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Food allergy prevalence is rapidly growing among school-age children in the United States, posing a significant health concern in school settings. This article aims to provide an overview of the current state of food allergy treatment options, emergency food allergy care plans, and using epinephrine autoinjectors. In addition, it explores potential future treatment options, including immunotherapy and novel therapeutic approaches. This article emphasizes the crucial role of school nurses in recognizing the treatment options currently available to students and their families, as well as fostering a safe environment for students with food allergies. [ABSTRACT FROM AUTHOR]

Human health is being impacted by anthropogenic (human-made) climate change. This article describes four ways that climate change may affect mental well-being in school-age children. First, natural disasters—such as more frequent and intense tornadoes and flash floods—may have a direct influence on mental well-being by contributing to acute anxiety and distress. Second, indirect effects of severe weather—including changes in social support systems—may affect mental well-being by increasing isolation. Third, children may suffer feelings of anxiety or depression if they perceive a sense of powerlessness to solve the challenges of a changing climate. Finally, school nurses need to be aware of the emergence of correlations—such as data that suggest increases in temperature may influence the use of inpatient mental health services and suicidal ideations—that require further scientific exploration. This article aims to increase school nurses' understanding of how climate changes may impact the mental well-being of school-age children and to provide strategies for creating a safe, healthy learning environment. This article is the fourth in a series aimed at raising awareness among school nurses about climate-associated illnesses and equipping them with the resources they need to protect school-age children's health. [ABSTRACT FROM AUTHOR]

This article shares an updated structure for school nurse evaluation using the School Nursing Practice Framework and the fourth edition of the School Nursing: Scope and Standards of Practice. This evaluation structure is modeled on work originally published in the January 2020 issue of NASN School Nurse. The original linking of the Framework for 21st Century School Nursing Practice and the 3rd edition of the School Nursing: Scope and Standards of Practice allowed the school nurse and their evaluators to understand the complex roles and responsibilities of the school nurse. This updated version incorporates the growing understanding of social issues and complex health concerns impacting school nursing practice. The School Nursing: Scope and Standards of Practice (4th ed.) competencies recognize issues including emerging technologies, structural barriers to health, and the complex health needs of students in an environment of inequities, violence, and underfunding, as well as the impact of natural disasters, public health crises, human migration, and social media on students. The updated School Nursing Practice Framework (Framework) likewise incorporates an understanding of the foundational aspect of the standards and the interconnectedness of the key principles. Our revised evaluation tool accomplishes the integration of the revised Framework with the updated standards of school nursing practice. [ABSTRACT FROM AUTHOR]

Clinical Practice Guidelines (CPGs) are statements informed by a systematic review of research/evidence and provide recommendations for clinical practice to improve healthcare quality and patient outcomes. The National Association of School Nurses (NASN) released School Nursing Evidence-Based Clinical Practice Guideline: Students with Allergies and Risk for Anaphylaxis, in 2023, to provide evidence-based recommendations specific to school nursing practice and support the role of the school nurse in providing high-quality care for school-age children with allergies and risk for anaphylaxis. This article will provide an overview of the CPG and Implementation Toolkit. The implementation toolkit is designed to provide school nurses with tools and resources to implement the recommendations into practice. These tools and resources include school policies; nursing assessments and intake; planning, training, implementing, and evaluating care; and data collection. Examples are discussed, including how to customize the toolkit resources to your current practice needs. [ABSTRACT FROM AUTHOR]

Extremely hot or humid days are anticipated to continue, occur more often, and intensify over time. School-age children are especially vulnerable to extreme heat. The primary acute health effects of heat on children can range from heat exhaustion to heatstroke. The purpose of this article is to raise awareness of the impact some acute heat-related illnesses have on school-age children's health and to provide school nurses with information on the signs and symptoms of heat-related illnesses as well as prevention tips to share with parents and school administrators. This is the fifth article in a series meant to inform school nurses about illnesses linked to the climate and provide them with the tools they need to safeguard children' health. [ABSTRACT FROM AUTHOR]

