ArticleLiterature Review

The Impact of School Nursing on School Performance: A Research Synthesis

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Abstract

School nurses work in an educational setting. Due to budget cuts, different goals, and confusion between educators and nurses regarding the school nurse role, school nurses are being asked to demonstrate their effectiveness and justify their presence in elementary and secondary schools. Although school nursing was first initiated 100 years ago, a review of the literature published since 1965 indicates that 15 studies have been conducted that examine the impact of school nurses on academic performance. However, today many articles have recommended more research linking school nursing to educational outcomes. This article synthesizes the results of 15 research articles. Findings from these studies indicate that nursing interventions targeted at specific populations, including parents, have had significant effects. A relationship between school nurses' interventions and absenteeism is also suggested. Limitations of these studies are discussed, along with suggestions for future research.

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... Over the following two months after the project, 12 additional nurses were hired by the NYSEA to serve in New York City schools (Wald). Other cities and states observed the benefits of the New York initiative and began their own school nursing programs (Maughan, 2003). These exciting beginnings laid the groundwork for the system of school nurses in existence throughout the country today. ...
... These school nurses care for more than 52 million students throughout the country (NASN 2003). Maughan (2003) presented the responsibility of schools in a succinct way: "The goal of the school system is to educate students and help them develop the skills needed in life" (p. 164). ...
... A student who is not as healthy as they can be cannot participate in the educational process as effectively as healthy students can. Absenteeism from school and other time spent out of class (such as office visits) influences students' ability to learn (Maughan 2003). Existing research has shown that nurses can influence rates of absenteeism (Allen, 2002;Fryer & Igoe, 1995;Kimmel, 1996). ...
Article
The purpose of this study was to evaluate current research on evidence-based practice (EBP) and best practices for school nurses addressing student asthma, as well as how school nurses integrate those practices with the IHP, the IEP, and other factors in daily practice. The objective of this study was is to explicate the framework for a qualitative meta-analysis of the existing research and literature addressing EBP and best practices. The method divided a general inquiry of research material, (in this case, best practices for school nurses treating asthma), into three categories: an analysis of theory, and analysis of methodology, and an analysis of findings. Triangulation of these three factors allowed a procedural approach to analyzing the collected data on best practices for school nurses with regard to student asthma. Results of the study offered three recommendations for best practice including proactive communication with other stakeholders, promotion of educational interventions, and teaching and reinforcing the principles of self-care for asthmatic students. The sources containing recommendations for school nurses managing student asthma did not directly address the definition of "best practice." The definitions and implementation of "best practice" are not consistent in the literature. Also, it may have been unnecessary to discuss the meaning or definition of "best practice" when making recommendations.
... The critical link with the failure to identify and treat students' MEB needs is that it results in diminished capacity to learn (Breslau, Lane, Sampson & Kessler, 2008;Briggs-Gowan & Carter, 2008;Freudenberg & Ruglis, 2007;Paternite, 2005;Vander Stoep, Weiss, Kuo, Cheng & Cohen, 2003). The SN may play a key role at the intersection of health, including mental health, and academic achievement (Hootman et al.,2003;Maughan, 2003;NASN, 2008;Puskar & Bernardo, 2007;Simmons, 2002;Smith & Firmin, 2009). SN are capable of identifying the early signs of MEB disorders which are frequently identifiable in its earliest stages by absenteeism, academic failure (Weismuller, Grasska, Alexander, White & Kramer, 2007) disciplinary problems and suspensions (Stanley, Canham & Cureton, 2006). ...
... Prevention, early identification and treatment of aggressor -victim problems has been urged. There is a need for identification of evidence based practice guidelines for SN and increased SN involvement and role expansion (Evans, 2006;Maughan, 2003;Mazurek Melnyk et al., 2007;Puskar & Bernardo 2007). Professionals both within as well as outside of nursing have indicated a need for on-going research in these areas (O'Connell, 2009;Schainker et al., 2005). ...
... SN leaders have indicated that SN and other school staff have no evidence-based intervention guidelines to assist students with somatic complaints that seek SN assistance (Shannon et al. 2010). Nurses and other professionals (Adams, 2009;Borowsky, 2010;Evans, 2006;Maughan, 2003;Mazurek Melnyk et al., 2007;Puskar & Bernardo, 2007;O'Connell, 2009;Schainker et al, 2005;Wandersman et al. 2008) have identified the need for practitioner perspectives to bridge the research to practice gap, identify evidence-based practice guidelines for SN, and increase SN engagement and role expansion. ...
Article
Full-text available
The purpose of this qualitative study was to explore school nurses’ (SN) perceptions of factors influencing their ability to identify, refer, and provide mental health services to students with early signs of mental, emotional, and behavioral (MEB) needs. The National Research Council and Institute of Medicine have urged a preventive public health approach to decrease adverse outcomes of unidentified and untreated MEB needs among children (O’Connell, 2009). Historically and theoretically based in public health, SN have daily contact with students and are in an optimal location for early identification, referral and provision of services, yet little empirical research describing their role is available. Five focus groups with 29 SN were conducted and four themes emerged through analysis of data: Frequent flyers : student visits to SN offices, the observations that alert SN to potential MEB needs; Digging to get the whole picture : the process SN frequently used to collect information necessary to confirm MEB needs; Road to referral : the resources used and barriers encountered within the referral process; and, Safety zone : the important role SN play in the provision of services to students with early signs of MEB needs. Within the provision of services was a collective subtheme across all five focus groups: What we need to better help our kids. In this category SN identified their educational limitations and learning needs, as well as potential strategies to improve provision of services for students with MEB needs. The findings of this study provide a lens into the complex and little explored are of early identification, referral and intervention processes used by SN to care for students with MEB needs. Understanding the role of the SN is a critical first step towards improving outcomes.
... In probing the gamut of ways the health office represents both health care and education, and their convergence in US public schools, this study engenders a renewed understanding of the significance of the complex relationship that exists between student health and educational outcome (Maughan, 2003;Geierstanger, Amaral, Mansour, & Walters, 2004). In a published comprehensive literature review, Symons, Cinelli, James, & Goff (1997) bring together the work of many researchers to "confirm a strong relationship between health risks and education outcomes" (p. ...
... The school nurse, as a health care professional, functioning within local and state rules and regulations, is positioned to serve students in an elementary school; she is prepared to intervene when they arrive in her office 'unhealthy' in providing health care that enables them to get back to their classrooms rather than be set home. Keeping children in school is an important role of the school nurse (Maughan, 2003). What Ann does to keep Wiggle Creek children well and in their classroom is an important story to tell. ...
... It reflects my assumptions about their body language as they responded to Ann's humor, or a response such as "left with a quickened step" or on occasion skipping out of the room. Maughan (2003) Further study is needed to explore the effect of care provided by the school nurse. ...
Article
To provide a high-quality education for all its students, schools must address a variety of needs that are related to physical, social and/or emotional health. School nurses are positioned to do that in the schools that they serve. Exploring how the school nurse intervenes to help children and their families to maintain a high level of health may contribute to an understanding of health care and academic achievement in the educational community. The purpose of this qualitative study is to gain an understanding of what a nurse does on a regular basis to provide health care to all children in a public school at the preventive and primary care levels in the United States health care delivery system. In an effort to contribute to existing knowledge about the relationship between health and education outcome, this year-long study utilized an ethnographic approach to examine what a particular school nurse does within the context of an elementary school with an enrollment of over 500 students and a 92% poverty rate. The findings strongly support that the school nurse interacts with children and staff in caring ways to: 1) negotiate daily medication administration to manage chronic illnesses according to district policy and nursing practice; 2) manage the treatment of episodic health complaints; and 3) record and communicate health information. Together they provide an understanding of the school nurse ‘caring for’ and ‘caring about’ children’s health to improve the possibility that they will be in their classroom. Adviser: Stephen A. Swidler
... 3.6.3. Oppsummering av studiene på helsepersonell i skolen Maughan (2003) konkluderer med at sykepleiere på skolen har en positiv effekt på forhold som påvirker elevenes mulighet til å laere og til å fullføre skolegangen. Studiene viser at det er signifikante korrelasjoner mellom sykepleiedekningen i skolen og helsen til elevene, både relatert til sykdom og mestring av sykdom i en skolekontekst, men også videre helsemål som graviditet, tobakk-og rusbruk, vold og dødsfall. ...
... I alle tre studier fant man at skolehelsetjenestens kontakt med foreldrene og naermiljøet rundt skolen bidro til å øke kontakten mellom skole og hjem og redusere sannsynligheten for helserelatert fravaer fra skolen og fravaer fra timene. Maughan (2003) ...
... Hvis vi ser på studien av Ertesvåg og Vaaland (2007), kan det se ut til at det tar tid å jobbe frem gode resultater av programmene, og at elever med lang ansiennitet i de ulike SEL-inspirerte programmene skårer bedre enn de med kort erfaring. Kapitlet om helsepersonell i skolen viser at helsesøstre kan ha en positiv effekt på forhold som påvirker elevens mulighet til å laere, spesielt gjennom redusert fravaer og bedre sykdomsmestring (Maughan (2003) og bistand til elever for å utvikle økt mestringstro . Til tross for at skolehelsetjenesten kan bidra til bedre helse hos elevene, er det usikkert om intervensjonene kan føre til styrket faglig kvalifisering for elevene. ...
... Academic outcomes were broadly defined as student academic performance in certain subjects or overall grade point average, absenteeism, class time missed during the day, or "seat time" (time in classroom). The search was limited to literature published after January 1, 2002, to minimize overlap with a previous review (Maughan, 2003), until June 24, 2018. This search was limited in EBSCOhost to English language and peer-reviewed journals, and agegroups of child and adolescent (2-18 years). ...
... This integrative review extended the prior review demonstrating the important contributions that school nurse clinicians make to academic outcomes, especially increasing the amount of time that children are present in the classroom (Maughan, 2003). In a setting of scarce resource allocation, this information can be shared with decision makers to delineate the role of school nurses in the educational mission of the school. ...
