Contribution Details

235Submission Type / Conference Track: Oral PresentationEducational Environment Improvement for Students who need Medical Care in Special Schools, JapanMaiko Sugawara1 , Takaaki Suzuki2Organization(s): 1: Toyo University, Japan; 2: Central Nippon Highway Engineering Tokyo Company Limited., JapanSubmitted by: Dr. Maiko Sugawara (Toyo University, JP), ID: 1094Keywords: special schools, profound and multiple disabilities, medical care, educational environment, school facility planning

Abstract

The rate of neonatal and infant mortality in Japan is one of the lowest in the world. Thanks to the progress of medical science and technology, more infants, who couldn’t survive after difficult deliveries in the past, can now be saved. However, in some cases after birth, daily medical care is required throughout their lives. In fact, the total number of kindergarten children and primary and secondary school students, who need daily medical care, has been increasing from 5,901 in 2006 to 8,116 in 2016, according to the Ministry of Education, Culture, Sports, Science and Technology, Japan (MEXT).In spite of this increase in the number of those requiring medical care, the facility improvement guidelines of special schools created by MEXT note few aspects regarding medical care. In addition, the architectural research of special schools in Japan is also insufficient.This paper focuses on the educational environment for students who need daily medical care in special schools and identifies the points of school planning for the future.Interviews with the principals and staff members of 7 special schools with a physical disability department in Japan were conducted between 2013 to 2015. These schools were selected due to the number of students with medical care needs and the number of nurses, the construction year and the scale of the buildings. After the interviews, the school buildings and the gyms were inspected, and explanations were given by the principles or staff regarding environmental management of the schools. From these surveys, the key points to improve the educational environment were identified, as follows:(1) In classrooms, teachers had a tendency to arrange corners for medical care and set various equipment up such as 1) humidifiers and air cleaners to prevent infections from spreading, 2) pots that contained hot water to wash medical care products, 3) carts to put commodities on such as suction equipment, general educational materials and self-supporting tools. Therefore, a major problem was the limited amount of space for activities in classrooms, which was much more limited than expected.(2) Medical care rooms are required to be located near classrooms and infirmaries so that the nurses can give medical care to the children promptly and efficiently. In addition, medical care rooms must have adequate space for vital checks and medical care for multiple students.(3) Water supply is an absolute necessity in classrooms and lunch rooms in order to wash students’ hands and medical equipment.(4) For tube fed students, consideration of adequate space needs to be required so that the students can spend lunch with their friends from an educational/social point of view.(5) For catheterization, there needs to be an appropriate number of special booths and space, a required bed, sufficient lighting and a layout for the ease of supporting students.(6) For tracheotomy and the suctioning of phlegm, air conditioners, humidifiers and air cleaners are vital to prevent the spread of infections.These insights and the awareness should be taken into school planning and refurbishing.

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Educational Environment Improvements for Students who need Medical Care in Special Schools, Japan

Maiko SugawaraTakaaki SuzukiToyo UniversityJAPAN

IAPS2018, Rome

Background

The Lowest newborn mortality rates1. Japan: 1 in 1,111 2. Iceland: 1 in 1,0003. Singapore: 1 in 9094. Finland: 1 in 8335. Estonia: 1 in 7695. Slovenia: 1 in 7697. Cyprus: 1 in 714

Note: Press released on Feb. 20th, 2018 by UNICEF

What is Medical Care?

Suctioning

Tube feeding

Urethral Catheterization

Artificial respirator

Hygiene control of tracheotomy

etc…

Background

Transition of Students who need daily medical care,in Special Schools (2006 ‐2016)

6.1%  of all students in special schools : (2016)

Number

59016136

66236981

730673507531

7842777481438116

5500

6000

6500

7000

7500

8000

8500

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

The facility improvement guidelines of special schools  

by the Ministry of Education

Purpose

Targets: Students who need daily medical carein special schools

What are the key points of school planning and design in the future for these students?

Method

No School Numberof pupils Built Visit date

1 Sakuraso 35(2013) 2012 July 9th,20152 Komei 216(2015) 1973 June 12th,20153 Kagayakinomori 63(2015) 2012 Sep. 10th,20154 Kofu 82(2015) 2007 Nov. 30th,20155 Ki Kosumosu 218(2015) 1999 Dec. 4th,20156 Shunan 87(2015) 2000 Dec.14th,20157 Akita kirari 104(2015) 2010 Feb.12th,2016

School visits and Interviews with the principals and teachers

Common features, problems and demands‐ Classrooms‐ Medical care rooms ‐ Lunch rooms for those being tube fed‐ Restrooms for urethral catheterization‐ Air control and outlets for the students who require 

tracheotomy suctioning

Analysis and Discussion

ClassroomsThe corners for medical care

Humidifiers, electrical devices and supportive tools

Medical care rooms

Medical care room

Infirmary

Sakuraso special schoolGround floor plan

Sakuraso special school

Ki Kosumosu special school

Lunch rooms for the tube fed students

Lunch roomKagayakinomori special school

Lunch roomKofu special school

Lunch at classroom with friendsSakuraso special school

connected

Restrooms for the urethral catheterization

Shunan special school Ki kosumosu special school

Air control and outlets for the students who require tracheotomy suctioning

ConclusionThe key points regarding school planning for those students‐ Classrooms should have enough space with corners for medical care, proper storage, necessary electrical devices and supportive tools.

‐ Medical care rooms need to be located next to infirmaries and classrooms with adequate space for multiple students.

‐ Lunch rooms should have proper and safe space for students who requiretube feeding, so as to be able to spend lunch with their classmates.

‐ Restrooms should have enough space and be functional for catheterization.‐ Air control devices can provide the appropriate room temperatures and humidity levels. 

‐ Having the appropriate number of electrical outlets is essential for health and safety reasons.

Thank you

Maiko SugawaraProfessor, Toyo UniversityE‐mail: sugawara@toyo.jp

Sakuraso Special School