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Purpose This study aimed to determine the effect of health screening and school nurse interventions using a community-based, comprehensive practice and documentation system to improve knowledge, behavior, and status scores of primary school students. Design and methods A quasi-experimental study design with pretest and posttest of a single group was used. The research was conducted between November 2017 and January 2018 with 473 students at a primary school in southern Turkey. Health screening procedures and the Omaha System were used to identify health problems. Evidence-based school nurse interventions were implemented. The outcomes, including knowledge, behaviors, and status scores, were measured using the Problem Rating Scale for Outcomes. The scores were evaluated at the baseline and at the end of 10 weeks. Results Students' health problems, such as inadequate vision, hypertension, obesity, and second-hand smoke, were identified during the health screening. None of the students was neglected or abused. The most common health problems concerned Oral health, Neuro-musculo-skeletal function, Nutrition, and Vision. The intervention categories included Teaching, Guidance, and Counseling (58.1%); Case Management (20.9%); Surveillance (17.8%); and Treatment and Procedures (3.2%). A significant increase in Knowledge, Behavior, and Status scores was noted after interventions. Conclusions The results showed that health screening was effective in detecting school-age children's health problems. Knowledge, behavior, and status of primary students improved after school nurse interventions. Practice implications School nurses can use health screening and evidence-based interventions to protect and improve children's health. The Omaha System enables robust documentation to demonstrate outcomes after interventions.

INTRODUCTION The aim of this study was to describe parents' reasoning in making decisions about vaccinating their daughters against human papilloma virus (HPV), a part of the Swedish vaccination programme. METHOD Twenty parents whose daughter had been offered HPV vaccination participated. Semi-structured individual interviews were conducted and analysed using thematic analysis. RESULTS The findings reveal that the decision-making process is complex. The parents trusted the vaccination programme and saw it as beneficial to society. They also described using different resources to decide about HPV vaccination, but they did not include their daughters in making the decision. DISCUSSION Parents need better vaccine and health literacy to be able to decide, based on evidence and in consultation with their daughters, on HPV vaccination. School nurses can play an important role in evidence-based decision-making about HPV vaccination and introducing children to this health-promoting intervention.

Do-it-yourself (DIY) artificial pancreas systems (APSs) are gaining popularity among children with type 1 diabetes. Little is known about how school systems provide care for children who use DIY APSs, and available guidance for schools is limited. This study explored school staff perspectives on DIY APSs through a national survey of school nurses about their current practices, beliefs, and attitudes toward DIY APSs. Although one-quarter (23%) of school nurses reported experience with DIY APSs in school, nearly half (46%) had no prior knowledge of this new technology. The majority (82%) reported that children should be allowed to use DIY APSs in school, although there was less consensus about school nurse responsibilities with these devices. Qualitative responses added context regarding potential barriers, including the need for more informed guidelines and training and fears of liability. Future development of school guidelines for DIY APSs is necessary and should incorporate stakeholder perspectives.

Objective Although the importance of stakeholder engagement (SE) for patient-centered research is recognized, few studies document SE processes and influence on research outcomes in the diabetes field. We applied a research-informed framework to evaluate the impact of SE on a pediatric diabetes study exploring school nurse perspectives on modern diabetes devices. Methods We recruited parents of children with type 1 diabetes, school nurses, and diabetes providers. Stakeholders convened virtually every 2 months for 12 months. Goals for SE included input on research materials, interpretation of findings, and future research directions. Processes were assessed using a validated survey. Immediate outcomes included changes to research materials and satisfaction. Secondary outcomes included research efficiency and value (acceptance by community partners). Results Each role was represented at every meeting. The majority of stakeholders (>70%) completed the survey at study midpoint and end points. All surveyed indicated that they had received all desired information, shared feedback, and felt valued. Stakeholders were satisfied with the meeting frequency. Participants appreciated learning from each other and expressed enthusiasm for continued research participation. They described their role as one of consultant rather than research team members. SE resulted in five additional interview questions. Nearly 70 comments added to the interpretation of qualitative themes. Findings were published within 12 months and recognized by the state school nursing organization. Conclusion SE was well received and led to meaningful changes in content and dissemination of a diabetes study. A systematic approach to evaluating SE can increase scientific rigor and reproducibility and contribute to best practices for SE in diabetes research.

Purpose: To expose students to various public health roles and complement clinical experience using simulated encounters.Design: This exploratory study assessed students' performance of basic nursing tasks for three public health nurse roles.Methods: 15-guided questions were used to evaluate a convenience sample of 137 students' expected performance compared to their actual performance of basic nursing skills.Findings: Students' performed well in all nurse roles with some significant differences in completing a few critical tasks in the case manager and school nurse roles.Conclusion: Simulation can address gaps in nursing programs and expose student nurses to various public health roles using real-life scenarios.Clinical Evidence: Lack of clinical sites in public health limits students' experience to a myriad of nurse functions within communities.

Anaphylaxis is a rapidly occurring allergic reaction that is potentially life threatening. Recognition of the early signs and prompt treatment of anaphylaxis is critical. School nurses are tasked with educating nonmedical school personnel on the recognition and treatment of anaphylaxis and emphasizing that epinephrine is the first line of treatment for anaphylaxis. Fortunately, there is now availability of multiple epinephrine administration devices. However, this also means that there are more devices that school nurses and nonmedical assistive personnel need to learn about to be able to administer in an emergency. Once epinephrine is administered, emergency medical services must be activated. Education regarding what to expect after the administration of epinephrine with respect to side effects and onset of action is also necessary. Though adjunctive medicines, such as antihistamines and inhalers, may also be administered after the injection of epinephrine, they should not be solely relied on in anaphylaxis. School nurses are uniquely situated for this role, as they understand the local environment in a school and can assess and reassess the needs of the faculty and staff.