Often, nurses new to the school setting find they have more questions than answers about school nursing practice but no mentor to ask. Questions often arise regarding medication administration, health records, health requirements to attend school, student illness, school health legislation, and state reporting requirements in the school setting, plus many more. This article outlines how one Regional Office of Education (ROE) in central Illinois partnered with a Certified School Nurse to establish a mentoring and networking program to foster relationships and information sharing among school nurses. [ABSTRACT FROM AUTHOR]

Climate change is having an unprecedented influence on human health. For example, increased frequency of storms with excessive precipitation may contribute to flooding, which contributes to increased water-related dermatological, gastrointestinal, and respiratory illnesses. Some of these water-related illnesses, which can be transmitted via recreational waterborne pathways, may be seen in school-age children. The purpose of this article is to raise awareness of the impact some recreational water-related illnesses have on school-age children's health and to provide school nurses with information on the signs and symptoms of these illnesses as well as prevention tips nurses may wish to share with parents. This is the third article in a series meant to inform school nurses about illnesses linked to local changes in weather that may be arising from global changes in climate and provide them with the tools they need to safeguard children's health. [ABSTRACT FROM AUTHOR]

This article is the third and final article in a series exploring the WHAT, WHY, and HOW of data collection and data utilization. The final step, the HOW of data submission, provides discussion and guidance in contributing your data to the collective voice, including submitting data from the school, district, state, and national levels. Submitting individual school nursing data enriches the bigger story and increases the awareness and meaningfulness of school health data, the role of the school nurse as an integral member of the school community, and the connections of student health and academic outcomes. This article will also explore how to submit your school health data and the opportunities to submit it to district, state, or national levels, including to the National School Health Data Set: Every Student Counts! (ESC!). [ABSTRACT FROM AUTHOR]

Climate change is having an unprecedented influence on human health. Children's allergies and respiratory problems are increasing because of rising pollen levels and air pollution. School nurses are well positioned to prevent and treat allergies, asthma, and other respiratory conditions. Due to their consistent presence with the school setting, nurses can promote health, wellness, and academic productivity by addressing poor indoor and outdoor air quality. The purpose of this article is to increase understanding of how air quality affects the health of school-age children and to provide school nurses with primary, secondary, and tertiary prevention strategies for ensuring clean and healthy learning environments. This is the second in a series of articles aimed at raising awareness among school nurses about climate-associated illnesses and equipping them with the resources they need to protect students' health. [ABSTRACT FROM AUTHOR]

This is the second in a series of articles looking at school health data collection from identification of data points to utilizing data to share your story and submit your data to contribute to the National School Health Data Set: Every Student Counts! This article focuses on using data to share your story. Data storytelling versus data visualization will be discussed as well as HOW schools nurses can utilize easy access programs to support this process. Building on the first article in the series, the school nurse will not only identify the WHY and WHAT related to data collection but also HOW to link school health data to educational data to increase the audience of the story and follow data sharing regulations. [ABSTRACT FROM AUTHOR]

This is the first in a series of three articles looking at school health data collection from identification of data points to utilizing data to share your story and submitting your data to contribute to the National School Health Data Set: Every Student Counts! Many school nurses cringe at the mention of data collection. However, everything we do as school nurses is data driven. Every documented assessment, observation, and conversation provides the school nurse with data. The barriers often noted to participating in formal data collection efforts are time, workload, access to an electronic health record, and not understanding the WHY, WHAT, and HOW. The key to data collection is identifying the data already being collected and starting where you are. Data collection is not something new that you need to find a way to fit into your already busy schedule. WHAT do you currently collect? WHY are you collecting the data you have? HOW do you collect it? WHAT do you do with the data? These are all very important questions, but let's take a closer look at the WHY, WHAT, and HOW behind data collection. [ABSTRACT FROM AUTHOR]