... A prior research synthesis evaluated 15 studies that included both nursing, as part of the intervention, and school outcomes (Maughan, 2003). This current review extends Maughan's (2003) work by including a synthesis of recent quantitative literature to the body of evidence on this topic. ...
Article
The empirical evidence from previous studies has demonstrated that school nurses are effective in assisting children and families to address health concerns, reduce absenteeism, and provide children with the opportunity to reach their potential academically. Impoverished children and those with disabilities and chronic illness are at risk of school failure. An integrative review was undertaken to critique the research between 2002 and 2018 that addressed the influence of school nurses on academic outcomes such as absenteeism, missed class time, grades, and test scores. The findings of the review suggest that the presence of a school nurse is associated with reduced absenteeism and missed class time but not with academic achievement. Overall, the research in this area is weak and future research using more rigorous study designs, examining broader school nurse roles, and long-term academic outcomes is indicated to evaluate the impact of school nurses on educational outcomes.
... [7][8][9] It is suggested that the school nurses who take part in every level of school health services can play an important role in the assessment and management of health risks of students and in having students adopt healthy life behaviors, and that many nursing practices have a positive impact on attendance rates and overall education. [10][11][12][13][14] Previous studies in the field show that in schools where nurses are employed, absenteeism associated with medical reasons are lower, and graduation rates, in-class participation, grades, and the rate of participation in social activities are higher. Leaving school early due to injury or sickness becomes a less common phenomenon when students are able to see a nurse at school. ...
... Leaving school early due to injury or sickness becomes a less common phenomenon when students are able to see a nurse at school. 12,[15][16][17] Maughan 12 emphasizes that there are findings contained in the literature in relation to a low rate of leaving school due to medical reasons and absenteeism because of illnesses and high rate of students graduation at schools, where school nurses work. However, in the same evaluation, it is stated that these findings do not commonly demonstrate the direct impact of school nurses on academic achievement due to methodological reasons and that there is a need for studies to be performed in this field. ...
... Leaving school early due to injury or sickness becomes a less common phenomenon when students are able to see a nurse at school. 12,[15][16][17] Maughan 12 emphasizes that there are findings contained in the literature in relation to a low rate of leaving school due to medical reasons and absenteeism because of illnesses and high rate of students graduation at schools, where school nurses work. However, in the same evaluation, it is stated that these findings do not commonly demonstrate the direct impact of school nurses on academic achievement due to methodological reasons and that there is a need for studies to be performed in this field. ...
Article
Full-text available
Introduction: School nursing services should be evaluated through health and academic outcomes of students; however, it is observed that the number of studies in this field is limited. The aim of this study is to evaluate the impact of comprehensive school nursing services provided to 4th grade primary school students on academic performance of students. Methods: The quasi-experimental study was conducted with 31 students attending a randomly selected school in economic disadvantaged area in Turky. Correlation analysis, repeated measures analyses of variance, multiple regression analysis were used to analyze the data with SPSS software. Results: At the end of school nursing practices, an increase was occurred in students’ academic achievement grades whereas a decrease was occurred in absenteeism and academic procrastination behaviors. Whilst it was determined that nursing interventions including treatment/ procedure and surveillance was associated to the decrease of absenteeism, it also was discovered that the change in the health status of the student after nursing interventions was related to the increase of the academic achievement grade and the decrease of the academic procrastination behavior score. Conclusion: In this study, the conclusion that comprehensive school nursing services contributed positively to the academic performance of students has been reached. In addition, it can be suggested that effective school nursing services should include services such as acute-chronic disease treatment, first aid, health screening, health improvement-protection, health education, guidance and counseling and case management.
...  Om school refusal behavior te voorkomen, zijn er scholen die mental health programs (school-based nursing programs) aanbieden waarin wordt gepraat met leerlingen die problemen hebben met aanwezigheid op school over onder meer ziekte, depressie en positieve en negatieve kanten van school (Houck & Perri, 2002;Maughan, 2003). Dergelijke programma's kunnen helpen bij angst, depressie, middelengebruik en stressvolle gebeurtenissen in het leven. ...
... In een aantal van de bestudeerde casussen kon de leerling tijdens het thuiszitten meedoen aan een programma. Uit verschillende onderzoeken blijkt dat programma's waarbij wordt gepraat met leerlingen die problemen hebben met aanwezigheid op school, kunnen helpen bij angst, depressie, middelengebruik en stressvolle gebeurtenissen in het leven (Houck & Perri, 2002;Maughan, 2003). In sommige bestudeerde casussen bezoekt de leerling tijdens het thuiszitten een instelling. ...
... School nursing is aligned with the promotion of health among school-aged children either in school or community settings. Historically, school nursing was designed as a public health measure, within the National Health Service (NHS) to address communicable diseases, inadequate nutrition in children, poor hygiene and other physical ailments that prevented children from attending school [1,2]. The nature of school nurse's role means they play an important part in the health and education of school children. ...
... The nature of school nurse's role means they play an important part in the health and education of school children. However, evidence of effectiveness of their practice (including impact on academic performance) has been limited [1][2][3][4]. This lack of evidence of effectiveness has recently given rise to debate regarding whether the school nurse role, in its current form is still needed in today's education system, particularly within the context of the current global economic climate. ...
Article
Full-text available
Background: The school nurse's role varies across countries. In Scotland, the Chief Nursing Officer recommended that the role should be refocused. The refocused programme emphasises nine care pathways with a view to improve pupils' health and wellbeing. Two sites were identified to test this new programme. Our aim was to assess how, for whom and under what circumstances the programme works in order to provide learning to support school nurse training and intended national roll-out. Methods: This study was a mixed methods study, using a realist evaluation approach, and conducted in three phases. In phase one, six nurse managers from both study sites took part in individual interviews or focus groups and this was complemented by programme documents to develop initial programme theory. In phase two, the programme theory was tested using qualitative data from 27 school nurses, and quantitative data from the first 6 months of the programme that captured patterns of referral. The programme theory was refined through analyses and interpretation of data in phase three. Results: The findings show that the programme enhanced opportunities for early and improved identification of health and wellbeing needs. The context of the nine pathways worked through the mechanism of streamlining referral of relevant cases to school nurses, and yielded positive outcomes by extending school nurses and thus children's engagement with wider services. The mental health and wellbeing pathway was the most frequently used, and nurses referred complex mental health cases to more specialist mental health services, but felt less equipped to deal with low to moderate cases. Conclusions: The programme facilitated early identification of risk but was less successful at equipping school nurses to actually deliver specific interventions as intended. Capacity building strategies for school nurses should seek to enhance intervention delivery skills within the parameters of the pathways. Realist evaluation provided a useful framework in terms of identifying contextual and mechanistic influences that required strengthening prior to wider implementation.
... Similarly, despite the importance of inter-professional initiatives to address the issues (VanderWielen et al., 2014), such collaborative efforts are rare (Boutilier & King, 2013). Maughan (2003) concludes in a synthesis of relevant research that interventions by teachers could have comparable positive effects on health teaching to those achieved by school nurses. However, she also notes that previous studies have shown that school nurses are better placed to help pupils with specific psychological needs, for example by teaching coping strategies to help students deal with stress. ...
... Brown et al., 2011) in order to enable effective pain management (Boutilier & King, 2013), and improve both the educational performance of some of the most vulnerable students (cf. Maughan, 2003) and their engagement in pedagogic practices (Ianson & Allan, 2004). However, this might be difficult to achieve since many of the school nurses noted that health and education are often treated as parallel issues in schools, under the aegis of different authorities (cf. . ...
Article
This article reports on the views of school nurses (n = 25) and students with recurrent pain (n = 24) in Sweden with regard to school-based pedagogic practices. A number of common categories with implications for pedagogic practice were identified by analysing qualitative interviews with these groups, using the coding techniques of grounded theory. The results indicate that a failure to develop trust made it difficult for some students to initiate contact with a school nurse and that some students perceive the issue of recurrent pain being of relevance to all young people, deserving coverage in the curriculum. We thus conclude that it is important to integrate personal, social and health education in the ordinary spaces of teaching and learning in order to complement and bolster the conventionally organised school health services in Sweden. However, this might be difficult to achieve because many of the school nurses emphasised that health and education were commonly treated on parallel tracks in their schools, under the management of different authorities.
... A review of educational interventions for self-management of asthma in children and adolescents found these programs to be effective in reducing school absenteeism (Guevara, Wolf, Grum, & Clark, 2003). Other medical interventions, such as 38 comprehensive handwashing and use of hand sanitizers have also demonstrated effectiveness in reducing absenteeism (Guinan, McGuckin, & Ali, 2002;Maughan, 2003). ...
... Reviews and meta-analyses have also been conducted of interventions to target other related school problems, such as problem behaviors, school performance, and anxiety and phobic disorders, with school attendance being one of the measures used Little & Harris, 2003;Mattison, 2000;Maughan, 2003;Wilson, Gottfredson, & Najaka, 2001). However, not all studies included in these reviews and meta-analyses measured attendance as attendance was not the primary 51 outcome being reviewed. ...
Article
The present study utilized systematic review methods and meta-analysis to quantitatively synthesize research and systematically examine the effects of indicated intervention programs on school attendance behaviors of elementary and secondary school students. A comprehensive search strategy resulted in the identification 11 randomized studies, 9 quasi-experimental studies and 13 single group pre-post test studies that met inclusion criteria. Effect sizes data and study, participant, and intervention characteristics were coded and analyzed. Analyses of the randomized and quasi-experimental studies were performed separately from the single group pre-post test studies. The meta-analytic findings showed overall positive and moderate effects of indicated attendance interventions on attendance outcomes. There was, however, significant heterogeneity found between studies. Moderator analyses were conducted to examine potential variables related to study, participant and intervention characteristics that may explain the variability in effect sizes. Behavioral interventions were found to be more effective than other interventions and, when combined with parental interventions, demonstrated greater effects than behavioral interventions alone. Attendance groups were also found to be effective, especially when combined with attendance monitoring and contracting/awards. Court-based, school-based and clinic-based programs produced similar effects. The available evidence did not support the use of family therapy or mentoring as indicated interventions. The findings of this meta-analysis also did not support the use of multi-modal or collaborative programs over simpler, non-collaborative interventions, even though multi-modal and/or collaborative interventions are often recommended as best practice. Although the interventions demonstrated a moderate mean effect, the mean absence rates at post-test for the majority of the studies remained above 10%; thus it appears that the majority of interventions are falling short in their attempts to improve student attendance to the point of achieving an acceptable level of regular attendance. In addition to evaluating the effects of interventions, this systematic review and meta-analysis uncovered a number of methodological shortcomings, absence of important variables and data as well as gaps in the evidence base. The author calls for a critical analysis of the practices, assumptions and social-political context underlying the extant evidence base. Implications for practice, policy and research are discussed as well as limitations of the present study.