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.

Background With the onset of the COVID-19 pandemic and state-mandated school closures in the spring of 2020, the management of type 1 diabetes in children underwent significant changes. The aim of our study was to assess the effect of stay-at-home orders on glycemic control in children. Methods We conducted a retrospective review of 238 children with type 1 and type 2 diabetes who were seen in the Pediatric Endocrinology Clinic at the University of South Alabama. Average Hemoglobin A1c (A1c) levels in the year prior to stay-at home orders (May 2019–April 2020) were compared with A1c values during the quarantine period (May 2020–July 2020) using a paired t-test. We also analyzed the change of A1c level with respect to sex, race, type of diabetes, type of insurance, and mode of insulin administration, using a 2-sample t-test. Results The average A1c significantly increased from 9.2% during the previous year to 9.5% during the quarantine period (p = 0.0097). The increase of A1c was significantly higher in public insurance patients (0.49% increase) compared to private insurance patients (0.03% increase), (p = 0.0137). We also observed a significant association between the direction of change and type of insurance. Forty-eight percent of public insurance patients had an A1c increase of > 0.5% while 54% of private insurance patients had no change or decrease in A1c (p = 0.0079). Conclusions The COVID-19 pandemic resulted in worsening glycemic control in children with type 1 diabetes, with those on public insurance affected in greater proportion than those with private insurance.

School-based telehealth (SBTH) offers an opportunity to overcome traditional barriers to providing comprehensive asthma care for children. Guided by an implementation science framework considering factors internal and external to the school setting, we characterized barriers and facilitators to asthma care within an existing SBTH program available in over 50 under-resourced South Carolina schools.This cross-sectional study assessed barriers and facilitators to SBTH asthma care delivery using web-based surveys of school nurses, specifically addressing school implementation of telehealth methods. Surveys evaluated practices and nurse and school-specific factors related to telehealth implementation including perceived barriers, organizational readiness and self-efficacy. Utilizers were schools who completed 1-10 average visits per month while non-utilizers completed less than 1 average visit per month. Descriptive statistics were performed to characterize perceptions in utilizers versus non-utilizers.Of 53 surveys distributed, 36 were completed (68% response rate). Commonly cited barriers included inadequate time due to competing tasks in both utilizers (65%) and non-utilizers (74%) as well as lack of caregiver involvement in care planning (94% of utilizers and 84% of non-utilizers). Of those utilizing specific, relevant telehealth services, schools scored high in perceptions of organizational readiness (We identified inadequate nurse time and challenges engaging caregivers as key barriers to implementation of a school-based telehealth asthma program providing care to an under-resourced population. Addressing these barriers when expanding telehealth services may promote utilization of telehealth.

This pilot survey was designed to evaluate the characteristics of anaphylactic events and epinephrine autoinjector (EAI) use in children in U.S. schools. A cross-sectional, web-based, pilot survey of schools participating in the EPIPEN4SCHOOLS® program (Mylan Specialty L.P., Canonsburg, PA) assessed characteristics of anaphylactic events and EAI use during the 2013–2014 academic year. Respondents reported 757 anaphylactic events experienced by students; student grade level was noted for 724 events. Of these events, 32.3% (234/724) were experienced by students in grade school, 18.6% (135/724) by students in middle school, and 49.0% (355/724) by students in high school. Frequency of food-related triggers was consistently high across grade levels. However, many events experienced by students in high school (22.3%, 79/355), middle school (15.0%, 20/135), and grade school (14.1%, 33/234) had an unknown trigger. In 36.0% of schools (2008/5579), only the school nurse and select staff received training to recogni...

Background Incidents of serious youth violence have increased; however, the effectiveness of school nurse interventions in reducing these incidents lacks evidence. Aim To better understand the current role of the school nurse in relation to serious youth violence. Methods A mixed-method approach was taken, involving two key elements: a staff survey exploring school nurse experiences, interventions and confidence in delivering serious youth violence education and identifying vulnerable children and young people, and an audit of emergency department referrals and school nurse responses. Results The survey provided no evidence of interventions to reduce serious youth violence. Staff recognised their role in educating children and young people but lacked confidence and wanted further support. School nurse work with children and young people where serious youth violence had been identified mainly involved safeguarding. Only nine of the 62 emergency department referrals were followed up with a face-to-face contact. Conclusion School nurses recognise their role in serious youth violence but are not reflecting this in practice. Change is required to fulfil their public health role in helping to prevent or reduce serious youth violence.

