Increasing Pool Testing and TTS Participation

Posted

Specializes in Pediatrics, Community Health, School Health. Has 26 years experience.

Hi,

I am being tasked with working on a "project" to increase our number of students across the district who are enrolled in our weekly pool testing and TTS program.  I honestly do not know what else to do to increase participation.  We have sent emails, made phone calls, sent texts, etc.  We have been doing weekly pool testing since fall of 2020 so this is nothing new.  I am at a. loss of what else to do to get more families to enroll. At the end of the day, more students enrolled is hugely helpful for the nurses when there is a + case so of course I want to be able to make their lives easier, but I also do not think admin understands that there is only so much one can do.  It is NOT mandatory, so if they do not want to sign their kid up then that's that.  If you have somehow managed to greatly increase participation in your district, I would love to hear what you did.

arlingtonnurse

80 Posts

Thank goodness my family liaison has been tasked with this.  We ask families to sign up on line but our rate of return is much higher if we send home the paper forms.  She has also sent home translated consents whenever needed.  We also ask the teachers to reach out to their families which is also much more effective as they often have closer connections to the family.  We also don't allow students in TTS if they aren't doing the pooled testing so highlighting how much school the student would miss with no remote option often pulls families off the fence.  At one point we considered a contest for the classes but eventually decided it might involve too much sharing of information than was appropriate.  That being said we have close to 95% of the kids enrolled (my liaison is a beast).

k1p1ssk, BSN, RN

Specializes in pediatrics, school nursing. Has 11 years experience. 610 Posts

I have heard from other nurses in my area that sending home the paper consent increased participation by 50% over the Spring-time. 

I would caution against the teachers reaching out to families - we have had issues with families believing the teachers "have an agenda" and are trying to brainwash the kids for simply telling the kids they need parental consent to participate. Kids twist words CONSTANTLY (in fact today, I got an angry voicemail from a parent who was convinced by her kids that we were vaccinating our entire school population this coming Friday when the clinic they were referring to is happening off of school grounds and after school hours....) 

If you leave it up to the facts and present them with a hard copy of the consent, they may be more willing to participate.

Jedrnurse, BSN, RN

Specializes in school nurse. Has 30 years experience. 2,614 Posts

I guess I'd start by trying to find out the reason(s) why people are declining to participate. That might help you come up with ways to help them re-think their choices. Any idea what's going on in their heads?

MHDNURSE

Specializes in Pediatrics, Community Health, School Health. Has 26 years experience. 697 Posts

1 minute ago, Jedrnurse said:

Any idea what's going on in their heads?

It's so hard to know.  As you can imagine, communication from schools has been beyond overwhelming and I think a lot of families are over it to be honest.  Like they see yet another email or text from school and do not even bother to read it.  We also have a population with many families who are spread way too thin, work 2-3 jobs, single parent households, etc.  So I imagine going online to sign up, or fill out one more form feels overwhelming.  

Cattz, ADN

Specializes in School Nurse. Having conversations with littles.. Has 36 years experience. 1,021 Posts

This is very interesting to me. Our school didn't even attempt to do Pool Testing- I didn't think there was any way that enough parents would go for it. We do TTS for school close contacts.

k1p1ssk, BSN, RN

Specializes in pediatrics, school nursing. Has 11 years experience. 610 Posts

2 hours ago, Jedrnurse said:

I guess I'd start by trying to find out the reason(s) why people are declining to participate. That might help you come up with ways to help them re-think their choices. Any idea what's going on in their heads?

I had a parent of a clearly ill student who told me there was no way I was putting a "government swab" up her kid's nose, even if it meant he could come back to school sooner (I was sending him home regardless). She came and picked him up and saw how sick he was, and said she was going to keep him out the next day as well and get a doctor's note so he could come back - fine, whatever. He got a 3 day weekend on top of that, but returned on Monday - no alternative dx, no negative covid test, so I called... and Mom was sweet as pie - oh go ahead, please do the swab, he's feeling much better, but if it's best for everyone go ahead, and what do I need to sign so he can be tested all the time, etc. etc... So I don't know if the MD office refused to write the letter or if she just forgot the sugar in her coffee that first morning... Though I haven't gotten the signed consent form back yet...

Jedrnurse, BSN, RN

Specializes in school nurse. Has 30 years experience. 2,614 Posts

6 minutes ago, k1p1ssk said:

I had a parent of a clearly ill student who told me there was no way I was putting a "government swab" up her kid's nose, even if it meant he could come back to school sooner (I was sending him home regardless). She came and picked him up and saw how sick he was, and said she was going to keep him out the next day as well and get a doctor's note so he could come back - fine, whatever. He got a 3 day weekend on top of that, but returned on Monday - no alternative dx, no negative covid test, so I called... and Mom was sweet as pie - oh go ahead, please do the swab, he's feeling much better, but if it's best for everyone go ahead, and what do I need to sign so he can be tested all the time, etc. etc... So I don't know if the MD office refused to write the letter or if she just forgot the sugar in her coffee that first morning... Though I haven't gotten the signed consent form back yet...

Wow. I just have regular swabs; now I want to try the government ones and see if they're any better.

Were you required by your district policy to let the student with possible COVID symptoms return without a negative test or quarantine period?

MHDNURSE

Specializes in Pediatrics, Community Health, School Health. Has 26 years experience. 697 Posts

17 hours ago, Jedrnurse said:

Wow. I just have regular swabs; now I want to try the government ones and see if they're any better.

🤣

k1p1ssk, BSN, RN

Specializes in pediatrics, school nursing. Has 11 years experience. 610 Posts

17 hours ago, Jedrnurse said:

Wow. I just have regular swabs; now I want to try the government ones and see if they're any better.

Were you required by your district policy to let the student with possible COVID symptoms return without a negative test or quarantine period?

No, if Mom hadn't agreed to the test when he came back to school, I would have kept him in my office and sent him home again. 

We're just following DESE & DPH guidelines, which would exclude the kid for 10 days from onset of symptoms unless they provide a negative covid test or alternative diagnosis.

 

JenTheSchoolRN, BSN, RN

Specializes in School nursing. 3,011 Posts

Send home paper consent forms. Don't use the CIC portal! I never used it. Used paper consents and Docusign on my end. 

Using this method, I got to 90% participation in grades 5-8 this fall at my school. Also, I have gotten families to opt into TTS when they aren't doing pooled testing and that unvaccinated student can't come to school unless they do TTS. I will work with a email consent yes and follow up with a paper form. No vaccine and no TTS agreement, kid gets sent home. I'd not had one parent say no to TTS this way :).

Now, my HS - opt in there is about 55%. But my vaccination numbers are much higher there. I actually had more families choosing to opt out. But again, paper consents going home made my numbers go from 33% to 55%. 

Edited by JenTheSchoolRN