... Findings from one review found that school nurses can have an influence on student absenteeism by targeting students with a history of high rates of absenteeism. 65 In addition, schools with smaller school nurse-to-student ratios were associated with lower absenteeism rates and higher graduation rates. 65 Counseling, psychological, and social services. ...
... 65 In addition, schools with smaller school nurse-to-student ratios were associated with lower absenteeism rates and higher graduation rates. 65 Counseling, psychological, and social services. Counseling, psychological, and social services offered in school help support the mental, behavioral, and social-emotional health of students and promote success in learning. ...
Article
Full-text available
BACKGROUND While it is a national priority to support the health and education of students, these sectors must better align, integrate, and collaborate to achieve this priority. This article summarizes the literature on the connection between health and academic achievement using the Whole School, Whole Community, and Whole Child (WSCC) framework as a way to address health-related barriers to learning.METHODSA literature review was conducted on the association between student health and academic achievement.RESULTSMost of the evidence examined the association between student health behaviors and academic achievement, with physical activity having the most published studies and consistent findings. The evidence supports the need for school health services by demonstrating the association between chronic conditions and decreased achievement. Safe and positive school environments were associated with improved health behaviors and achievement. Engaging families and community members in schools also had a positive effect on students' health and achievement.CONCLUSIONS Schools can improve the health and learning of students by supporting opportunities to learn about and practice healthy behaviors, providing school health services, creating safe and positive school environments, and engaging families and community. This evidence supports WSCC as a potential framework for achieving national educational and health goals.
... 24 However, although a public education for CCC is mandated by law, 25 the amount, type, and quality of health care they should receive in educational systems is not well defined, despite evidence that the quality of care a CCC receives in school affects school attendance and performance. 26,27 Schools provide a stable environment for children, and since children spend a great deal of time there, the school is positioned as a place where health care often needs to be delivered. Federal agencies have called upon school-based health care professionals to monitor or treat chronic conditions, 6 and there is evidence that school nurse delivery of health care to CCC in school improves child health outcomes. ...
... There is evidence that the quantity and quality of school-based care can significantly influence child health and educational outcomes. [26][27][28]30,42 The evaluation method includes survey and interview data gathering techniques. Combining methods of data collection will allow for pre-and posttesting and statistical analysis of trends and associations. ...
Article
School-aged children with chronic conditions (CCC) are increasing in number and bring health needs into classrooms, with implications for learning. Changing technologies and complex care requirements for CCC have left school nurses, the primary health care professional in educational settings, seeking support and further training to provide quality care for CCC. This article describes the development and implementation of a Web-based program, eSchoolCare, designed to extend the expertise of professionals in an academic health care system to school nurses to improve CCC care. The eSchoolCare project serves as an exemplar of an innovative health care delivery support system.
... International studies show that cuts in economic resources have led to the function of school nurses being questioned. It seems that lack of information about the role of school nurses, and absence of research regarding the school nurses' work, together with increasing demands for efficiency, has resulted in the need for school nurses being questioned (Wainwright et al., 2000;Maughan, 2003). Evidence of their effectiveness is also necessary in order to show the importance of the school nurses' work to politicians and other decisionmakers (Wainwright et al., 2000). ...
... Evidence of their effectiveness is also necessary in order to show the importance of the school nurses' work to politicians and other decisionmakers (Wainwright et al., 2000). In addition, the difficulty school nurses have in getting their work noticed as well as uncertainty concerning the role of the school nurse are further factors that contribute to their function being questioned (Maughan, 2003;Winland & Shannon, 2004). ...
Article
Full-text available
Increasing health problems among children place demands on school health care. It is unclear how contextual issues, e.g. reduced resources and low priority, impact the practising of health care work within the educational system. The aim was to gain a deeper understanding of school nurses' perceptions of their opportunities for practising and handling health support work within the educational system. A qualitative study in line with constructivist grounded theory based on data from six focus group interviews with 24 school nurses. The results explain the conditions in which school nurses practise health support work within the educational system, as described in a conceptual model. The core category in the model was labelled construction of space and legitimacy for individual health support work within the educational setting. The model comprised four additional categories: experiencing restricted conditions for practising health support work; working alone and in isolation: retaining individual health support; and compromising and negotiating position and legitimacy. Interests and positions of political and organisational leaders, the school personnel and children/parents, as well as the school nurse's own strategies, constructed a limited space and legitimacy for health support work.
... All children and youth deserve to have decent opportunities to grow, develop, learn, and lead a healthy life. Extensive evidence shows that health impacts educational attainment and in a reciprocal way, education is a powerful predictor of health outcomes (Basch, 2011;Braveman, Cubbin, Egerter, Williams, & Pamuk, 2010;Ickovics et al., 2014;Maughan, 2003;Michael, Merlo, Basch, Wentzel, & Wechsler, 2015;Murray, Low, Hollis, Cross, & Davis, 2007; National Academies of Sciences, Engineering, and Children of low socioeconomic status typically have poorer health and lower life expectancies than their wealthier counterparts (Wasserman et al., 2019;Jensen, Berens, & Nelson, 2017;Jiang & Koball, 2018;Olshanksy et al., 2012). Currently, 41% of children in the United States (U.S.) live in poor or low-income families and 50% of children qualify for state health insurance (Jiang & Koball, 2018;Centers for Medicare & Medicaid Services, 2018). ...
... However, school nursing is often unrecognized as a crucial and cost-effective part of the public health system that provides community-based healthcare that promotes student health, advances academic success, and helps students develop to their full potential. Effective school nursing services programs and policies are associated with better student attendance and health outcomes (Maughan, 2003;Yun et al., 2018;NASN, 2017;Wang et al., 2014;Lear, 2007;Brener et al., 2017). While school-based health centers also offer health services in a small percentage of school systems, they function mostly to provide primary care. ...
Preprint
Healthcare systems are increasingly accountable for safety and quality. States have a key role in protecting and promoting the health of their youth, setting regulations and standards for school health services structures and processes. Yet, the lack of an instrument for state-level self-assessment of equity and quality infrastructure supports hinders progress toward improving in school health services delivery. This macro health system project, conducted in three phases, developed a valid and reliable instrument for state-level self-assessment of infrastructure necessary for supporting quality school nursing services. The phases were identification of state-level structures and processes domains and indicators; a content expert survey evaluating the validity of the measure; and a pilot test of the measure with Rhode Island state-level school health leaders. The resulting State-level School Health Infrastructure Measure, comprised of seven domains and related indicators assesses for the presence of evidence-based school nursing practice standards and resources; school nursing workforce professional competency standards and professional development; school nursing delivery of school-age population healthcare; equity in student access to professional school nursing services; cross-sector state leadership, governance, collaboration, linkages, and networks among health and youth service entities; school health information technology and data integration; and stable funding for school nursing services. The instrument appears to be feasible, cost effective, valid, and reliable for assisting states to identify and build quality school nursing services delivery capacity to improve the health of school-age youth.
... 24 However, although a public education for CCC is mandated by law, 25 the amount, type, and quality of health care they should receive in educational systems is not well defined, despite evidence that the quality of care a CCC receives in school affects school attendance and performance. 26,27 Schools provide a stable environment for children, and since children spend a great deal of time there, the school is positioned as a place where health care often needs to be delivered. Federal agencies have called upon school-based health care professionals to monitor or treat chronic conditions, 6 and there is evidence that school nurse delivery of health care to CCC in school improves child health outcomes. ...
... There is evidence that the quantity and quality of school-based care can significantly influence child health and educational outcomes. [26][27][28]30,42 The evaluation method includes survey and interview data gathering techniques. Combining methods of data collection will allow for pre-and posttesting and statistical analysis of trends and associations. ...
Conference Paper
School-age youth increasingly bring a variety of health-related needs into classrooms. The extent to which these needs are met has implications for children and families. The school nurse is the primary professional in the educational setting providing care for students with chronic conditions. eSchoolCare is an innovative iPad-based educational program providing on-the-go support for rural school nurses who care for children with chronic health conditions. The 3-year project is funded by a grant from the US Health Resources and Services Administration. The eSchoolCare program provides step-by-step guidance for nurses on delivering care for common chronic conditions in schools on an anytime-anywhere basis. The materials include videos, photographs, and links to journal articles and online resources. Five chronic pediatric conditions are covered: (1) asthma, (2) diabetes, (3) allergy, (4) cancer, and (5) mental health disorders. School nurses identified these frequently encountered conditions as those for which they were interested in further training. The materials were developed in partnership with advanced practice nurses at a local children's hospital, based on established guidelines, and reviewed by a panel consisting of a physician, an advanced practice nurse, a school nurse, and a special education specialist. eSchoolCare will affect as many as 34,000 children with chronic conditions by serving about 90 school nurses practicing in rural areas. Baseline evaluation data, including nurse/school demographics, satisfaction, knowledge, skill, and confidence, among others, will be collected prior to enrollment and annually thereafter. This model has the potential to be successful in other rural or remote areas nationally.