Violence is a public health crisis. It is especially concerning when it involves youth, whether they be victims, perpetrators, or observers. Part 1 of this two-part series categorizes the types of violence toward and by youth. There is a great deal of information on the prevalence of violence, mostly related to school shootings. However, the literature provides limited information on the antecedents of violent behaviors, and there is a dearth of information on "why" youth engage in violence. This is the unanswered question that drives Part 1 of this series. The beginning steps to understand "why" are viewed through the lens of a modified ABC Model (antecedent, behavior, consequence). Interventions for youth violence will be explored in Part 2. [ABSTRACT FROM AUTHOR]

Violence toward and by youth is a public health crisis that can partially be addressed by the modified Antecedent, Behavior, Consequence (ABC) Model. Part I of this two-part series discussed the types of violence and the risk and protective factors that affect the prevalence of violence; it also addressed the emotions and thoughts that occur before the behaviors to help explain "why" youth engage in violence. Part II focuses on possible interventions by the school nurse and school staff. The modified ABC Model allows school nurses to focus on interventions that address the emotions and thoughts resulting from the antecedents as well as promote protective factors. Through their role in primary prevention, school nurses can also address risk factors for violence and participate in school and the wider community's efforts to mitigate violence. [ABSTRACT FROM AUTHOR]

Climate change is associated with global health emergencies. School-age children are particularly susceptible to the health effects associated with climate change. School nurses are uniquely positioned to address children's climate-associated illnesses. This article is the first in a series of articles that aims to inform existing knowledge gaps, raise awareness among school nurses, and equip school nurses with the skills they need to protect the health of school-age children. This series of articles will briefly discuss different aspects of the Impact of Climate Change on Human Health diagram, which was created by the Centers for Disease Control and Prevention. [ABSTRACT FROM AUTHOR]

While all nurses likely have a resume, most do not have a Curriculum Vitae or CV. CVs are used to provide a complete picture of your professional history. Resumes are crafted to highlight a candidate's fitness for a particular position. In contrast, a CV is a complete record of one's professional career and accomplishments. A CV is a comprehensive document that, along with your education and job history, is a record of all your professional achievements and activities. [ABSTRACT FROM AUTHOR]

Vaccine hesitance is a public health issue that school nurses often address in practice. It has become even more prevalent during the coronavirus disease 2019 (COVID-19) pandemic. Vaccine compliance among schoolchildren is essential to the health of an entire community, given that many pediatric illnesses are vaccine-preventable. School nurses are involved in the promotion of vaccines in a school district, as they provide health education to students and families and are responsible for vaccine surveillance. Promoting vaccine compliance as a matter of public health can be challenging for school nurses, especially if a community holds strong beliefs regarding the necessity of pediatric vaccines. This article reviews the history of vaccine mandates, addresses challenges associated with vaccine compliance, and provides interventions school nurses can use when providing care to students and families regarding vaccine hesitancy. In following the nursing process, a school nurse is able to identify students missing vaccine(s) and evaluate for hesitancy, before implementing interventions that provide education to students and families. Several cost-efficient and accessible interventions can facilitate effective education and promote vaccine compliance. School nurses can forge trusting relationships and engage in compassionate dialogue to support vaccine compliance in the school. [ABSTRACT FROM AUTHOR]

Every nurse will be asked to write a letter of recommendation during their career. It is a privilege to be invited to write a letter of recommendation. A well-written letter of recommendation can make or break a stellar individual's chances of receiving the recognition they deserve or getting the job they want. Some find the prospect of writing a letter of recommendation intimidating, however, writing one does not have to be daunting. In this article, we will share a formula you can use to write a succinct, data-driven, and effective letter of support. [ABSTRACT FROM AUTHOR]

The National Association of School Nurses (NASN) launched the National School Health Data Set: Every Student Counts! data initiative in 2018. The data set is comprised of four main areas and has an overarching goal of identifying best practices in school health to meet the needs of students and improve health outcomes. Management of the recent pandemic might have interfered with school nurses participating in this initiative. The goal of this article is to reenergize and familiarize school nurses with this data initiative and highlight the data points added or expanded since 2018 and why they are important to school nursing practice and addressing health equity of students. For more information on NASN's National School Health Data Set: Every Student Counts!, go to https://nasn.org/everystudentcounts. [ABSTRACT FROM AUTHOR]