The aim of this study was to measure the knowledge and attitudes of school staff regarding care in school for children with type 1 diabetes and to evaluate the contribution of the "Diabetes Program at School"(DPS). The data were collected through an online survey consisting of 55 questions, which included 39 knowledge and 16 attitude questions. The survey was delivered to the participating school staff via a link. A total of 55,677 people who completed 100% of the survey were included. Of the participants, 76% were teachers, 23% were school administrators and 0.1% were school nurses. 73% (40732) of the participants stated that they had heard about the "DPS". Of the participants who were aware of the DPS 75%, 50%, and 41% stated an increase in their knowledge level, self-confidence, and awareness respectively. Both scores were positively associated with being female and school nurse, having students with diabetes in the school, having been trained in childhood diabetes, being familiar with the program and being from the Western region of Turkey. The DPS is well known among school staff including teachers, school administrators, and school nurses. However, there are clear regional differences in the knowledge and attitude of school staff regarding diabetes care at school. Therefore, regional differences should be taken into account when planning the necessary interventions to prevent any further increase in the current inequalities. In addition, increasing the number of school nurses, together with strengthening the knowledge and attitude of school staff, can improve the level of diabetes care at school.

The goal of this study is to assess the referral rate accuracy of photoscreening versus the chart methodology in identifying preschool children at risk of amblyopia and amblyogenic refractive error. Vision screenings using the plusoptiX S12 and the LEA chart were performed on 127 children, aged 3–5 years old. Comprehensive eye exams were performed after screenings. The sensitivity and specificity of the plusoptiX S12 were 80.3% and 92.1% and the LEA chart were 43.6% and 94.8%, respectively. The sensitivity of the plusoptiX S12 is significantly higher than the LEA ( p value

Objective: To elucidate the common perceptions of standard precautions and bloodborne diseases, as represented by hepatitis B virus (HBV) and C virus (HCV) infections, among school nurse teachers in Japan. Material and methods: We conducted a questionnaire survey targeting school nurse teachers who were employed at public elementary or junior high schools. The questionnaire had 2 categories: awareness and implementation of standard precautions in the school setting and the other was awareness and provision for bloodborne diseases. Results: A total of 63 school nurse teachers were enrolled in the study. Almost all (96.8%) the school nurse teachers had sufficient knowledge of standard precautions and bloodborne diseases according to the responses. When attending students with a common cold or gastroenteritis, all respondents washed their hands thoroughly, and most of them (92.3% and 89.7%, respectively) wore a facemask. They wore gloves more frequently when attending students with gastroenteritis than when attending those with a common cold. Thirty-one (49.2%) had examinations for HBV and 21 (33.9%) for HCV. Only 11 respondents (18.3%) received an HBV vaccination. Discussion: This study shows that the actual usage of measures for infection prevention and control (IPC) remained incomplete, partly because of the insufficient personal protective equipment in the schools. The appropriate implementation of IPC in the school environment should be done as soon as possible. As school nurse teachers continue to address many pathological agents, they should strictly use standard precautions whenever attending to students. Further investigations in these areas are required.

This study examined the association between two implementation factors, nurse-reported intervention adherence and self-efficacy, and children’s outcomes in school nurse–delivered anxiety interventions. Data were collected in a pilot randomized controlled effectiveness trial with 54 children and 21 school nurses. Nurses implemented either a cognitive behavioral or relaxation-skills-only intervention. Nurse questionnaires assessed implementation factors. Independent evaluators assessed changes in children’s anxiety symptoms at postintervention and at 3-month follow-up using clinical improvement and global functioning scales. Regression analyses indicated that greater intervention adherence was associated with greater anxiety symptom improvement at follow-up. Nurse self-efficacy interacted with intervention group, such that nurses with higher self-efficacy who implemented the cognitive behavioral intervention tended to have children show improvement and higher postintervention functioning. The impact of implementation factors on children’s outcomes may differ depending on intervention type. Self-efficacy may be important for nurses using relatively complex interventions. Intervention adherence should be supported through training and consultation.

Mental health problems among children present an important public health issue worldwide. Early detection, assessment, and support in schools might have a significant impact on mental health outcomes and child health and wellbeing. The purpose of this article is to show the mental health support system and its historical transition in Japan. In general, Japanese schools have a Yogo teacher (a school nurse) who works full time, as well as three types of mental health specialists who work part time: school counselors, advisors, and social workers. The regularity of visits from the three types of specialists depends on schools and regions. In general, school counselors visit schools more often than do other specialists, for approximately 4 h per week. The other specialists either visit the schools rarely or not at all because they are sometimes not hired. The strengths of the Japanese system included much provision of psychological consultations and a small budget compared to Western countries. Almost all school counselors are clinical psychologists with master's degrees who are skillful at handling students' mental problems. Moreover, they are capable of providing intensive psychological counseling in school settings in Japan. The weakness is that there is no specialist available who supports students' academic or school life. General teachers take on the role of the Western countries' "school counselors." There are also few specialists who can be approached for social support compared to Western countries.

Childhood obesity is an important public health issue that can affect child health and academic outcomes. Schools are essential in promoting healthy childhood behaviors through the implementation of programs that reach the whole school community. School nurses can play a key role in designing, implementing, and evaluating feasible strategies, including school-based nutrition and physical activity messaging programs, that meet school-specific needs. This article will explain how school nurses can utilize principles of the Framework for 21st Century School Nursing Practice™ to design programs that engage the whole school community while addressing implementation barriers.