... Other factors are whether the school nurses are present in the school and whether they have time to meet the needs of the students (Morberg, Lagerström, & Dellve, 2012). However, the presence of school nurses in schools provides support to both students and school staff (Hill & Hollis, 2012) and improves the health of students (Baisch, Lundeen, & Murphy, 2011) as well as their school performance (Maughan, 2003). From the perspective of school nurses, engendering trust seems to be of critical value in relationships with students (Summach, 2011) and attentiveness to their narratives can engage the adolescents in a problem-solving process (Langaard & Toverud, 2010). ...
Article
In Sweden, school nurses are part of the School Health Service with the main objective of health promotion to support students' health and attainment of educational goals. The aim in this phenomenological study was to illuminate the experiences of school nurses in promoting the health and well-being of adolescent girls. Seventeen school nurses were interviewed, both in groups and individually, to facilitate personal disclosure and expressions from their lived experiences. To achieve their goal of improving the health of adolescent girls, school nurses require flexibility in their approach and in endeavoring to make a positive difference they experience many challenges. This study concluded that school nurses can tactfully provide adolescent girls with knowledge and health guidance adjusted to individual needs and empowering the individual girl to participate in her own health process.
... Når det gjelder helseprofesjonene, synes det å vaere en positiv sammenheng mellom helseprofesjonenes utbredelse i skolene og en rekke utfallsmål, blant annet fravaer (Maughan, 2003). Eksistensen av helseprofesjoner synes også å ha positiv effekt for ulike målgrupper, som elever med astma, hodepine etc., og bidrar til laering og til å fullføre skolegangen. ...
... Implementing a Coordinated School Health program is an effective strategy to improve students' health, prevent or reduce risk behaviors, and support learning in schools (Center for Disease Control and Prevention, 2011c; Kolbe, 2005). Furthermore, since health and well-being are highly correlated with school attendance and academic performance it is important to identify school programs and policies that cultivate children's successes (Chomitz, et al., 2009;Guttu, Engelke, & Swanson, 2004;Jones, 2008;Maughan, 2003;Murray, Low, Hollis, Cross, & Davis, 2007). A Coordinated School Health program consists of an eight-component model: health education, physical education, health services, nutrition services, counseling, psychological, and social services, healthy and safe school environment, health promotion for staff, and family community involvement are the components (Allensworth & Kolbe, 1987). ...
... School nurse positions are often cut as schools struggle with decreased state funding and lower property tax revenues still recovering from the recession (Ellerson, 2012). Although there are studies that demonstrate the effectiveness and cost savings attributed to school nurses (Bergren, 2013;Maughan, 2003;Wang et al., 2014), significantly more research and statistics supporting school nurse practice outcomes is needed. Data collection across large numbers of nurses and a wide range of school nurse delivery models is necessary to measure the impact of school nurse presence, intensity, and the impact of interventions on child health and education outcomes (Johnson & Bergren, 2011;. ...
Article
School nurses cite barriers to collecting comprehensive data on the care they provide. This study evaluated the feasibility of collecting school nurse data on selected child health and education outcomes. Outcome variables included school health office visits; health provider, parent, and staff communication; early dismissal; and medications administered. On an average day, the school nurses cared for 43.5 students, administered 14 medications, and averaged of 17 daily communications. Day 1 data collection times averaged 15 min or less. By Day 5, 6.6 min was needed to complete the survey. Data collection was feasible for 76% of those who elected to participate. Feasibility is enhanced by limiting the number of data points and the number of days for data collection using a data collection web interface. Data collection across large numbers of nurses and a wide range of school nurse delivery models is necessary to measure the impact of school nurse presence and interventions on child health and education outcomes.
... 3 The National Association of School Nurses (NASN) purports that school nurses directly impact a student's academic performance and ability to learn. 4 Examples of studies supporting this conclusion have demonstrated that a school nurse can influence a student's school performance, absenteeism, and overall quality of life. [5][6][7] A variety of challenges face this population of health professionals. School nurses are required to practice independently in a community setting and meet the complex health needs inherent within diverse school populations. ...
Article
School nurses are an integral though often underserved population within the health care and education professions. To develop an effective outreach program for this group, an academic health sciences library conducted an information needs assessment of public school nurses in Tulsa County, Oklahoma. An online survey collected perceptions regarding information needs and behaviors, and a focus group session further explored the survey results. The assessment revealed that school nurses frequently require specific types of information to perform their responsibilities and face challenges accessing and integrating research into their daily practice. This article presents the implications and results of this assessment.
... Support from the organization is related to the provision of safe, efficient and quality care, and has an impact on workload. Maughan (2003): Literature review of several studies found that nurses working in schools reduce student absenteeism. Pennington & Delaney (2008): Better school nurse to student ratio is related to better attendance, and nurses are less likely to dismiss students early compared to nonlicensed personnel. ...
Article
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Recognizing the need for a school nurse workload model based on more than the number of students in a caseload, the National Association of School Nurses issued recommendations related to measuring school nurse workload. Next, a workforce acuity task force (WATF) was charged with identifying the steps needed to further the recommendations. As a first step, the WATF focused on identifying existing literature and practices related to school nurse workload. The purpose of this article is to synthesize and categorize the factors that were identified, delineate sources for collecting and retrieving these factors, and make recommendations for clinicians and researchers interested in developing instruments to measure school nurse workload.
... 12 Although limited, emerging research provides evidence of the positive impact of school nurses on a number of student health and academic outcomes. Higher nurse-to-student ratios have been associated with significant improvements in immunization rates; student health records accuracy; referrals 13 and followup care for students with asthma, diabetes, vision problems, psychosocial problems, and injury prevention and reporting, 14 as well as fewer school absences and emergency room (ER) visits, 15 in particular for students diagnosed with asthma. 8 These results have been particularly noted among schools with full-time nurses, when compared to part-time nurses. ...
Article
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With increasing budget cuts to education and social services, rigorous evaluation needs to document school nurses' impact on student health, academic outcomes, and district funding. Utilizing a quasi-experimental design, we evaluated outcomes in 4 schools with added full-time nurses and 5 matched schools with part-time nurses in the San Jose Unified School District. Student data and logistic regression models were used to examine predictors of illness-related absenteeism for 2006-2007 and 2008-2009. We calculated average daily attendance (ADA) funding and parent wages associated with an improvement in illness-related absenteeism. Utilizing parent surveys, we also estimated the cost of services for asthma-related visits to the emergency room (ER; N = 2489). Children with asthma were more likely to be absent due to illness; however, mean absenteeism due to illness decreased when full-time nurses were added to demonstration schools but increased in comparison schools during 2008-2009, resulting in a potential savings of $48,518.62 in ADA funding (N = 6081). Parents in demonstration schools reported fewer ER visits, and the estimated savings in ER services and parent wages were significant. Full-time school nurses play an important role in improving asthma management among students in underserved schools, which can impact school absenteeism and attendance-related economic costs.
... Samtidigt finns det behov av att skolhälsovården tydligare synliggör sin egen arena och sitt specifika kunskapsområde. Detta gäller i synnerhet skolsköterskans arbetsfält då nationella och internationella studier visar att skolsköterskors kunskap inte utnyttjas i sin fulla potential (Clausson, 2008), att skolhälsovårdens arbetsområde är otydligt och osynligt (Lightfoot & Bines, 2000), att skolsköterskans roll blivit ifrågasatt (Maughan, 2003;Winland & Shannon, 2004) och att det behövs forskning för att tydliggöra skolhälsovårdens arbete (Wainwright, Thomas & Jones, 2000). ...
... Not surprisingly, researchers were more likely to measure absenteeism-related outcomes than academic performance outcomes. This is consistent with previous studies because although school nurses influence academic performance, so do other education and health professionals (Maughan, 2003). ...
Article
School nurses intervene with students, parents, and school staff to advance the health and academic success of students. We conducted an integrative literature review of published research to describe the types of school nurse interventions and health and education outcome measures and to examine how school nurse interventions were linked to student outcomes. Sixty-five studies met the inclusion criteria. We used the National Association of School Nurses' Framework for 21st Century School Nursing Practice to categorize school nurse interventions and health and education outcome measures. The majority of interventions were categorized under the care coordination principle, most commonly, motivational interviewing and counseling. In 17 studies, school nurse interventions were linked to improved student outcomes. Most studies (80%) were descriptive. To advance school nursing science, researchers can build on this foundation with more rigorous research methods to evaluate the impact of school nurse interventions and activities on student health and education outcomes.
... • Six percent of children missed 11 or more days of school in the past 12 months due to illness or injury (Bloom et al., 2011). Repeated studies identified that school nurses reduce absenteeism (Maughan, 2003) and that a higher nurse-to-student ratio is related to better attendance (Pennington & Delaney, 2008). • School absence affects performance, contributes to school drop-out, and has economic and social repercussions for individuals, families, and communities (Pennington & Delaney, 2008). ...
... Leroy, Wallin, & Lee, 2017;Maughan, 2003;Wyman, 2005), but the nurses' role in producing these outcomes is not apparent to the population served by the school nurse.There are consequences to stakeholders misunderstanding the school nurse role, and few states mandate a nurse in every school. During times of budget constraints, districts sometimes cut nursing services by eliminating nurses, reducing their hours, or replacing them with unlicensed personnel, not realizing that the presence of a registered school nurse improves the health of students, reduces medical care costs to society, and increases principal, teacher, and parent productivity (Baisch, Lundeen, & Murphy, 2011: Wang et al., 2014. ...
Article
Problem: Stakeholders often misunderstand the role of the school nurse resulting in underutilization or elimination of school nurse positions. Social media and school nurse websites are recommended to increase school nurse visibility and change the public narrative of school nursing. Objective: The objective of this needs assessment is to determine whether school nurses are using web presence to increase their visibility to affect the narrative of school nursing. Method: An evaluation was conducted to determine the presence and content of school nurse websites in 50 schools and their school districts across the nation. Results: Fewer than one third of school nurses have websites, three fourths of districts have a school district health websites, and there was no evidence of a nurse in 10% of the school websites assessed. Anticipated contribution to practice: The needs assessment determined that nurses are not maximizing school websites to communicate their role to stakeholders.