Human health is dependent on the health of the planet. Overwhelming evidence indicates that environmental degradation and climate change is negatively affecting planetary health and is on a worsening trajectory. The health of our children, especially those who live in poverty, suffer from chronic disease, or are otherwise disadvantaged, will benefit most from successful efforts to change this trajectory or will suffer the most if we do nothing. School nurses, members of the largest and most trusted group of healthcare providers, have a professional and ethical obligation to address environmental degradation and the impact on our students and communities. Research suggests that knowledge about climate change and the associated health impacts are positively correlated to school nurses' attitudes and behaviors. This article aims to raise school nurse awareness, understanding, and agency regarding the possible trajectories of environmental degradation, implications to the health and well-being of current and future generations of children, and evidence-based actions to positively influence the trajectory. The Framework for 21st Century School Nurse Practice™ advocates a practice model that is student centered and provides a mind-set for school nursing to approach the topic of planetary and environmental health. [ABSTRACT FROM AUTHOR]

Role transition can be a struggle for new or seasoned nurses moving into the specialty of school. School nursing, a specialized field that entails a scope of practice and competencies very different from other settings, is not taught in many primary nursing education programs. New nurses may find themselves unprepared for their role without a proper orientation, causing them to feel anxious and not ready to care for students properly, leading to attrition. This article describes the barriers and facilitators to smooth role transition and provides evidence-based orientation strategies for new school nurses. [ABSTRACT FROM AUTHOR]

The growth of social development entails a progression where youth learn to interact with those around them. This manuscript provides interventions school nurses may use to incorporate social development into their daily practice and interactions with students. Social-emotional skills are pivotal to children's and adolescents' health, well-being, and academic success. Healthy social development can lead to improved self-confidence and better social relationships and have long-term benefits into adulthood. There is still much to learn about how the COVID-19 pandemic has affected the social development of children and adolescents. Nevertheless, school personnel, including the school nurse, must collaborate to support students, families, and each other to cultivate an environment that connects social development with education, health, and well-being. [ABSTRACT FROM AUTHOR]

The importance of students feeling connected in school cannot be overstated, as this perception is crucial to support their health and well-being. A lack of school connectedness can lead to adverse physical and mental health outcomes, including bully victimization. Numerous factors, including individual, social, and environmental, influence students' perceived sense of school connectedness. School nurses are well positioned to establish and maintain school connectedness due to their knowledge, accessibility to students, and familiarity with the school environment. This article details the importance of school connectedness and describes the associations between school connectedness, bullying, and mental health. In addition, we offer recommendations geared toward school nurses regarding strengthening school connectedness and promoting a culture of care and inclusivity within school environments, especially salient in the context of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Since asthma is the most common noncommunicable chronic childhood disease in the United States, school nurses will encounter students with this health condition. The purpose of this article is to present the school nurse as the leader in directing the management of a student's chronic health condition at school. This article provides a table of resources and discusses many aspects of asthma management, including utilization of the student's asthma action plan, student-specific school accommodation needs, the importance of developing individualized healthcare plans, providing education to school staff related to asthma management and determining of the family and student knowledge level, as well as strategies to minimize exacerbations. The article also explores school nurse opportunity to advocate for emergency asthma medication access as a part of emergency preparedness. School-based asthma management can be complex and school nurses have a pivotal role in asthma management in a school. [ABSTRACT FROM AUTHOR]

Local school wellness policies (LWP) guide school districts' efforts to establish school environments that promote students' health, well-being, and ability to learn that include school U.S. Department of Agriculture nutrition and physical activity requirements. Looking through the lens of the Whole School, Whole Community, Whole Child model and NASN's Framework for 21st Century School Nursing Practice™, LWP can be expanded beyond the tradition focus of nutrition and physical activity to address the health and academic needs of students with chronic health conditions. School nurses need to be actively involved on district wellness councils as schools prepare to conduct their required triennial assessment of current LWP equipped with an understanding of the Alliance for a Healthier Generations' updated model wellness policy and NASN's supplemental wellness policy language to address management of students with chronic health conditions. [ABSTRACT FROM AUTHOR]

