Evaluation of concussion education, prevention and management policies in school districts of a rural state : implications for practice and policy change

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Montana State University - Bozeman, College of Nursing


Concussions have become a national issue in organized youth and adult sports. Estimates indicate there are upwards of 3 million concussions yearly. Concussions are unique in the fact that they can cause serious long-term effects and even death if not managed properly. All 50 states have passed laws mandating school districts implement policies and procedures to educate stakeholders about the nature and risks of concussions and subsequently statutes on the proper management of concussed athletes. Montana passed the Dylan Steiger's Protection of Youth Athletes Act in 2013. It is the purpose of this paper to analyze data from interviews and appraisal of school district concussion policies and procedures in the state of Montana; ultimately describing the current state of implementation. Subsequently, recommendations for policy change, school and clinic practice will be made. School district superintendents were interviewed from 12 counties in Montana. A tool was created to specifically inquire about superintendent knowledge regarding the current policies and procedures in their respective districts as they pertain to the statutes set forth by the DSPYAA (2013). Subsequently, the policies and procedures in these schools were critically analyzed against the statutes of the DSPYAA (2013). Superintendents had general knowledge of each districts policies and procedures, though many were unsure or unaware of multiple key aspects that are mandated by the law. Critical analysis of district policies and procedures also showed deficiencies when compared to the mandates of the law. Also many districts denied having adequate health care resources. Recommendations include amendment of the DSPYAA (2013) by restructuring definitions within the law to provide clarity. Amendment should also include multidisciplinary concussion management teams, preferably including superintendents and licensed health care providers, which conduct concussed student-athletes through a gradual return-to-learn process. Superintendents play an important role in ensuring policies and procedures are appropriately implemented and abide by the DSPYAA. It is also recommended that school staff, officials, and local LHCPs be educated on the most current management recommendations. These recommendations may be facilitated by the nurse practitioner considering they have competency in leadership, quality, policy, and health care delivery systems.




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