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Executive Summary

In 2016-17, Hawaii Keiki expanded access to school based nurses to 65,000 public school students enrolled with the Hawaii Department of Education (DOE), nearly doubling the program reach since its launch in 2014-15. Hawaii Keiki provided 11 nurses across 7 Complex Areas (106) schools to support student, school and system success through numerous health related activities.

Direct Services

  • Launched 6 School-Based Health Centers in 6 Complex Areas (1 Hawaii Island; 5 Oahu) staffed with an APRN providing assessment and medical treatment for acute health conditions
  • Nearly 20% of health room visits and 1,570 cases were referred by SHAs to nurses
  • Provided 133 prescriptions and medication administrations requiring RN/APRN license
  • Provided flu vaccine with the Stop Flu at School program through DOH
  • Participated in vision screening with EyeSpy 20/20 vision screening software at 26 schools
  • Facilitated hearing screenings in lower elementary school grades

Data Collection

  • Implemented a school health electronic documentation system at 12 school sites.
  • Worked with the vendor to create reports to meet Hawaii needs
  • Data shows:
    • 26,594 visits to the health room and 1,216 medication events for 5,867 students
    • Visit reasons: 44% illness-related; 39% injury related; 17% health guidance
    • Visit disposition: 85% returned to class; 14% dismissed from health room; 1% remained in health room

2017-18 Planned Activities

Hawaii Keiki received DOE funding to expand school nursing statewide to 15 Complex Areas:

  • Statewide public school system support
    • 256 schools with approximately 180,000 students across the State of Hawaii
    • Establish 8 new School-Based Health Center in 8 new Complex Areas
  • 20 project schools will have School-Based Health Care services provided by Hawaii Keiki Nurses
  • Increased access to services through UHM Nursing funded grants to introduce pilots to selected schools
    • Hawaii Interprofessional Practice and Education Coalition including pharmacy and APRN students, psychiatry fellows, and pediatric dentist
    • Develop oral health program providing screening and dental sealants
  • Support and consultation to DOE OCISS School Health Services Section for
    • Expanding the pilot electronic health room management system, HealthOffice Anywhere®, to all 256 schools
    • Continued collaboration and development with community organizations

Program Activities and Highlights

DOE Complex Areas with the Hawaii Keiki Program:


  • Kapaa-Kauai-Waimea: 16 public K-12 schools, 9,000+ students


  • Kau-Keaau-Pahoa: 9 public K-12 schools, 5,000+ students


  • Castle-Kahuku: 16 public K-12 schools, 8,000+ students
  • Farrington-Kaiser-Kalani: 25 public K-12 schools, 15,000+ students
  • Kailua-Kalaheo: 14 public K-12 schools, 6,000+ students
  • Nanakuli-Waianae: 9 public K-12 schools, 8,000+ students
  • Pearl City-Waipahu: 17 public K-12 schools, 14,000+ students

Program Growth

School Year Nurses Complex Areas Schools Keiki
2014-15 4 5 59 37,000
2015-16 6 6 89 51,000
2016-17 11 7 106 65,000


2016-2017 Staffing/Scope Expansion
Quarter 1
  • Onboarding of 2 new Complex Area APRNs and 1 School RN
  • Recruitment of 2 additional School RNs and 2 APRN vacancies
  • Launch of 6 new School-Based Health Centers in 6 Complex Areas including:
    • Outreach to all students in school for parental consent for services
    • Implementation of EPIC Electronic Medical Record and billing system
  • 10 School Health Assistants (SHAs) trained in HealthOffice Anywhere® [HOA] documentation system
Quarter 2
  • New School RN contract established serving 2 additional elementary schools
  • 1 APRN position and all 3 remaining School RN vacancies filled
  • Implemented pilot of HOA in 12 school health rooms with Hawaii Keiki nurses
Quarter 3
  • SHA Manual Project to update health room procedures with evidence-based practice guidelines in collaboration with UH Manoa Nursing faculty and DOH Public Health Nursing Branch
  • Executed new MOU between DOH-DOE-Hawaii Keiki establishing expanded program services to DOE and formalizing coordination between parties
  • All vacancies filled with nurses providing care at 12 schools in 7 complex areas
Quarter 4
  • Enhanced DOE integration initiated through transition of program to OCISS under School Health Services Section
  • SHA Manual Project final draft completed and delivered to DOE
  • Legislature approved DOE budget for state-wide expansion to 8 new complex areas starting in the 2017-18 school year
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