The arrival of SARS-Co-V-2 (severe acute respiratory syndrome coronavirus 2) has brought not only the COVID-19 (coronavirus disease 2019) pandemic but also the development of a cluster of symptoms known as multisystem inflammatory syndrome in children (MIS-C). Information regarding the long-term implications of COVID-19 infections in children, as well as MIS-C, is scarce and is emerging on an almost daily basis. The purpose of this article is to provide an overview of the recent literature regarding COVID-19 and MIS-C, a Kawasaki-like inflammatory syndrome that developed in children around the same time the COVID-19 pandemic began. Because the school nurse monitors children across a variety of developmental domains, they are in a unique position to identify changes and notice long-term trends related to the health and development of children who contract both COVID-19 and MIS-C. [ABSTRACT FROM AUTHOR]

School nurses are seeing increased numbers of children who are living in poverty. The Missouri Community Action Program Poverty Simulation was presented to school nurses to increase their awareness of what it might be like to live in poverty and the related healthcare barriers. Participants shared their reactions and knowledge gained in the simulation in a postparticipation survey with the simulation facilitators. Some participants shared practice changes that they made as a result of their participation in the simulation, which included use of additional referral resources, being less judgmental, and increased empathy. [ABSTRACT FROM AUTHOR]

Safety isolation protocols in response to the COVID-19 (coronavirus disease 2019) pandemic have had the unintended consequence of social isolation for adolescents, youth who have a developmental need for autonomy and peer connection. Social isolation alone can lead to various psychological effects such as anxiety, stress, low mood, fear, frustration, and boredom. School nurses serve a vital role in addressing stress among adolescents by initiating early interventions, ensuring positive school experiences for students, and providing support surrounding the development of mental health disorders. Through implementation of NASN's Framework for 21st Century School Nursing Practice, school nurses address stress among high school students during the COVID-19 pandemic. Innovative interventions can include recognizing signs and symptoms of stress on physical and emotional health, advocating for mental health literacy curriculums, social prescribing, incorporating anticipatory guidance related to health promotion lifestyle practices into each school health encounter, and creating a virtual school health office to reach students while COVID-19 safety isolation continues. [ABSTRACT FROM AUTHOR]

This article is the second in a series of three articles discussing the importance of interprofessional collaboration between the school nurse and other school-based and community professionals to create a healthcare team. Developing the healthcare team begins with identifying the individual medical, mental health, and educational needs of the student. Expertise in both education and healthcare systems makes school nurses ideal candidates for coordinating with the healthcare team to meet the needs of the student. This article builds on the first article by providing some examples of the collaboration that occurs between the school nurse and other team members, as well as identifying facilitators and barriers to this collaboration. [ABSTRACT FROM AUTHOR]

Children and adults with Type 1 and Type 2 diabetes are at risk for severe hypoglycemia, an unpredictable and potentially life-threatening situation. Severe hypoglycemia creates low blood glucose levels in which a person has an altered mental status or physical symptoms that require assistance from another individual to treat the hypoglycemia. Treatment of severe hypoglycemia is a medical emergency and prompt treatment is important for the well-being of students with diabetes. If left untreated, severe hypoglycemia can lead to death. Glucagon is a medication used to treat severe hypoglycemia outside of a healthcare facility. Recently, more stable and easier to use formulations of glucagon have become available. The purpose of this pharmacology update is to describe two new formulations of ready to use glucagon: an intranasal and subcutaneous, autoinjector formulation. [ABSTRACT FROM AUTHOR]

Due to collaborative relationships fostered with school staff and the ability to form long-term trusting relationships with students, school nurses are uniquely situated to address the issue of child abuse detection and prevention in this age of online education brought about by coronavirus disease 2019 (COVID-19). School nurses can and should champion the cause of child safety in their schools, even during school closures through the implementation of key nursing interventions such as staff education on detecting child abuse in online environments. School nurses can also protect children by supporting parents who are dealing with great stressors due to the current global pandemic. Providing resources for families, encouraging parental self-care, educating families about online safety, and encouraging family discussion about child abuse all help to prevent abuse and maltreatment of children. When child abuse goes unreported because of school closures, school nurses can bridge the gap and advocate for detection and prevention in online education. [ABSTRACT FROM AUTHOR]