ObjectivesTo explore factors perceived as positive or negative among young people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in relation to school and everyday life.DesignA qualitative study with semistructured individual interviews performed at the local hospital or at the informants’ homes between September 2017 and January 2018, with an additional telephone interview to collect data on experiences from the COVID-19 pandemic, conducted in September 2020. Data were analysed using a grounded theory approach.SettingThe informants were recruited from two university hospitals that offer interdisciplinary assessments of young people with CFS/ME from various parts of Norway.ParticipantsFive males and 13 females aged 13–21 years with CFS/ME diagnosed 3–56 months prior to the interviews participated.ResultsThe informants were concerned about a lack of educational adaptations and missed social life at school. Educational and social adaptations could improve schooling and health among young people with CFS/ME. Negative experiences were related to a lack of knowledge about CFS/ME among school personnel and young people’s difficulties to limit activities. Online teaching as experienced during the COVID-19 pandemic was described as positive both for education and social life.ConclusionsYoung people with CFS/ME can benefit from better educational adaptations and increased social interaction with peers. From the participants’ view, factors that limit learning and socialisation include a lack of knowledge about CFS/ME among teachers and school personnel, expectations from teachers of doing more than they could manage at school, feeling alone coping with the disease and not recognising their own limitations regarding what they are able to do. Suggested factors perceived to enhance learning and socialisation were a better understanding of the disease among school personnel and peers, suitable educational adaptations and being able to socialise with peers.

The present qualitative study is a part of the process evaluation of a complex intervention, the randomized controlled trial, “Prevention of human papillomavirus (HPV) in a school-based setting.” We aimed to explore participating school nurses’ perceptions and experiences of delivering the educational HPV intervention to adolescents aged 16. Focus group interviews were conducted with school nurses ( n = 20) and analyzed with inductive qualitative content analysis. The overall theme Easily adapted into the existing role as a school nurse permeated the participants’ views. The nurses were in favor of delivering an intervention that increased the HPV vaccination rates and improved beliefs and awareness about HPV prevention. It suits their work and health-promoting aspect of their role well and can easily be adapted into the current school health consultant curriculum. Having material in different languages to share with adolescents and their parents to promote equal health was deemed important.

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.

Background There is an increasing concern over adolescent concussions in sports due to risks of long-term negative effects. This study analyzed data over three school years on reported concussion incidence rates by season, high school grade levels and gender, and reported symptoms by school nurses versus athletic trainers, from New Jersey student-athlete concussion data available from an online school-based surveillance system. Methods School nurses and athletic trainers reported 300 concussions within five days from when each occurred over three school years, 2015–2018, in team sports and physical education in New Jersey high schools. Analysis was further conducted on symptoms and number of symptoms reported by school nurses versus school athletic trainers for each documented student-athlete concussion. Estimated concussion incidence rates were calculated using state agency verified school enrollment data. Findings Concussions most commonly occurred during fall, followed by spring, then winter. Concussion incidence rates ranged from 6.3/1000 (4.99, 7.55) – 9.1/1000 (7.27, 10.98) students over the three school years of the study. Athletic trainers completed 86% of the reports while nurses completed 11% (position or title of 3%, or n = 7, were not disclosed); the values were similar when considering only fall pre-season and regular season sports (88, 10, 2%, respectively). On average, across the three school years, athletic trainers reported about 3.5 symptoms per report while nurses reported 2.7 (values in fall seasons only were 3.7 and 3.1, respectively.) Conclusions Certified athletic trainers, compared to school nurses, more often completed concussion report forms and reported more symptoms per injured student, perhaps due partly to closer contact and immediate care provided after injury. Additionally, this study had a higher concussion incidence rate during fall sports seasons compared to winter and spring. Future research can further improve our understanding of concussions among adolescent student-athletes to better inform concussion identification, management and recovery protocols.

To evaluate whether school nurses can assist pediatricians in providing asthma care and reduce school absenteeism through a program called Easy Breathing for Schools (EzBfS), a 5-element school nurse-led asthma management program and the effectiveness in reducing school absenteeism.Fifteen public school nurses in an urban community implemented EzBfS during the 2015-16 and 2016-17 school years. Program elements included assessment of asthma risk and asthma control, asthma education, medication review, and a pediatrician communication tool. School absence for any reason was the primary outcome; absentee rates for students with asthma enrolled in the program were compared to students with asthma in the entire school population using negative binomial regression.School nurses enrolled 251/2,126 students with physician-confirmed asthma (2015-16: n = 114 and 2016-17: n = 137). Sixty eight percent of participants were Latino and 25% were Black with a mean age of 8.7 ± 2.2 years. Absentee rates were higher in children with asthma compared to children without asthma (8.3% vs 7.0% absent, respectively P.001). Students enrolled in the program experienced a 25% decrease in absentee rate after adjusting for age, sex, race/ethnicity, and school year (rate ratio = 0.75, 95% confidence interval, 0.67, 0.85) as compared to students with asthma not enrolled in the program. Participants also demonstrated improvement in inhaler technique score (P.001). Ninety two percent of the nurses were satisfied with the program.EzBfS, a pragmatic, nurse-led asthma management program, was successfully implemented by school nurses and significantly decreased school absences among a sample of students with asthma.

