of insurance status. In addition, our nurses provide health education and collaborate with community partners to expand health services, such as vision, hearing and dental screenings.”

Impact of health on student attendance and learning

In 2014, UHM and HIDOE partnered to create Hawaii Keiki to address the impact of health on student attendance and learning especially focused on the needs of Title 1 schools.

The program enhances and builds school-based health services that screen for treatable health conditions; provide referral to primary health care and patient centered medical home services; prevent and control communicable disease; and provide emergency care for illness or injury.

Nurse on Oahu takes a student's blood pressure

School-based health services

The program was designed to be flexible and agile to respond to emerging and ongoing student, school and community needs as well as funding availability. The Hawaii Keiki RNs (registered nurses) and APRNs (advanced practice registered nurses) are a resource to the entire school community. They lead the coordination of school health services and assists in school wellness promotion and health careers readiness. Hawaii Keiki nurses collaborate with and make referrals to health systems and individual care providers.

By utilizing technology such as telehealth, Hawaii Keiki has expanded equitable access to care for physical and mental health needs. A Hawaii Keiki RN can virtually connect a student to a Hawaii Keiki APRN. With the presence of dedicated nurses in schools, it allows principals and teachers to focus on education rather than students’ health care.

Hawaii Keiki nurses school year 2023-24

Health care delivered the local way

Hawaii Keiki nurses are compassionate and engaged health care providers. Many serve in the communities they were born and raised in, and others travel across the state to communities they have adopted as family. Every school, community and island experiences different challenges and health disparities. Hawaii Keiki nurses adapt and respond to the unique medical, socio-economic and geographic issues for their complex area.

“When we created Hawaii Keiki, our goal was to find nurses who would build an academic nurse-led school-based health program from the ground up,” said Mary G. Boland, DrPH, RN, FAAN, Dean Emerita, UH Manoa Nursing. “We focused on creating a program custom designed for the unique qualities of Hawaii and our public school education system because HIDOE is one system across all islands, separated by geographic distance and size. Hawaii Keiki is currently the largest school-based health program in the state and I am so proud of how the program has grown over the past 9 years. I find deep satisfaction knowing that nurses have truly made a difference in the lives of thousands of Hawaii students.”

Evidence of Success

The Hawaii Keiki: Healthy and Ready to Learn model has expanded access to health care and reduced health disparities for children and contributed to an emerging body of evidence on school health. During the COVID-19 pandemic, Hawaii Keiki continued to grow in size and scope to meet the needs of the students, community, and schools. When the state’s public schools closed during the pandemic, the program launched a hotline answered by Hawaii Keiki nurses to provide health advice, information on community services as well as to conduct telehealth visits upon requests.

School Nursing Services (in operation since 2014)

  • Expanded from 59 schools to all 258 public schools across the state
  • 75% of students in 2022-2023 returned to class instead of being sent home after a visit to a Hawaii Keiki clinic
  • Grown from 4 nurses to approximately 160 registered nurses, advanced practice registered nurses, dental hygienists, dentists and health technicians in 2023
  • The program now offers: school nursing, telehealth, mental health services, dental services, health hotline, Vaccines for Children and recently expanded services to Hawaii Charter Schools
  • 82% of Hawaii public schools participated in the Hawaii Keiki Narcan/CPR training initiative to reduce potential opioid overdose on school campuses

Dental Services (in operation since 2020)

  • Provides no-cost dental screening focused on high-need schools and has received on-going grant funding from Hawaii Dental Service Foundation since 2019
  • Expanded services from 6 schools on one island in 2020, to 68 schools on three islands in 2023
  • 61% of students in 2022-2023 who received dental assessments received dental sealants

Dental Hygienist conducts dental assessment and sealant at school

Promotion of Health Professions

  • Provides training and education for School Health Assistants (HIDOE employees) to increase their lifesaving and first-aid skills
  • Provides clinical experiences for University of Hawaii students from nursing, dental hygiene, pharmacy, sociology and psychology departments
  • Actively supports the HIDOE Career Pathways by engaging with high school student health academies and career fairs

“The Academy is proud to designate unique and solution-oriented initiatives as Edge Runners. The diverse focus of Edge Runner models highlight the wide range of services, vital support, and team-based approaches that the nursing profession provides,” said Academy President Kenneth White, PhD, AGACNP, ACHPN, FACHE, FAAN. “The Hawaii Keiki: Healthy & Ready to Learn Program applies nurses as innovative change agents who are addressing a specific health care challenge.”

All of the Academy’s Edge Runner profiles are available to view here. The program leads for each of these innovative models of care will be honored at the 2023 Health Policy Conference, taking place October 5-7, 2023 in Washington, DC.


About the American Academy of Nursing

The American Academy of Nursing serves the public by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. Academy Fellows are inducted into the organization for their extraordinary contributions to improve health locally and globally. With more than 2,900 Fellows, the Academy represents nursing’s most accomplished leaders in policy, research, administration, practice, and academia.

About Hawaii Keiki: Healthy & Ready to Learn

Hawaii Keiki is a partnership between UH Manoa Nursing and the Hawaii Department of Education and sits at the intersection of education and health to support the HIDOE to achieve student, school, and system success. The program is designed to improve access and quality of health services in the school by coordinating and expanding existing efforts of the partners and community resources. The program is enhancing and building school based health services that screen for treatable health conditions; provide referral to primary health care and patient centered medical home services; prevent and control communicable disease and other health problems; and provide emergency care for illness or injury.

Contact: Desiree Uyeda, marketing manager
(808) 956-2904

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