Motivational interviewing (MI) is a collaborative communication style that can be integrated into everyday practice to improve conversations and serve as a catalyst for behavior change. This article reviews the fundamental principles and basic skills of MI. It discusses how MI has evolved from a therapeutic modality to a conversational style, applicable in the school setting and specifically for school nurses. The article provides an overview of how MI can be used by school nurses, challenges they may face, and resources to support implementation. [ABSTRACT FROM AUTHOR]

Intellectual disability may affect the access school children have to curriculum and social experiences. While these children often have difficulty with social relationships, academic functioning, and communication, they also may experience pain on a daily basis. Communication difficulties present challenges for school nurses to identify and assess pain in students with intellectual disability. Although considered a gold standard for pain assessment, self-report cannot always be used for students with intellectual disability. School nurses must find methods other than self-reports of pain intensity to adequately assess these children's pain, such as collaborating with the student's caregiver(s), observing the student in the classroom, or assuming pain is present and offering an appropriate pain management intervention. [ABSTRACT FROM AUTHOR]

Technology is pervasive in society and reaches across all age-groups. The use of technology in youth has risen steadily in the past two decades through access to television, internet, computers, social media, and gaming in various formats. Due to this increased exposure and access, concerns have developed among mental health and healthcare providers regarding gaming addiction in youth. The American Psychiatric Association mentioned internet gaming disorder in the 2013 publication of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.). While not recognized as a specific diagnosis at the time of publication, there was a call for further research and evaluation of this phenomenon. Research indicates there are negative impacts on academic performance, social development, and self-concept in game-addicted youth. The purpose of this article is to provide the school nurse with information needed to recognize and care for youth at risk for and those experiencing gaming addiction. The school nurse is poised to provide nursing care in the school setting to educate, prevent, and help manage youth with gaming addiction risks and experiences, as part of an interdisciplinary team. [ABSTRACT FROM AUTHOR]

Electronic, or "e"-cigarette use has been adopted by an alarming number of teens in recent years. E-cigarettes are neither legal for youth nor considered safe for use by youth. E-cigarette companies have targeted youth in their marketing strategies and developed appealing flavors with high nicotine content to ensure dependence on their products. Schools lack adequate resources and capacity to address e-cigarette use, relying mostly on punitive sanctions for what is essentially a health issue. School nurses can help their districts and schools by navigating appropriate consequences for vaping, providing accurate information and education, providing cessation resources, advocating for student support, and informing stakeholders on population health strategies to prevent initiation and reduce youth e-cigarette use. [ABSTRACT FROM AUTHOR]

The occurrence of mass shootings in U.S. public schools is increasing. For this reason, schools have begun expanding their awareness and preparation for these crises. However, in most preparation strategies, students with disabilities are not accounted for, which leaves an already vulnerable population at further risk. Due to their expertise in working with students with diverse needs and promoting health and safety in schools, school nurses are the ideal persons to lead the discussion about safety deficits when it comes to school shootings and students with special needs. This article provides a rationale for school nurses taking leadership roles in creating school shooting policies as well as provides guidelines for how nurses can work collaboratively to keep students with disabilities safe. [ABSTRACT FROM AUTHOR]

Immunization compliance can require time and resources not readily available to school nurses in urban schools. Furthermore, immunizations can be perceived as lower priority at the high school level. But communicable disease outbreaks, such as the one experienced across the United States with measles, highlight the important role of school nurses in compliance activities. Using a five-step process, a school nurse was able to update one urban high school's database to more accurately reflect student measles vaccination compliance. An initial immunization database query indicated that 12% of approximately 2,000 enrolled students lacked even one measles-containing vaccine. A search through the state immunization registry and individual student educational folders revealed that 65% of these students actually had at least one measles vaccination. Remedies under consideration by the district in addressing this discrepancy are described. The remaining students (4% of total enrollment) required the additional steps of notification and intensive follow-up with students and their families. Within 2 months, fewer than 1% of students lacked a record of measles vaccination. The five steps presented can be adapted to achieve compliance with all required vaccines. [ABSTRACT FROM AUTHOR]