... Reviews and meta-analyses have also been conducted of interventions to target other related school problems, such as problem behaviors, school performance, and anxiety and phobic disorders, with school attendance being one of the measures used Little & Harris, 2003;Maughan, 2003;Mattison, 2000;Wilson, Gottfredson, and Najaka, 2001). However, not all studies included in these reviews and meta-analyses measured attendance as attendance was not the primary problem being reviewed. ...
... Health professionals were mainly school nurses. Maughan's (2003) literature review aimed to identify the educational benefits of school nurses, and she found that nurses in school have positive effects on the factors affecting students' ability to learn and to finish school. The studies found significant correlations between nursing coverage in schools and students' health, both of which related to disease and coping with illness in the school context. ...
Article
The main objective of this study is to identify and understand interprofessional collaboration practices in schools using a mixed-methods design. First, we conducted a literature review on interprofessional collaboration in schools to give insights into the ways teachers and other professions collaborate with each other, and what kind of interprofessional interventions show positive effects on teaching and learning. Second, we collected data from five Norwegian elementary schools to gain knowledge of factors that facilitate and hinder interprofessional collaboration. The results show that interprofessional collaboration was defined differently in the literature, and that research is lacking on interprofessional collaboration that involves multiple professions in school. Interventions in which social workers and school nurses were involved gave positive, though small-to-moderate, effects on a range of outcome measures. However, interventions that targeted the whole school were found to be the most promising for making changes that persist over time.
... In addition to these single empirical studies, there are also literature reviews on the effects of interprofessional collaboration on pupils. In these reviews, the collaboration is mainly between a specific professional group and the school, such as school social workers (Allen-Meares et al., 2013;Franklin, Kim, & Tripodi, 2009), teaching assistants (Farrell et al., 2010;Lindsay, 2007), and school nurses (Kvarme et al., 2010;Maughan, 2003). ...
Article
Increased demand for interprofessional collaboration within the educational field also increases the need for the development and evaluation of interventions to improve collaboration. In Norway, the LOG model was developed and implemented in compulsory schools to facilitate interprofessional collaboration by increasing arenas for more efficient use of existing interprofessional resources. We evaluate the effects of the model on teachers’ perceptions of interprofessional collaboration in a cluster-randomized trial, with 19 schools randomized to the experimental group and 16 schools to the control group. We use data from 5th–7th grade teachers in the 35 participating schools (N = 157) prior to randomization and one-year into the implementation. Response rates were 70% and 74%, respectively. The PINCOM-Q scale was used to analyze effects of the model on various dimensions of interprofessional collaboration. At the one-year follow-up, the LOG model demonstrates no significant effects on teachers’ perceptions of interprofessional collaboration. However, there is an indication of effect on the organizational aim dimension (ES = −0.39, CI = −0.82–0.03), but the evidence is not conclusive.
... Last, findings on the impact of using the WSCC model (as opposed to select components) on creating and sustaining healthy school communities are almost absent in the literature, including no comparisons of the relative impact or importance of the 10 different WSCC domains on health. Over time, researchers have documented the link between individual components of the WSCC model and academic success (Anderson, 1982;Maughan, 2003;Murray et al., 2007;Pucher et al., 2013;Sibley & Etnier, 2003), but as noted by Rasberry et al. (2015), understanding the cumulative impact of WSCC on the culture of health in schools is essential to guide schools in developing priorities, policies, and targets for funding applications. Michael et al.'s (2015) literature review provides the evidence that links specific WSCC components to health individually, but a thorough and comprehensive evaluation of this multifaceted model is needed and must be disseminated in peer-reviewed venues that also reach academic researchers. ...
Article
The Whole School, Whole Community, Whole Child (WSCC) model is a student-centered approach that focuses on a culture of health to support student success. Despite its use, the empirical evidence supporting the model is unclear. We conducted a scoping review to understand the research supporting WSCC as a model for student/school health. The search included studies published in English language peer-reviewed journals from 2014 to 2020. Eight articles met criteria for review. Overall, findings from this review reveal a relatively small body of research specific to the WSCC model. Because WSCC is presented as a model for schools throughout the United States, the development of a larger body of research supporting the model as an evidence-based framework will enhance credibility and confidence in the model. School nurses, as leaders, coordinators, and advocates, are well positioned to test and disseminate the model to those seeking to introduce WSCC in their school or district.
... Positive effects of the intervention on the health and health behaviors of adolescents were not found. This is in line with earlier research, showing little evidence for the effectiveness of short-term counseling by school nurses [39][40][41]. In this study, only one consultation was offered to adolescents. ...
Article
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Unlabelled: This study evaluates the appreciation, application and effects of an intervention (Your Health), in which adolescents received a consultation with the school nurse. A cluster randomized controlled trial with an intervention and control group (care-as-usual) was conducted among first-grade senior vocational students. Adolescents (n = 418) completed a questionnaire at baseline and 6-month follow-up assessing health and health behaviors. School absenteeism was monitored via the school registration system. After the consultation, adolescents and nurses evaluated the consultation by questionnaire. Adolescents appreciated being invited for the consultation and gave the consultation a positive mean rating of 8.78 on a 10-point scale. Adolescents rated the other nine items on the appreciation of the consultation also high. In 36.8% of the adolescents, nurses suspected problems. Most often these adolescents were given tailored advice (59.3%) or they were referred to another professional (40.7%). No statistically significant effects of the intervention were found on the health and health behaviors of adolescents. This study supports the use of Your Health as a promising intervention to reach senior vocational students. Future research is needed to evaluate long-term effects and the effects and appreciation of the subsequent help that is offered. Trial registration: www.trialregister.nl, NTR3545.
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Truancy is a significant problem in the U.S. and in other countries around the world. Truancy has been linked to serious immediate and far-reaching consequences for youth, families, and schools and communities, leading researchers, practitioners, and policy makers to try to understand and to address the problem. Although numerous and significant steps have been taken at the local, state, and national levels to reduce truancy, the rates of truancy have at best remained stable or at worst been on the rise, depending on the indicator utilized to assess truancy rates. The costs and impact of chronic truancy are significant, with both short- and long-term implications for the truant youth as well as for the family, school, and community. Although several narrative reviews and one meta-analysis of attendance and truancy interventions have attempted to summarize the extant research, there are a number of limitations to these reviews. It is imperative that we systematically synthesize and examine the evidence base to provide a comprehensive picture of interventions that are being utilized to intervene with chronic truants, to identify interventions that are effective and ineffective, and to identify gaps and areas in which more research needs to be conducted to better inform practice and policy.
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While Sub-Saharan countries have improved primary school education significantly, secondary education is still far behind the rest of the world. Ugandan government introduced universal secondary education (USE) policy to improve secondary education in 2007.In this study we evaluate the impacts of USE policy on secondary school enrollments using household panel data. We find that USE policy has considerably increased public secondary school enrollments especially for girls from poor households. Still, Uganda may need further improvement in terms of quality of secondary school education.
Article
Objective: To describe the changing role of school nurses in eight New Zealand (NZ) secondary schools from low socio-economic areas with high Pacific Island and Māori rolls. Methods: An evaluation of a pilot addressing under-achievement in low-decile schools in Auckland, NZ (2002-05). Annual semi-structured school nurse interviews and analysis of routinely collected school health service data were undertaken. Results: Two patterns of school nurse operation were identified: an embracing pattern, where nurses embraced the concept of providing school-based health services; and a Band-Aid pattern, where only the basics for student health care were provided by school nurses. Conclusions and Implications: School nurses with an embracing pattern of practice provided more effective school-based health services. School health services are better served by nurses with structured postgraduate education that fosters the development of a nurse-practitioner role. Co-ordination of school nurses either at a regional or national level is required.
Article
Background: The specific health services provided to students at school and the model for delivering these services vary across districts and schools. This article describes the characteristics of school health services in the United States, including state- and district-level policies and school practices. Methods: The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study (SHPPS) every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of school districts (n=449). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=1029). Results: Most US schools provided basic health services to students, but relatively few provided prevention services or more specialized health services. Although state- and district-level policies requiring school nurses or specifying maximum nurse-to-student ratios were relatively rare, 86.3% of schools had at least a part-time school nurse, and 52.4% of these schools, or 45.1% of all schools, had a nurse-to-student ratio of at least 1:750. Conclusions: SHPPS 2006 suggests that the breadth of school health services can and should be improved, but school districts need policy, legislative, and fiscal support to make this happen. Increasing the percentage of schools with sufficient school nurses is a critical step toward enabling schools to provide more services, but schools also need to enhance collaboration and linkages with community resources if schools are to be able to meet both the health and academic needs of students.
Article
Chronic absenteeism is associated with poor health and educational outcomes. School nurses have great potential to address the health and educational needs that contribute to absenteeism. Through qualitative analysis of interviews with school nurses, we characterize their current role in reducing absenteeism and identify barriers 3 that limit their capacity to meet this goal, organized by the Framework for 21st Century School Nursing Practice. Interviewees ( n = 23) identified actions perceived to reduce absenteeism aligned with domains of care coordination, leadership, quality improvement, and community and public health. Barriers perceived to limit the capacity of school nurses to address absenteeism were identified within these domains and ranged from student- and family-level to federal-level barriers. Specific healthcare system-level barriers included insufficient communication with community-based healthcare teams and the need for coordinated approaches across health and education sectors to address absenteeism. Strategic opportunities exist to address barriers to comprehensive school nursing practice and reduce absenteeism.