The purpose of this study was to analyze the role of a school nurse in managing elementary student with Type 1 diabetes. To identify the role of a school nurse in managing elementary student with Type 1 diabetes, DACUM job analysis was used. The DACUM committee were consisted with 4 expert school nurses, 1 emergency room nurse, 1 university professor in nursing faculty, and 1 nurse expert in DACUM analysis. They identified the tasks associated with each duty and completed the DACUM chart and suggested the priority of importance, difficulty, and performance level. The role of school nurse in managing elementary student with Type 1 diabetes were defined as ; Improve self-management of elementary student with Type 1 diabetes to lead a healthy school life. 9 duties and 57 tasks were identified for the role of a school nurse in managing elementary student with Type 1 diabetes. The task ‘Support to build emergency medical services system’ and the task ‘Provide emergency nursing care’ were the priority training area for elementary school nurse in managing elementary student with Type 1 diabetes. It is necessary to develop a training curriculum including how to build emergency medical services system and to improve emergency nursing care skills.

Asthma is the most common chronic disorder in schoolchildren and the school nurse plays an important role in supporting children with asthma ( Borgmeyer et al, 2005 ; Huss et al, 2001 ). School nurse have an important role in educating children about self-management and early management of exacerbations ( Ahmad and Grimes, 2011 ). This can lead to a reduction in absenteeism, and support their general wellbeing ( Ahmad and Grimes, 2011 ; Moonie et al, 2008 ; Rodriguez et al, 2013 ). Part of this role includes educating children and young adults about inhaler technique, and this is one area which nurses require further education and training ( Lalani et al, 2012 ; De Tratto et al, 2014 ). There is also a call for school nurses to work with a range of clinicians to support their students ( Hollenbach and Cloutier, 2014 ; Wilson et al, 2009 ).

The purpose of the study was to describe and compare pupils' experience of teaching about cancer, when a nurse used two different formats of teaching material to teach pupils aged from 10 to 12 years. Pupils from schools in Western Sweden were randomised to either Imaginary Friends or SEE-HEAR-DO pictures. A total of 197 of 231 pupils (85%) participated, and a majority knew someone who had had cancer before, and thought it was valuable to get knowledge about cancer. The Imaginary Friends intervention group felt happier/more content and calmer/more relaxed, and less tense/nervous after the education about cancer. The SEE-HEAR-DO group felt happier/more content after the education, and were to a significantly higher extent stimulated to ask questions. Both Imaginary Friends and SEE-HEAR-DO pictures can be used as teaching materials for pupils. The use of SEE-HEAR-DO pictures may increase the interaction between the school nurse and the pupils.

Migration has resulted in specialist community public health nurses (SCPHN), specifically SCPHN school nurses, encountering female genital mutilation (FGM) more commonly in practice, requiring them to upskill to offer support and raise awareness ( Robinson, 2011 ). A policy was critically analysed, and a literature review conducted, to identify evidence-based strategies to enable the SCPHNSN to effectively raise FGM awareness to school-aged pupils. The findings highlighted three themes – Education, cultural influence and community leader and FGM survivor engagement, which translated into practice as a SCPHNSN-led FGM education project ( Diop and Askew, 2009 , Adeniran et al. 2015 , Galukande et al. 2015 , Raible et al. 2017 , Connelly et al. 2018 , Johnson et al. 2018 ). A project such as this would enable the SCPHNSN to raise pupil awareness, increase knowledge of support services, achieving practice decline over time.

Sex plays a role in mediating different susceptibilities and outcomes of disease and injury. Sports injuries are included in this phenomenon, as recent research demonstrates that males and females show differences in incidences of varying injuries, presentations of injury, and treatment outcomes. Incidence of certain sports injuries like anterior cruciate ligament injury or patellofemoral pain syndrome may vary widely between male and female athletes, with female athletes being more susceptible to anterior cruciate ligament injury and patellofemoral pain syndrome. Treatment outcomes for males and females may also vary widely. For example, males have a higher risk of recurrent shoulder instability compared with females. These variances among incidence and outcome following certain injuries highlight the necessity of understanding these differences to provide quality care. It is especially important for the school nurse to be aware of these sex differences as they are well positioned to make youth athletes and their families aware of the varying injury susceptibilities among them.

The Specialized Health Needs Interagency Collaboration (SHNIC) program at the Kennedy Krieger Institute is a community-based program that provides on-site training and technical assistance to safely manage the integration of children with special health needs into educational and community settings. SHNIC frequently receives seizure education requests throughout the school year, specifically regarding vagus nerve stimulation. Vagus nerve stimulation involves an implanted medical device used to deliver electrical pulses to the vagus nerve for additional seizure management. The school nurse needs to understand the purpose and function of the hidden medical device, including the parameters for use of the device and magnet, safety considerations, and side effects. SHNIC has developed educational materials specific to vagus nerve stimulation to aid the school nurse in providing staff training, developing care plans, and creating a safe school experience for students with special health needs.

This study examined the factors associated with triage competency among school nurses in South Korea. Using a convenience sampling method, 386 school nurses employed in elementary, middle, or high schools completed a cross-sectional survey that included a modified version of the Triage Competency Scale for emergency room nurses. Information regarding experience working in schools and hospitals, education level, school types, age, emergency nursing care certifications, school locations, and serious emergency experience at school was collected. Analyses were performed using SPSS version 25.0, independent t-tests, analyses of variance, Spearman’s correlation, and ordinal logistic regression. Triage competency was higher for school nurses who were employed in metropolitan regions (odds ratio [OR] = 1.63, p = 0.017) and had serious emergency experience (OR = 1.76, p = 0.008). As the participants’ experience at schools or hospitals increased by one year, their triage competency score increased by 2% (OR = 1.02, p = 0.037) and 14% (OR = 1.14, p &lt, 0.001), respectively. These findings could be used to develop policies and educational programs that promote school nurses’ triage competency. Further, they suggest the importance of establishing an organizational support system to develop guidelines and a feedback system to improve school nurses’ triage competency.