The majority of states have legalized medical marijuana (MM) despite its Federal Schedule 1 designation as an illegal substance. Public schools must comply with Drug Free Workplace laws or risk the loss of federal funding. To address the conflict between state and federal laws regulating MM, the National Association of School Nurses issued a position brief in January 2019. The accompanying article introduces the Cannabis/Marijuana Position Brief and provides guidance for school nurses who encounter a student treated with MM. Topics addressed include background implications of federal marijuana and hemp law, mechanism of action for MM, Epidiolex overview, current research regarding efficacy of MM for common qualifying conditions, and implications for school nursing practice. [ABSTRACT FROM AUTHOR]

The purpose of this article is to demonstrate how the Framework for 21st Century School Nursing Practice™ can provide a structure for evaluation using the School Nursing: Scope and Standards of Practice (3rd ed.), thus allowing the school nurse and school nurse evaluators to gain a better understanding of school nursing practice. According to NASN's Position Statement Supervision and Evaluation of the School Nurse, standards should be used to evaluate the clinical practice of school nurses. Our project accomplishes this integration of the Framework, the standards, and the evaluation of school nursing practice. [ABSTRACT FROM AUTHOR]

School attendance is a predictor of academic achievement. Chronic absenteeism, defined as missing 10% or more school days affects 14% of all students nationwide. District attendance processes, policies, and data were analyzed in a demographically diverse southern California high school. A review of the attendance history of 117 ninth and tenth graders, who missed at least 10% of days in school, showed that 66% of the absences were due to illness. Prior to the project, these students were not referred for nursing intervention. Results of this quality improvement project supported the adoption of a specific code for absences due to illness. A district procedure for illness chronic absence was adopted to allow early nursing intervention for students with chronic absences prior to the development of illness-related academic underperformance. This project demonstrates nursing roles in the quality improvement and care coordination aspects of the NASN's Framework for 21st Century School Nursing Practice™. [ABSTRACT FROM AUTHOR]

Lyme disease is the most common vector-borne disease in the United States with Lyme arthritis becoming one of the most common symptoms of Lyme disease. It is imperative that school nurses become familiar with vector-borne disease and promptly consider Lyme arthritis to be contemplated as a differential diagnosis of a child presenting to the office with a limp and joint pain and swelling with no history of acute injury. The following article will discuss the overview, implications and management of Lyme arthritis in the school setting and includes a relevant IHP for school nurses to utilize in practice. [ABSTRACT FROM AUTHOR]

Childhood and adolescent obesity are epidemic in the United States. Because of this crisis, schools in our nation have been challenged to develop strategies to decrease the number of overweight and obese youth, with many states passing legislation requiring body mass index (BMI) monitoring by the school. This may be done as a screening or surveillance program depending on the state, with some states requiring notification to parents. As school nurses are often the only health professional in the school, they are typically the employee tasked with leading the BMI screening programs. School nurses, both in states requiring and in states without requirements for BMI screening programs, must be knowledgeable about evidence-based programs and strategies that have promise in reversing the obesity epidemic. Indeed, school nurses are in a position to be an active participant in the fight against the obesity and overweight crisis. [ABSTRACT FROM AUTHOR]

Immunization noncompliance is a public health issue. Vaccines have been noted as one of the most effective public health interventions against the spread of infectious disease. However, there is an increase in the number of nonmedical exemptions and vaccine hesitancy. This has been linked to a decrease in the fear of contracting vaccine preventable diseases to public concerns regarding vaccine safety. Research has shown that decreased vaccine coverage lessens the effect of herd immunity placing those who are unvaccinated or unable to be vaccinated at increased risk of contracting vaccine preventable diseases. These factors have led to legislative action with some states implementing stricter exemption laws and stronger enforcement of vaccine mandates. Within the school setting, the school nurse is in a unique position working within both the educational and healthcare domains. The monitoring of immunizations is a key and vital factor in ensuring the health and safety of the school community. [ABSTRACT FROM AUTHOR]

