Monday, December 11, 2023

The American Academy of Nursing calls the Hawaiian Keiki program an “Edge Runner”: Kauai Now

The American Academy Of Nursing Calls The Hawaiian Keiki Program An “Edge Runner”: Kauai Now

A partnership between the University of Hawai’i at Mānoa Nursing and the Hawai’i State Department of Education, the Hawai’i Keiki: Healthy & Ready to Learn Program, has been recognized as an Edge Runner by the American Academy of Nursing.

Edge Runners are evidence-based, nurse-developed models that demonstrate significant clinical, financial, community and policy outcomes with proven sustainability and reproducibility. Each of these programs highlights the ingenuity and collaboration of nurses in developing new ways to deliver care and promote health equity.

The program was developed in 2014 to examine the impact of health on student attendance and learning, with a particular focus on the needs of Title 1 schools. Hawaiʻi Keiki improves and builds school-based health services that screen for treatable health conditions; Providing referrals to primary health care and patient-centered medical home services; prevent and control communicable diseases; and provide emergency care in the event of illness or injury.


The program is designed to be flexible and agile to respond to new and current needs of students, schools and communities, as well as the availability of funding. The Hawaiian Keiki Nurses and Advanced Practice Registered Nurses are a resource for the entire school community. They lead the coordination of school health services and help promote school wellness and preparation for health careers. Hawai’i Keiki nurses work with and refer health systems and individual care providers.

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Through the use of technologies such as telemedicine, Hawai’i Keiki has expanded equitable access to care for physical and mental health needs. A Hawai’i Keiki nurse can virtually connect a student with a Hawai’i Keiki advanced practice nurse. Having dedicated nurses in schools allows principals and teachers to focus on education rather than student health care.

The Hawai’i Keiki: Healthy and Ready to Learn model has expanded access to health care, reduced health disparities for children, and contributed to new evidence on school health. During the COVID-19 pandemic, Hawai‘i Keiki continued to grow in size and scope to meet the needs of students, the community and schools. When the state’s public schools closed during the pandemic, the program set up a hotline answered by Hawaiian keiki nurses to provide health advice and community service information and to conduct telemedicine visits upon request.

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School nursing service (in operation since 2014)

  • Expansion from 59 schools to all 258 public schools statewide
  • 75% of students in 2022-23 returned to class after attending a Hawaiian keiki clinic instead of being sent home
  • In 2023, the number has grown from four nurses to approximately 160 registered nurses, advanced practice nurses, dental hygienists, dentists and health technicians
  • The program now offers: school nursing, telemedicine, mental health services, dental services, health hotline, childhood immunizations, and recently expanded services for Hawai’i Charter Schools
  • 82% of Hawaii public schools participated in the Hawaii Keiki Narcan/CPR training initiative to reduce possible opioid overdoses on school campuses

Dental services (in operation since 2020)

  • Provides free dental exams focused on high-need schools and has received ongoing grants from the Hawai’i Dental Service Foundation since 2019
  • Expanded services from six schools on one island in 2020 to 68 schools on three islands in 2023
  • 61% of students in 2022-23 who received dental exams received dental sealants
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Promotion of health professions

  • Provides education and training to School Health Assistants (HIDOE employees) to improve their life-saving and first aid skills
  • Provides clinical experiences for UH students in nursing, dental hygiene, pharmacy, sociology and psychology
  • Actively supports the HIDOE Career Pathways by collaborating with health academies and career fairs for high school students

“The Academy is proud to recognize unique and solution-oriented initiatives as Edge Runners. “The diverse focus of the Edge Runner models underscores the broad range of services, critical support and team-based approaches that the nursing profession offers,” said Kenneth White, president of the American Academy of Nursing. “The Hawai’i Keiki: Healthy & Ready to Learn program leverages nurses as innovative changemakers who address a specific healthcare challenge.”

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