This paper provides new evidence that preventive health care services delivered at schools and provided at a relatively low cost have positive and lasting impacts. We use variation from a 1999‐reform in Norway that induced substantial differences in the availability of health professionals across municipalities and cohorts. In municipalities with one fewer school nurse per 1,000 schoolage children before the reform there was an increase in the availability of nurses of 35% from the pre‐ to the post‐reform period, attributed to the policy change. The reform reduced teenage pregnancies and increased college attendance for girls. It also reduced the take‐up of welfare benefits by ages 26 and 30 and increased the planned use of primary and specialist health care services at ages 25‐35, without impacts on emergency room admissions. The reform also improved the health of newborns of affected new mothers and reduced the likelihood of miscarriages., CINCH working paper series, vol. 2021, no. 04

Schools often provide medication management to children at school, yet, most U.S. schools lack a full-time, licensed nurse. Schools rely heavily on unlicensed assistive personnel (UAP) to perform such tasks. This systematic review examined medication management among K-12 school nurses. Keyword searches in three databases were performed. We included studies that examined: (a) K-12 charter, private/parochial, or public schools, (b) UAPs and licensed nurses, (c) policies and practices for medication management, or (d) nurse delegation laws. Three concepts were synthesized: (a) level of training, (b) nurse delegation, and (c) emergency medications. One-hundred twelve articles were screened. Of these, 37.5% (42/112) were comprehensively reviewed. Eighty-one percent discussed level of training, 69% nurse delegation, and 57% emergency medications. Succinct and consistent policies within and across the United States aimed at increasing access to emergency medications in schools remain necessary.

The primary goal of this study was to examine young adults’ perspectives about the effects of their food allergies (FAs) on their social lives from school-age to young adulthood. Young adults aged 18–21 ( n = 10) at the University of South Carolina were interviewed. A qualitative descriptive method to find themes and commonalities from transcribed interviews was used for data analysis. Identified themes were (1) feeling different and being isolated, (2) strategies for managing feeling different and being isolated, (3) strategies for managing safety, and (4) acceptance of myself and by others. School-age children attributed the school lunch allergy table as contributing to social isolation. Additionally, participants described feeling different and concerns about safety. Strategies to mitigate those experiences were identified by participants. Implications for children with FAs, their parents, school nurses, and other education and health professionals who work with children are presented.

New diabetes devices are increasingly standard of care for pediatric type 1 diabetes management. Youth often need caregiver assistance to use these devices, including at school. The aim of this study was to assess school nurse confidence with devices, which, to our knowledge, no study has previously evaluated. School nurses in Pennsylvania were recruited to complete a questionnaire, designed by our group and demonstrating content validity, evaluating confidence in specific skills. Each item was scored on a 5-point scale with low confidence considered a response of 1-2, moderate confidence 3, and high confidence 4-5. Respondents (n=269) were 99% female, 96% white, and mean age was 52 years. The majority had experience with insulin pumps (95%) and continuous glucose monitors (CGM, 92%), but not sensor-augmented pumps (34%). Primary forms of device training were informal learning from parents (68%), other nurses (49%), or web searches (49%); fewer (37%) received formal training from a medical center. Median response for insulin pump-related items was 3.1/5 and for CGM items 3.5/5, suggesting moderate confidence overall. We found a moderate positive correlation between confidence with pumps (0.47, p0.05) between device confidence and years of experience as a school nurse, grades covered, or geographic region. A high proportion of nurses reported low confidence with certain skills, including operating a sensor-augmented pump (63%), setting a temporary basal rate (58%), changing the pump site (54%), knowing when CGM calibration is appropriate (48%), overriding pump calculations (42%), monitoring a CGM tracing (42%), or suspending insulin delivery (40%). Our findings suggest that school nurse confidence with diabetes devices varies by type of skill. Further validation of this questionnaire may help identify gaps in skills and tailor education as newer technology continues to emerge. Disclosure C. March: None. A. L. Hill: None. T. M. Kazmerski: None. G. E. Switzer: None. E. Wallace: None. L. M. Siminerio: Advisory Panel; Self; Abbott Diabetes, Bayer U. S., Research Support; Self; Becton, Dickinson and Company. E. Miller: None. I. Libman: Advisory Panel; Self; Novo Nordisk. Funding Cochrane Weber Endowment Award

Multidisciplinary collaboration for healthy student outcomes is not a new concept for school nurses nor is working with public health officials in promoting school–community initiatives. The SARS-CoV-2 (COVID-19; severe acute respiratory syndrome coronavirus 2, coronavirus disease 2019) virus further highlighted the need to work together to promote best practice strategies to arm the community with information and guidance to prevent illness. The McHenry County Health Department recognized the expertise school nurses have in school health and formed a voluntary School Nurse Task Force. This collaboration worked to implement requirements for operating a school during a pandemic. The task force adapted those concepts into a toolkit to assist schools to meet health requirements throughout the most significant pandemic in over 100 years.