Article
In deze studie worden de waardering, toepassing en effecten van een extra contactmoment (Your Health) met een jeugdverpleegkundige in het middelbaar beroepsonderwijs (mbo) geëvalueerd. Een studie met een interventie- en controlegroep (gebruikelijke zorg) is uitgevoerd onder eerstejaars mbo-studenten van niveau 1 en 2. Adolescenten (n = 418) hebben bij de voormeting en na 6 maanden een vragenlijst ingevuld over hun gezondheid en gezondheidsgedrag. Schoolverzuim werd geregistreerd via het verzuimregistratiesysteem van de scholen. Na het consult hebben adolescenten en verpleegkundigen het consult geëvalueerd via een evaluatieformulier. Van de adolescenten die uitgenodigd waren voor een consult heeft 80,0 % dit consult bijgewoond. De adolescenten gaven het consult een positieve gemiddelde beoordeling van 8,8 op een 10-puntsschaal. Bij 36,8 % van de adolescenten vermoedde de verpleegkundige problemen. De meerderheid van deze adolescenten kreeg inhoudelijk advies (59,3 %) of werd doorverwezen naar een andere professional (40,7 %). Er werden geen statistisch significante effecten van de interventie gevonden op de gezondheid en het gezondheidsgedrag van de adolescenten. Deze studie ondersteunt het gebruik van Your Health als een veelbelovende interventie om mbo-studenten te bereiken. Verder onderzoek is nodig naar de effecten van het consult op de langere termijn, waarbij de vervolghulp die ingezet wordt naar aanleiding van het consult wordt betrokken.
Article
Research indicates that school nursing services are cost-effective, but the National Association of School Nurses estimates that 25% of schools do not have a school nurse (SN). The purpose of this study was to identify the characteristics of Illinois school districts that employed SNs. This was a secondary data analysis of Illinois School Report Card system data as well as data obtained from district websites regarding SNs. Employment of an SN was determined for 95% of the 862 existing districts. Binary logistic regression analysis found that district size was the largest significant predictor of employment of an SN. Other factors included the type of district and diversity of the teaching staff as well as the percentage of students receiving special education services or with limited English proficiency. These findings indicate where to focus advocacy and policy efforts to encourage employment of SNs.
Article
There is a need for rigorous research documenting the important role of school nurses in facilitating positive health outcomes among students. Poorly managed care can affect student absenteeism rates, which are associated with academic performance and school funding, and students in underresourced schools are at particularly higher risk of suffering chronic conditions (e.g., asthma, diabetes) that necessitate proper care and management. The San Jose Unified School District (SJUSD) Nurse Demonstration Project was developed as a five-year endeavor to expand school nursing and formally link school nurses to a school-based health clinic. The initiative provides for full-time school nurses at four elementary and middle schools in SJUSD, and a nurse practitioner at School Health Clinics of Santa Clara County. The objectives are to: (1) improve access to primary care and prevention services, specifically asthma and chronic condition management and (2) facilitate the establishment of a medical home for students. Evaluation of the project employs a mixed methods research design, including a logic model, an intervention and control study design (comparing outcome measures in the four demonstration schools with five "control" schools), parent, teacher, and school administrator feedback, systematic nurse reports, and quantitative analysis of school health and administrative data, including health conditions and absenteeism information. Key findings in Phase I of the project are discussed, including improvement in screening and referrals, follow-up care among students with asthma, and mean days absent due to illness. With increasing budget cuts to public schools, documenting the impact of full-time school nurses will remain crucial in leveraging support and resources for school health services. Findings of this project indicate that school nurses provide valuable services and could be a major player in providing and coordinating effective management and prevention of chronic disease among children.
Article
A major focus of school nursing interventions is to improve school attendance. In many schools, parents are required to leave work and/or to arrange transportation to bring their children over-the-counter medicines. Many times these children went home, missing class and making it difficult to keep up with class work. The purpose of this study was to examine the impact of a new policy and procedure allowing school nurses to administer certain over-the-counter medications in elementary schools in a southern New Mexico public school district. "Sent home" rates before implementation of the new policy were compared with sent home rates for 2 years following implementation. Although not statistically significant, findings indicated that over-the-counter medication administration by school nurses does show a trend toward sending fewer students home and, therefore, keeping them in the learning environment.
Article
In June 2016, the American Academy of Pediatrics released its new policy statement recommending a full-time registered nurse in every school building. Indeed, increasing attention is being focused on school nursing, in part due to recent legislation, including the Affordable Care Act, the Healthy Hunger-Free Kids Act, and the Every Student Succeeds Act. Advocating for nursing practice within an education setting presents unique challenges in terms of changing the common perception of school nurses, variances in funding streams for school nursing, and the ability to link health outcomes with educational outcomes. The purpose of this article is to discuss the rationale for a school nurse in every building along with presenting action steps that individual and groups of school nurses can utilize to advocate for a full-time registered nurse in every school.
Article
Purpose The purpose of this paper is to investigate the evolution of school nursing in the United States in the early decades of the 20th century, highlighting the linkages between schools and public health and the challenges nurses faced. Design/methodology/approach This historical essay examines the discussions about school nursing and school nurses’ descriptions of their work. Findings In the Progressive period, though the responsibilities of school nurse were never clearly defined, nurses quickly became accepted, respected members of the school, with few objecting to their practices. Nonetheless, nurses consistently faced financial complications that limited, and continue to limit, their effectiveness in schools and communities Originality/value Few histories of school health have documented the critical role nurses have played and their important, although contested, position today. This paper points to the obstacles restricting the development of dynamic school nurse programs today.
Chapter
Prevalence rates of chronic illness in childhood have increased steadily over the last several decades. Caring for the child with chronic illness is a complex task that requires a multidisciplinary approach across multiple care settings. In addition to the medical settings of outpatient clinics, emergency rooms, and hospitals, children with chronic illness receive care in their homes, schools, and communities. Chronic illness and frequent or prolonged hospitalizations can negatively affect a child’s physical, cognitive, emotional, and psychological development. Health-care providers can identify problems and mitigate negative consequences. Chronic illness in children has a significant impact on their future adult health. Health-care models must maximize the health potential of children with chronic illness.
Article
In the UK one in five people get gastroenteritis each year (National Institute for Health and Care Excellence, 2017). This illness is also more common in young children, who may present with more than one case a year ( World Health Organization, 2013 ). Both Norwalk-like viruses and rotavirus are also seasonal, occurring particularly during the Winter season ( Ihouye et al, 2000 ). In fact, in both industrialised and developing countries, viruses are the main causative factor of acute diarrhoea in the winter season ( World Gastroenterology Organization, 2012 ). In most cases the illness can last a week, but it can persist with a risk of dehydration or complications. School nurses can play a substantial role in improving children's performance at school, absentee rates and general wellbeing ( Maughan, 2003 ). Parents may also seek advice from the school nurse about how to treat this condition or schools' exclusion criteria. This literature review of the clinical evidence and national guidelines will therefore be of particular interest to school nurses in the independent sector, based in schools and in special school nursing teams.
Article
More than 6.5 million children in the United States, approximately 13% of all students, miss 15 or more days of school each year. The rates of chronic absenteeism vary between states, communities, and schools, with significant disparities based on income, race, and ethnicity. Chronic school absenteeism, starting as early as preschool and kindergarten, puts students at risk for poor school performance and school dropout, which in turn, put them at risk for unhealthy behaviors as adolescents and young adults as well as poor long-term health outcomes. Pediatricians and their colleagues caring for children in the medical setting have opportunities at the individual patient and/or family, practice, and population levels to promote school attendance and reduce chronic absenteeism and resulting health disparities. Although this policy statement is primarily focused on absenteeism related to students’ physical and mental health, pediatricians may play a role in addressing absenteeism attributable to a wide range of factors through individual interactions with patients and their parents and through community-, state-, and federal-level advocacy.
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A report on the research behind approaches to reducing chronic absenteeism.
Article
Résumé Introduction Cet article propose une revue exploratoire de littérature sur l’utilisation des théories dans un contexte de santé scolaire et de la petite enfance. Objectif de l’étude La recherche effectuée à partir de bases de données (Cinahl, Pubmed et Psychinfo) visait à identifier les modèles, théories ou approches infirmières utilisables dans ces contextes et à circonscrire en quoi ces différents cadres théoriques permettaient d’optimiser la prise en soins des jeunes. Méthode Douze articles ont été retenus et ont permis d’établir quelques recommandations. La contribution spécifique de l’infirmière dans ce contexte exige une expertise et de l’autonomie afin de gérer la complexité des situations rencontrées. Principaux résultats Considérer l’expérience de santé de chaque famille comme unique et établir un partenariat avec la famille permet de construire une relation de confiance et de promouvoir leur santé. Les théories infirmières servent de guide pour soutenir les bonnes pratiques et pour légitimer la contribution singulière de la discipline dans ce domaine d’activité.
Article
This protocol describes a randomized controlled trial where additional school nurse resources are assigned to work systemically with schools to improve the school environment and reduce bullying among and absence of 5th–7th grade students. Approximately 9000 students will have participated each year from 2018 to 2020 from 107 schools located in 12 Norwegian municipalities. Academic performance is studied as a secondary outcome.
Article
For many decades, nurses especially in Anglo-American and Scandinavian countries have operated as «School (Health) Nurses» and have supervised children and teenagers in all health-related matters. This review applies to the question which specific tasks and roles School Nurses fulfil in these countries and which of the tasks in Germany also could be carried out by adequately qualified nurses. 34 articles were found by systematic literature search which focused on general descriptions of the roles and tasks of School Nurses. Overall, eleven central fields of duties could be identified. They included the treatment of injuries, acute and chronic illnesses, emergency care, preventive and health-promoting activities, information, education and counselling, the assessment of health-related problems and needs, the development and implementation of appropriate services as well as the fields: communication, cooperation and management of supply. With a view to the positive international experiences, the implementation of School Nurses in Germany seems to be a promising approach to promote both health and educational goals. Therefore, an additional university qualification «School Nursing» based on the existing international curricula is required.
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This study sought to determine the population effects of both classroom-based and risk-based interventions designed to reduce cardiovascular disease risk factors in children. Elementary school children (n = 2109; age range: 7-12 years) were randomized by school to a classroom-based intervention for all third and fourth graders, a risk-based intervention only for those with 1 or more cardiovascular disease risk factors, or a control group. The 8-week interventions involved both knowledge--attitude and physical activity components. School-level analyses showed that physical activity in the risk-based group and posttest knowledge in the classroom-based group were significantly higher than in the control group. With regard to trends shown by individual-level analyses, cholesterol dropped more in the classroom-based than in the control group, and skinfold thickness decreased 2.9% in the classroom-based group and 3.2% in the risk-based group (as compared with a 1.1% increase in the control group). Both classroom-based and risk-based interventions had positive effects on physical activity and knowledge, with trends toward reduced body fat and cholesterol. However, the classroom-based approach was easier to implement and evidenced stronger results than the risk-based intervention.