School nurses play a major role in the care of students with food-related diversities balancing responsibilities such as providing a safe environment, encouraging leadership and community outreach, giving guidance to family and peers with care coordination, and providing needed accommodations so that all students may thrive in the school setting. It is essential that school nurses share their understanding of what it is like to live with the serious genetic autoimmune disorder known as celiac disease. With improved knowledge, the school education team, nutritional staff, and guidance counselors will have a better understanding of what the student is facing and the unique challenges it presents, because celiac disease is not a food allergy, but much more. [ABSTRACT FROM AUTHOR]

The hybrid closed-loop insulin delivery system, a form of "artificial pancreas," is composed of an insulin pump, a standardized algorithm, and a continuous glucose monitor. The system streamlines insulin delivery by connecting continuous glucose monitor data with an insulin pump and an algorithm to drive basal insulin delivery. The hybrid closed-loop insulin delivery system, approved by the Food and Drug Administration in 2016 for children older than 7 years, is a major improvement in the management of type 1 diabetes. The purpose of this article is to educate school nurses about the components of the hybrid closed-loop insulin delivery system, the relevance to care, and the future direction of blood glucose management. [ABSTRACT FROM AUTHOR]

As 21st-century school nurses, we address students holistically to meet their needs. The ASCD and the Centers for Disease Control and Prevention's coordinated school health model "Whole School, Whole Child, Whole Community" resonates with many school nurses. However, implementing the model can be challenging. This article explains how the school district of St. Johnsbury, Vermont, uses data to leverage their whole child team to meet their school district's needs. [ABSTRACT FROM AUTHOR]

Data collection and use is an integral competency for school nursing practice. The 3S (Student–School Nurse–School Community) Model is a visual representation of how to categorize school health data and identify what data are needed. This article introduces the model and shows a logical progression of how data align to influence outcomes and provides a tool for analyzing school health data. [ABSTRACT FROM AUTHOR]

For Part 3 of the NASN School Nurse series exploring NASN’s past, present, and future, Lindsey Minchella interviews NASN President, Nina Fekaris and President-elect, Laurie Combe to discuss their school nursing perspective and philosophies. These three school nursing leaders discuss what is responsible for their long tenure as school nurses, changes witnessed in student health over the years, how NASN makes a difference for students and school nurses, the future of school nursing, and the power of NASN members’ voices to improve student health and academic outcomes. [ABSTRACT FROM AUTHOR]

The National Association of School Nurses (NASN) is launching a new data initiative: National School Health Data Set: Every Student Counts! This article describes the vision of the initiative, as well as what school nurses can do to advance a data-driven school health culture. This is the first article in a data and school nursing series for the 2018-2019 school year. For more information on NASN’s initiative and to learn how school nurses can join the data revolution, go to http://nasn.org/everystudentcounts [ABSTRACT FROM AUTHOR]

School nurses are essential healthcare providers to children with autism spectrum disorder (ASD). In providing this care, school nurses may need to accommodate the unique challenges that children with ASD may face, including but not limited to sensory sensitivities, communicative and social difficulties, difficulties remembering event sequencing and directions, and poor time management skills. The aim of this article is to provide school nurses and healthcare providers evidence-based interventions and strategies that they may use to increase the compliance of hygiene behaviors and routines for children with ASD. [ABSTRACT FROM AUTHOR]

There is a significant disparity in roles, responsibilities, education, training, and expertise between the school nurse and building administrator. Because of this disparity, a natural chasm must be bridged to optimize student health, safety, well-being, and achievement in the classroom while meeting the individual needs of both professionals. This article constructs and presents a new school nurse-building administrator relationship model, the foundation of which is formed from the pioneering and seminal work on high-performance professional relationships and outcomes of Lewin and Drucker. The authors posit that this new model provides the framework for successful school nurse-building administrator interactions that will lead to optimal student outcomes. [ABSTRACT FROM AUTHOR]