Substance abuse in adolescents has been recognized as a public health problem at the national and global levels. Adolescents are at risk for experimenting with substances. School nurses in secondary schools are well positioned to screen and counsel students on substance use. In this project, school nurses’ self-efficacy levels increased in using the Screening, Brief Intervention, and Referral to Treatment (SBIRT) process posteducation, and SBIRT was integrated into school nurses’ practice. Initiatives aimed at stopping or preventing substance use are beneficial for a healthy society.

Objective: The primary aim of this randomized controlled trial, conducted in Minneapolis/St. Paul, Minnesota (2014–2019), was to evaluate the effects of a school-based, school nurse-delivered, secondary obesity prevention intervention to reduce excess weight gain among preadolescent children with obesity or at risk of developing obesity. Methods: Parent/child dyads (n = 132) were randomized to the 9-month Students, Nurses, and Parents Seeking Healthy Options Together (SNAPSHOT) intervention (32.5 contact hours) or newsletter-only control group. Eligible children were 8 to 12 years old, proficient in English, and with a BMI ≥75th percentile, calculated using height/weight reported by a parent, school nurse, or clinician. The primary outcome was child BMI for sex/age z-score (BMIz) at postintervention (12 months) and follow-up (24 months). Results: Among children, 63% were non-White, 51% were male, and 51% with obesity, including 21% with severe obesity. Among families, 59% received economic assistance and 30% reported food insecurity. The mean number of intervention contact hours received was 20 (range: 0–32.5). Among dyads (n = 54) receiving the intervention, parents were very satisfied/satisfied with SNAPSHOT and SNAPSHOT staff, 96% and 100%, respectively, and very likely/likely (97%) to recommend SNAPSHOT to others. Most (70%) children liked the kid group sessions “a lot.” In an intent-to-treat analysis, there were no significant between-group differences in child BMIz at 12 [0.04; 95% confidence interval (CI) −0.07 to 0.16] or 24 months (0.06; 95% CI −0.08 to 0.20), with participant retention of 92% and 93%, respectively. Conclusions: The SNAPSHOT intervention was well received, but did not improve BMI in a mostly diverse, low-income preadolescent population. Approaches to intervention delivery that are feasible, maximize accessibility, and optimize clinician and school nurse collaboration warrant consideration. Clinical trial registration identifier NCT02029976.

Introduction: Chronic fatigue syndrome (CFS/ME) is a disabling disease severely impacting school attendance, education, and social life in young students. Uncertainties surrounding CFS/ME etiology may impact the interpretation of CFS/ME in schools. Thus, school personnel need information from health care providers to make adequate adaptations to education and social life at school for these students.Objectives: To explore teachers, counselors, and school nurses' experiences with adapting education for students with CFS/ME aged 13–19 in secondary and high schools.Design: A qualitative study with focus group interviews and individual interviews performed face-to-face or digitally between November 2020 and March 2021. Data were analyzed using Systematic text condensation.Participants: Six teachers, two counselors, and four school nurses in secondary and high school participated.Results: Adapting education for students with CFS/ME was challenging, especially before the students received a diagnosis. The challenges were related to identifying the students' adaptational needs, maintaining a teacher-student relationship due to school absence, difficulties in maintaining continuity of education, and uncertainty regarding the diagnosis. Successful adaptations were related to quickly reacting to school absence, early referral to educational, psychological services, a close collaboration with the school management, and the development of digital teaching for students with CFS/ME. Interdisciplinary collaboration and a clear, constructive plan with adaptive measures, including maintained teacher-student communication and educational and social adaptations, may be useful in preventing the losses, young people, with CFS/ME experience.Conclusion: Early interdisciplinary collaboration to adapt education and social life at school for students with CFS/ME, may support teachers, counselors, and school nurses in their efforts to adapt education and prevent losses related to academic and social development in students with CFS/ME.

The objectives of the study were to explore the experiences of school health officers in identifying and managing mental health problems of secondary school students and to gather recommendations from the school officers for improving the effectiveness of mental health care in secondary schools in Can Tho City, Vietnam. We conducted a qualitative study based on in-depth interviews using a semi-structured guideline with 15 school health officers at 15 secondary schools in Can Tho City, Vietnam. Data were analyzed using content-driven analysis to identify recurring themes. The school health officers reported that stress, depression, suicidal ideation, and sexual orientation issues were the most commonly encountered mental health problems among their students. The officers worked with a limited range of interventions for helping these students, such as giving non-narcotic analgesics or advising students to take a short break at school or to go home. Most of them felt that their training was insufficient to deal with mental health problems in an optimal way. They recommended further training to improve their knowledge and skills in recognizing and managing mental health problems in students. They also considered a university-sponsored mental health website a good source of information on mental health care for students. School health officers reported that they did not feel well equipped to manage mental health problems because of insufficient training, lack confidence, and absence of an appropriate network for advice and referral. Updated policies and programs are needed for initial training and refresher courses, which will strengthen the role of school health officers as first line support for secondary school students with mental health problems.

Background Determination of adequate school nurse staffing is a complex process. School nurse-to-student ratios and the health services school nurses provide to students should be considered. The purpose of this study was to examine the impact of North Carolina school nurse-to-student ratios and school nurse health services on the health and education outcomes (eg, absences, grades, self-management) of students receiving services for asthma and diabetes. Methods This study of all 115 school districts in North Carolina used the Annual School Health Services Report Survey from 2011 to 2016. Descriptive statistics for health services, programs and outcomes, and generalized linear modeling were used to estimate the association of ratios and health services with asthma and diabetes outcomes. Results By the 2015-2016 school year, the average ratio decreased to 1:1086 in North Carolina public schools. Annually, 100,187 students received services for asthma, 3832 students received services for type 1 diabetes, and 913 students received services for type 2 diabetes. Lower ratios and nurse health services were associated with improved student outcomes, including decreased absences (p = .05), improved grades (p = .05), and student self-management of their health condition (p = .05). Conclusions Lower school nurse-to-student ratios and services were associated with improvements in students' health and education outcomes.