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This study determined the effect of provider (nurse or teacher) and training method (workshop or self-preparation) on outcomes of a social influences smoking prevention program. One hundred elementary schools were stratified by school risk score (high risk = high smoking rate among senior students) and assigned randomly to conditions: (1) teacher/self-preparation, (2) teacher/workshop, (3) nurse/self-preparation, (4) nurse/workshop, and (5) control. Intervention occurred in grades 6 to 8. Smoking status at the end of grade 8 was the primary endpoint variable. Intervention reduced grade 8 smoking rates in high-risk schools (smoking rates of 26.9% in control vs 16.0% in intervention schools) but not in low-risk schools. There were no significant differences in outcome as a function of training method and no significant differences in outcome between teacher-provided and nurse-provided interventions in high- and medium-risk schools. Although nurses achieved better outcomes than did teachers in low-risk schools, neither provider type achieved outcomes superior to the control condition in those schools. Workshop training did not affect outcomes. Teachers and nurses were equally effective providers. Results suggest that programming should target high-risk schools.
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School connectedness, or the feeling of closeness to school personnel and the school environment, decreases the likelihood of health risk behaviors during adolescence. The objective of this study was to identify factors differentiating youth who do and do not feel connected to their schools in an effort to target school-based interventions to those at highest health risk. The study population consisted of all students attending the 7th through 12th grades of 8 public schools. The students were asked to complete a modified version of the in-school survey designed for the National Longitudinal Study of Adolescent Health (Add Health). The school connectedness score (SCS) was the summation of 5 survey items. Bivariate analyses were used to evaluate the association between SCS and 13 self-reported variables. Stepwise linear regression was conducted to identify the set of factors best predicting connectedness, and logistic regression analysis was performed to identify students with SCS >1 standard deviation below the mean. Of the 3491 students receiving surveys, 1959 (56%) submitted usable surveys. The sample was 47% white and 38% black. Median age was 15. Median grade was 9th. The SCS was normally distributed with a mean of 15.7 and a possible range of 5 to 25. Of the 12 variables associated with connectedness, 7 (gender, race, extracurricular involvement, cigarette use, health status, school nurse visits, and school area) entered the linear regression model. All but gender were significant in the logistic model predicting students with SCS >1 standard deviation below the mean. In our sample, decreasing school connectedness was associated with 4 potentially modifiable factors: declining health status, increasing school nurse visits, cigarette use, and lack of extracurricular involvement. Black race, female gender, and urban schools were also associated with lower SCS. Further work is needed to better understand the link between these variables and school connectedness. If these associations are found in other populations, school health providers could use these markers to target youth in need of assistance.
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Health promotion and the role of the school nurse: a systematic review This paper describes findings from a systematic review of the literature on the effectiveness of school nurses in promoting the health of school children. The paper gives a brief account of the background to the study and the search strategy adopted. Some key findings are presented and discussed. The brief for the review was to seek evidence of effectiveness in the practice of school nurses. The results of the review were disappointing, in that little research of acceptable quality was found and little could be said about effectiveness. The result is therefore a more diffuse review that gives a summary of descriptive research and current views and opinions, although it does also present some pointers for future research. The study was funded by Health Promotion Wales.
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This study examined the relationship between asthma management strategies used by parents and parental perception of children's vulnerability to illness. Home interviews were conducted with 101 parents of children previously hospitalized with asthma. The child vulnerability scale (CVS) was employed to assess parents' perception of their children's vulnerability to illness. The asthma severity index (ASI) was used to measure the frequency and intensity of asthma symptoms experienced by children in the preceding 12 months. Five markers of parental asthma management were assessed: (i) school absences; (ii) visits to the general practitioner (GP); (iii) visits to the emergency room (ER); (iv) hospitalizations; and (v) whether children are using a regular preventer.After controlling for the frequency and intensity of children's asthma symptoms, parents who perceived that their children were more vulnerable to medical illness were significantly more likely to keep their children home from school (P = 0.01), were more likely to take their children to the GP for acute asthma care (P = 0.02), and were more likely to be giving their children regular preventer medication (P = 0.02). In contrast, the use of tertiary pediatric care services was not significantly associated with parental perceptions of their children's vulnerability.The results suggest that parental attitudes and beliefs about the vulnerability of their children to illness were associated with greater use of GP services by parents and more frequent school absences for children. The use of hospital services by parents appeared to be more strongly associated with the actual level of children's asthma symptoms than their vulnerability to illness. Pediatr Pulmonol. 2000; 29:88–93. © 2000 Wiley-Liss, Inc.
Article
In recent years nursing personnel associated with a County Health Department have become involved in efforts to assess the effectiveness of their services, with particular emphasis on determining the benefits to the populations they serve. The present study was developed in response to questions concerning whether the skills of professional nurses were being utilized to best advantage within the school system. It was decided that identification of children with a past record of high absence would be a reasonable way of defining a group of children with a high risk of future episodes of illness and possibly a high prevalence of basic health problems. Since it was anticipated that children so defined could benefit from nursing service, it was concluded that high absence children constituted an appropriate risk group to which nursing services could be profitably directed. This group was therefore selected for the pilot program. The major objectives of the study were to consider the utility of directing nursing services to a defined risk group and to document the results of the experience in terms of patient outcomes, specifically, change in absence experience. The basic working hypothesis was that focused nursing attention would be positively associated with a reduction in days absent. From the perspective of the service agency some of the concomitant benefits from the study are: the methodology, using absence as an indicator, suggests a practical approach to identification of a high risk population; the school health program can be planned to further explore emphasis on prevention through selected priorities rather than continuing to be crisis oriented; and efforts can be directed toward development of improved documentation of nursing intervention not only to provide an improved data base for evaluation but also to meet the current demand for accountability. In addition to providing a meaningful experience in program evaluation for nursing staff within the health department, participation in the study promoted more effective communication between the school system and the health department which share joint responsibility for the school health program.
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To determine the effects of a school-based, nurse-run prenatal counseling program, records of prenatal care visits of students and their infants' birth weights (i.e., cases) were obtained from the state live birth certificate tape for 1985-1987. From the same tape, a mother residing in the same community but not enrolled in the program was matched with each case on eight criteria to serve as a control. A total of 288 matched case-control pairs were obtained. Using McNemar's test, a significantly higher percentage of the cases received adequate prenatal care than did the controls.
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The purpose of this study was to determine the relationships between stressful life events, children's absenteeism, and the use of school health services and to examine the effect of preexisting family characteristics on these relationships. One hundred twenty-four parents of 124 children aged 6 to 11 years attending a New York City elementary school were questioned. Undesirable stressful life events, baseline health status, and family structure, routines, and functioning were measured at entry into the study. Data on the number of absentee days and the number and reason for each visit to the health room made by the children in the study were collected from school records. Results indicated that stressful life events occurring during the study were associated with both absenteeism and visits to the health room. Even when previous health status was considered, stressful life events were associated with absenteeism and use of the health room. In addition, those children who experienced both stressful events and unstable family characteristics were more likely to be absent than those who had either alone. This effect was not true for the use of the health room, where those children who experienced stressful events were the highest users. Implications for the provision of school health services are discussed.
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A program designed to teach self-management skills to asthmatic children and their parents was performed by a nurse-educator utilizing health education techniques. Goals included: (1) reduce frequency and severity of asthma; (2) reduce emergency room visits and hospitalizations; (3) reduce school absenteeism; (4) develop positive family self-help attitudes; and (5) incorporate patient-parent education in an office. After informed consent was obtained, 26 asthmatic children, aged 2 to 14 years, were selected and evaluated. Appropriate asthma management including avoidance, medications, and immunotherapy, if indicated, was initiated for both a study group (13 patients) and a comparison group (13 patients). Symptom and medication diaries were kept for six to 18 months. Educational intervention by a nurse-educator, including four hours of individual instruction, group classes, telephone access, and monitoring for the study patients, resulted in fewer hospitalizations and emergency room visits as compared to control patients, tenfold less school absenteeism, and fewer asthma attacks. Estimated hospital and emergency room costs were much less in the educated group. These results were accomplished by improving comprehension of and compliance with the medical management program by the study patients and their families; more medications were used and therapy for asthma was initiated earlier.
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In New South Wales, health screening of school entrants provides the only mechanism for routine monitoring of immunisation uptake in children. School health nurses are in the best position to improve the compliance with immunisation at this age. We compared two interventions to be used by the nurses to increase immunisation uptake in school entrants who reported missing either the measles-mumps vaccine and/or the pre-school diphtheria-tetanus toxoid and oral polio vaccine boosters. Parents in the passive intervention group were sent a letter and leaflet encouraging immunisation; the active intervention group received a telephone reminder from the nurse in addition to the written materials. Both groups were followed up at a later date to assess final immunisation outcome. Of 817 children screened, 88.2% had been immunised against measles and 73.6% had received the booster; 239 children were randomised to the two interventions. Excluding children lost to follow up and those fully immunised at the start of the study, 20 (37%) of 54 were immunised following the passive intervention, and 35 (71%) out of 49 following the active intervention (P = 0.001). Receipt of the letter and leaflet was associated with an increased uptake of booster vaccination (P = 0.036). The active intervention required 14.7 telephone calls and 1.6 uses of the interpreter service per completed immunisation. The passive intervention resulted in worthwhile increases in immunisation rate with minimum cost. A greater improvement in immunisation outcome was achieved by the active intervention, but its use was labour intensive and may only be warranted if high immunisation rates in this age-group are given priority.
Article
A randomized trial of an instructional method was conducted in which school nurses taught children asthma self-management principles and skills, including peak flow monitoring, in 20-min, individual sessions over an 8-week period. Thirty-six children participated. An intervention group of 18 children received the teaching sessions. A control group of 18 children received regular care by the nurses, but no teaching sessions. The sample included 64% boys, 69% African-Americans, and 69% Medicaid recipients. The average age of subjects was 10.2 years. The two groups were demographically similar, but despite random assignment, the control group had a significantly earlier age of onset of asthma and tended to have had more asthma attacks in the preceding year. These factors were statistically controlled in outcome analyses. Results of group comparisons showed no significant differences in the number of postintervention emergency room visits and days absent from school. However, nurses reported that children who practiced breathing exercises had less anxiety during exacerbations, and the nurses' knowledge of the children's baseline peak expiratory flow rates facilitated care of the children. Nurses expressed the opinion that the individual sessions with students might be useful in motivating them to participate effectively in later group sessions. The intervention was well accepted by students, parents, and nurses. We believe that this intervention is promising as a practical, low-cost approach to enhancing children's asthma self-management skills and warrants further testing in a larger sample, with the intervention conducted over a longer period.
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A handwashing program for elementary school students was developed and implemented by the school nurse in a suburban elementary school. The program consisted of surveying teachers, inspecting handwashing facilities, and providing classroom presentations and follow-up activities. Absenteeism records indicated a significant decrease in absenteeism for illness during the two months following the presentations.
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Compared the efficacy of a school-based, nurse-administered relaxation training intervention to a no-treatment control condition for children (10–15 years old) with chronic tension-type headache and the outcome at posttreatment and a 6-month follow-up. The study was conducted in a controlled between-group design including 26 schoolchildren who were randomly assigned to the two treatment conditions. Results showed that headache activity in the children treated with relaxation training was significantly more reduced than among those in the no-treatment control group at posttreatment as well as the 6-month follow-up. At these evaluations, 69% and 73% of the pupils, respectively, treated with relaxation had achieved a clinically significant headache improvement (at least a 50% improvement) as compared to 8% and 27% of the pupils, respectively, in the no-treatment control group. Thus, a school-based, nurse-administered relaxation training program seems to be a viable treatment approach for children with chronic tension-type headaches.
Article
This study examined the effects of brief nurse consultations in preventing alcohol use among inner-city youth. Participants included 138 sixth-eighth grade students attending an inner-city public school in Jacksonville, Florida. Subjects were randomly assigned by computer to either the intervention (STARS program) or a control group. Baseline and three-month post-tests were conducted at the target school site. A significant difference was found on heavy alcohol use with intervention subjects showing a reduction and control subjects an increase in heavy drinking (t = -2.33, 120df, p = .02). No differences were found between groups on other alcohol use measures. This study's findings indicate that a series of brief nurse consultations appear to reduce heavy alcohol consumption among urban school youth.
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In the National Action Plan for Comprehensive School Health Education, representatives for over 40 health, education, and social service organizations viewed education and health as independent systems. Participation concluded that healthy children learn better, and they cautioned that no curriculum can compensate for deficiencies in student health status. While literature confirms the complexity of health issues confronting today's students, schools face enormous pressure to improve academic skills. Local school leaders and stakeholders often remain unconvinced that improving student health represents a means to achieving improved academic outcomes. A rich body of literature confirms a direct link between student health risk behavior and education outcomes, education behavior, and student attitudes about education. This article summarizes relevant information concerning the health risk behavioral categories of intentional injuries; tobacco; alcohol, and other drugs; dietary, physical activity, and sexual risk behaviors.
Article
In Tucson, Arizona, an elementary school-based violence prevention program (PeaceBuilders) was implemented during the 1994-1995 school year. Anecdotal evidence from school nurses suggested that children were visiting the nurse less often following the implementation of the program. We examined nurses' logs to assess whether the program had an impact on visits to the school nurse. For the school years 1993-1994 and 1994-1995, the weekly number of nurse visits for all reasons, all injuries, and injuries caused by fights in each of the four PeaceBuilders schools were compared with those for three control schools. As part of a planned evaluation, schools had been matched on demographic factors and randomly assigned as intervention or control schools. Between 1993-1994 and 1994-1995, the rate of visits/1,000 student days decreased 12.6% in the intervention schools while remaining unchanged in the comparison schools. The same trend was detected for injury-related visits. Rates of fighting-related injuries changed little in the intervention schools but increased 56.0% in the control schools. An analysis of covariance confirmed that injuries and visits to nurses decreased in intervention schools relative to control schools. These data indicate that in the intervention schools, injuries and visits to the school nurse decreased over the two-year period and that the intervention may have contributed to this change. They also suggest that visits to the school nurses' office may be a useful tool to evaluate some types of elementary school-based violence prevention programs.
Article
To evaluate a program designed to help high school students with depressive symptomology to effectively cope. Two-phase experimental study. Rural high school students (N = 222), ages 14 through 19 years, were surveyed to identify teens with depressive symptomatology, identify stressful life events and coping styles of at-risk subjects, and evaluate a cognitive-behavioral group intervention to enhance students' coping and affect levels of depression. Students with depressive symptomatology were randomized into control (n = 18) or intervention (n = 23) groups. Intervention subjects were treated with a nurse-led, 8-week cognitive skills group, conducted at school. On posttesting, the intervention groups demonstrated reduced depressive symptoms in females and a wider range of coping compared with controls. School-based nurses are in an ideal position to provide assessment, referral, and intervention programs in the natural setting of the school. Results of this study indicate that such programs can be implemented successfully in schools and have the potential to promote mental health in teenagers.
Article
The purpose of this study was to describe the factors that predict compliance among adolescents with a chronic illness. The data were collected by questionnaires from adolescents with asthma, epilepsy, juvenile rheumatoid arthritis (JRA) and insulin-dependent diabetes mellitus (IDDM). Groups of 300 adolescents with these illnesses were selected from the Finnish Social Insurance Institution's register, giving a total study series of 1200 individuals. The final response percentage was 88% (n = 1061). The data were analysed with the SPSS software. Logistic regression was used to indicate the predictors of good compliance. The compliance of adolescents with a chronic disease was predicted on the basis of support from parents, nurses, physicians and friends, as well as motivation, energy and willpower. The most powerful predictor was support from nurses. The likelihood of adolescents supported by nurses complying with health regimens was 7.28-fold compared to the adolescents who did not receive support from nurses. The next powerful predictor was energy and willpower. Adolescents who had the energy and willpower to take care of themselves complied with health regimens with a 6.69-fold likelihood compared to the adolescents who did not have energy and willpower. Adolescents who had good motivation were 5.28 times more likely to comply than the adolescents who did not have motivation. Support from parents, physicians and friends similarly predicted good compliance with health regimens.
Article
Historically, school nursing has not documented sufficiently the health issues in schools, nor has it prioritized these issues for school nursing interventions or evaluated the effectiveness of nursing interventions. The National Association of School Nurses (NASN) is strongly committed to the advancement of children's health. Thus, NASN is developing an infrastructure to support research that articulates the health conditions affecting children's school success and the contributions of school nursing to children's health and academic success. In 1999, NASN participated with the National Center for School Health and the National Nursing Coalition for School Health at a Research Summit to set a school nursing research agenda. Needs and issues were identified for future research activities. The primary outcome was the identification that school nurses must practice the standards of care pertaining to research. These standards specify that clinicians be informed about, supportive of, and participate in the conduct and use of research.
Article
As a follow-up to an Invitational Summit Conference in 1999, 27 nurse leaders representing school nursing and nursing research in child health were requested to participate in a Delphi study for purposes of prioritizing research issues in school nursing. The issues to be prioritized were identified during the Invitational Summit meeting. A three-round Delphi process was used to arrive at consensus on the most important research issues affecting school nurses today. Criteria for the rankings included policy support for the research, ability to be funded, magnitude and severity of the problem, likelihood of making a difference, and potential for partnership. The overall response rate for participation in all three rounds was 61%. Consensus was reached on the top-10 most important research issues. The two most important were consistent through all three rounds. These were (a) the impact of school nurse services on student health, and (b) the relationship between school nurse practice and educational outcomes.
Article
Considerable information exists about the impact of school health services on student health and academic achievement. Much less information exists about the specific impact of school nursing services. This article reports on a Washington State project that studied documentation of outcomes of school nurse interventions, the scope of the school nurse role, and the infrastructure necessary to report outcomes of school nursing. A literature review about outcomes of school nursing was conducted. Twenty-two leaders in school nurse issues were interviewed. The literature review yielded 15 articles documenting positive outcomes of school nursing. Interview analysis revealed leader ideas about important outcomes of school nurse services and the infrastructure needed to document the impact of school nursing. The existing literature on positive outcomes addresses a limited portion of the school nurse role. Components of infrastructure necessary to document outcomes are delineated. Resources for infrastructure development are discussed.
The relationship between the health of school-age children and learning: Implications for schools (NSBA's School Health Resource Database No. 11250). Lansing, MI: Michigan Department of Education Bridg-ing student health risks and academic achievement through comprehensive school health programs
  • C A Swingle
Swingle, C. A. (1997). The relationship between the health of school-age children and learning: Implications for schools (NSBA's School Health Resource Database No. 11250). Lansing, MI: Michigan Department of Education. Symons, C. W., Cinelli, B., James, T. C., & Groff, P. (1997). Bridg-ing student health risks and academic achievement through comprehensive school health programs. Journal of School Health, 67(6), 220–227.
The house on Henry Street
  • L D Wald
Wald, L. D. (1915). The house on Henry Street. New York: Henry Holt.
Walk a mile in my shoes: Accountability. Na-tional Forum: The Phi Kappa Phi Journal
  • L Weller
Weller, L. (2001). Walk a mile in my shoes: Accountability. Na-tional Forum: The Phi Kappa Phi Journal, 81(4), 27–28.
A well-ness program for your staff sets a healthy example for stu-dents
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  • D Allensworth
Wolford, C. A., Wolford, M. R., & Allensworth, D. (1988). A well-ness program for your staff sets a healthy example for stu-dents. American School Board Journal, 175, 38–39.