PurposeThe assessment of the role of school nurses in the oral health education and counselling of children and adolescents aged 7–19 years.MethodsA self-administered questionnaire was used to evaluate nurses’ practice in oral health education, previous training in caries prevention, collaboration with a dentist and self-assessment of knowledge. Data were analysed with the Chi square test.ResultsThe study group consisted of 140 Polish school nurses. Respondents declared the following activities: dietary counselling (99.2%), oral hygiene education (92.8%), NHS-funded supervised fluoride prophylaxis (82.8%), and caries screenings (4.3%). 47.1% participated in training on caries prevention, 25.7% had a collaboration with a dentist. Nurses from schools located in towns less frequently provided oral hygiene education (p p p p p p ConclusionPolish school nurses have potentially crucial roles in improving the oral health status in pupils through oral hygiene education, dietary counselling and fluoride prophylaxis included in their duties.

As length of hospital stay at T1D diagnosis declines, clinicians must innovate to manage pediatric T1D care. Concurrently, insulin pump and continuous glucose monitor (CGM) use has increased in Massachusetts (MA) youth. Objectives: To report school nurse assessments of: 1. time MA school nurses coordinate parent-student T1D care; 2. prevalence of IP and CGM use in MA schools. Methods: Questionnaires were emailed to 1330 licensed school nurses in March 2019; 327 (25%) submitted data on 576 students, i.e., student/RN = 1.76. Demographics: School Nurses: The School Health Unit in the Commonwealth of MA is divided into 5 regions: Western, Central, MetroWest/Boston, Northeast and Southeast. 93% of questionnaires were answered by public school nurses; 94% of nurses work in 1 school and 5% in 2 schools; 67% of schools have 1 FTE, 31% have 2 FTE and 3% have ≥3 FTE nurses;33% attended a T1D continuing education course in the past year. Demographics: Students: ages 3 to 18 years, enrolled in pre-school-grade 12; 29% receive free, reduced or universal free school lunch; 4% speak English as a 2nd language; 67% have a 504 plan, 19% an Individualized Education Plan, and 79% an Individualized Health Care Plan. Attendance, Tardiness and Early Dismissal: School year 2018 - 2019: 12% of students were reported absent ≥10% of days; 8% were reported tardy ≥10% of days due to home T1D management; and 10% were dismissed early due to T1D management concerns at school. No student was dismissed from school via ambulance. Technology: 50% wear an insulin pump and 96% were reported to monitor glucose at school. Of those, 32% monitor interstitial and capillary glucose, 30% monitor only interstitial glucose and 37% monitor only capillary glucose. Four percent do not monitor glucose at school. Communication: School nurse respondents spend 4.3 minutes/student/day communicating w a student’s parent/guardian. Massachusetts school nurses have ~7 hours/day to assist T1D-affected youth and the data supports most students see a school nurse daily. Disclosure M. Quinn: Advisory Panel; Self; Dexcom, Inc. C.M. Pettengill: None. J. Afzali: None. S. Toulouse: None. J. Afzali: None. L.A. Melchionda: None. A. Linehan: None. J. Connolly: None.

Kronik hastalık, prevalansı yıllar geçtikçe artan, tıbbi bakım gerektiren, çocukları fiziksel, psikososyal ve akademik olarak etkileyen bir durumdur. Kronik hastalığı olan çocukların günlük gereksinimleri sağlıklı akranlarından farklılık gösterebilmektedir. Kronik hastalığı olan okul dönemindeki çocukların okulda ilaç kullanma, ölçüm yapma, beslenme, hareket etme, solunum ve boşaltım ile ilgili fiziksel gereksinimleri bulunmaktadır. Kronik hastalığı olan çocukların psikososyal ve davranışsal değişiklik gösterdiği ve psikososyal olarak desteklenmesi gerektiği belirtilmiştir. Çocukların motivasyonunun artması için desteklenmeye gereksinimleri bulunmaktadır. Okulda kronik hastalık yönetiminin sağlanabilmesinde okul hemşiresine olan gereksinim kaçınılmazdır. Bu derlemede kronik hastalığı olan çocukların okuldaki gereksinimlerinin karşılanması ve bakımında okul hemşiresinin görev ve sorumlulukları, bakım, eğitim, sağlık politikaları ve yönetsel yönleri ele alınmıştır., Chronic disease is a condition which prevalence has increased over the years, requiring medical care, affecting children physically, psychosocially and academically. Daily needs of children with chronic diseases may differ from their healthy peers. They may need medication and blood glucose, nutrition and excretion monitoring at school. Associations between chronic diseases and emotional, behavioural, social and overall vulnerabilities were reported. The children should be supported psychosocially. Children need support to increase their motivation. The needs for a school nurse is inevitable in ensuring chronic disease management at school. In this review, the duties and responsibilities of the school nurse, care education, health policies and managerial aspects and care of the needs of children with chronic diseases are discussed.