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School nurses are accountable for recording and maintaining student health information and documenting nursing care in a manner that is timely, accurate, legible, complete, retrievable, and securely protected. The most efficient, effective, safe, and secure method for managing student health information is through EHR utilization. For the purposes of this position statement, the term EHR refers only to software platform systems designed specifically for school nursing that use the nursing process, standardized nursing language and data points, and established standards of confidentiality, security, and privacy set by the Health Information Portability and Accountability Act (HIPAA) and the Family Rights Educational Privacy Act (FERPA). Documentation that school nurses enter into an EHR produces usable data which can be monitored, gathered, extracted, compared, analyzed, and leveraged to track and measure trends and outcomes. Use of EHRs in the school setting is also advantageous in case management and care coordination efforts, particularly for students with complex health needs and chronic conditions. EHRs are an essential tool for school nurses to efficiently and effectively manage health information to optimize student healthcare quality, safety, coordination, and to improve student population health. EHRs enhance 21st century school nursing practices to provide equitable, evidence-based, student-centered healthcare that enables school-age youth to reach their full educational potential. [This Position Statement was initially adopted in January 2019 and revised in January 2024.]

School attendance is essential for academic success. Significant loss of learning time due to chronic absenteeism critically impacts academic attainment and places students at risk for school dropout and potentially negative lifelong effects on health, education, employment opportunities, and financial stability. To resolve chronic absenteeism, it is critical to first identify underlying root causes. Causes are often related to health, academic, school, family, community, or structural factors. To successfully decrease chronic absenteeism, it is essential that "school nurses routinely be included as integral members of school attendance teams" (Rankine et al., 2021, para 38). As members of school attendance teams, school nurses provide expert guidance on student health, safety, and social-emotional factors. School nurses contribute critical health perspectives to the development of individualized attendance intervention plans, school programs, restorative practices, and equitable policies that address chronic absenteeism. [This Position Statement was initially adopted in June 2018 and revised in June 2023.]

Bullying is a significant issue in schools and in the lives of students. By definition, bullying is unwanted and repeated aggressive and intentionally harmful behavior involving a perceived or real imbalance of power among school age youth. Bullying that occurs during students' years in school can result in school absenteeism, academic difficulties, social problems, and poor physical or mental health, with potentially lasting negative effects into adulthood. Currently, federal laws do not specifically address bullying, nor are there national mandates for bullying prevention curricula in schools. However, schools that receive federal funding are obligated to address and resolve incidences of bullying, including discriminatory harassment based on race, national origin, color, sex (including sexual orientation and gender identity), age, disability, or religion. At district and school levels, addressing bullying requires cohesive efforts by school personnel inclusive of school nurses, and also involves students, families, and community members. School nurses bridge health and education and thus, are well-positioned to lead and facilitate collaboration to address bullying. School nurses are essential members of the school community who make important contributions to multifaceted efforts to protect students from bullying, so that every student can be free to learn in a safe, supportive, and equitable environment. [This Position Statement was initially adopted in June 2018 and revised in June 2023.]

It is the position of the National Association of School Nurses (NASN) that healthcare transition (HCT) planning and implementation for all students with healthcare needs should be a well-coordinated process that occurs whenever a student moves into, through, or out of a school setting. The continuation of safe, quality, equitable care for all students with healthcare needs is essential for supporting positive health and academic outcomes, so that all students have equal opportunities to attain their full potential. As a vital member of the interprofessional school-based team, the registered professional school nurse (hereinafter referred to as school nurse) is ideally situated to provide expertise, leadership, and care coordination for students during HCT (NASN, 2022). This statement provides the background and rationale for NASN's position. [This Position Statement was initially adopted in January 2019 and revised in January 2024.]

It is the position of the National Association of School Nurses (NASN) to actively support and protect the right of all students, including those with healthcare needs or disabilities, to participate in school-sponsored trips, in accordance with federal regulations (U.S. Department of Education [USDOE]/Office for Civil Rights [OCR], 2020). The registered professional school nurse (hereinafter referred to as school nurse) has the expertise necessary to prepare, plan, educate, and coordinate with staff, families, students, and other healthcare professionals in arranging equitable, inclusive, and appropriate care for all students to be able to attend school-sponsored trips. This statement provides the background and rationale for NASN's position. [This Position Statement was initially adopted in June 2013 and revised in January 2024.]

It is the position of the National Association of School Nurses (NASN) that regularly scheduled recess during the school day should be regarded as a childhood right that is necessary for the optimal health and educational growth of all students, and that recess should not be withheld for any student. The registered professional school nurse (hereinafter referred to as school nurse) bridges health and education and can apply leadership and collaborative skills to advocate for equitable policies that support scheduled recess and reject withholding recess (NASN, 2016, 2020). Safeguarding scheduled recess is important for promoting the physical, emotional, social, and cognitive development of all students. This statement provides the background and rationale for NASN's position. [This Position Statement was initially adopted in January 2019 and revised in January 2024.]

It is the position of the National Association of School Nurses (NASN) that every student should attend school in a safe, supportive, and equitable environment. Access to a registered professional nurse (hereinafter referred to as a school nurse) democratizes healthcare for the most vulnerable students and families. This document provides the background and rationale for NASN's position. [This document replaces the position statement, "School violence -- The role of the school nurse" (Adopted June 2013, Revised June 2018).]

It is the position of the National Association of School Nurses (NASN) that healthy and safe communities are essential for the optimal health, well-being, academic success, and lifelong achievement of all school age youth (NASN, 2022a). Bridging education and healthcare, the registered professional school nurse (hereinafter referred to as school nurse), is uniquely situated to protect and promote student and community health, to work collaboratively to respond to public and population health needs, and to contribute to building an equitable culture of health that places "well-being at the center of every life, decision and policy" (NASN, 2022b, p. 100). This document provides the background/rationale for NASN's position. [This Position Statement was initially adopted in January 2018 and revised in January 2023.]

The National Association of School Nurses (NASN) believes school nursing services that are reimbursed in other healthcare environments should also be reimbursed in the school setting. The registered professional school nurse (hereinafter referred to as the school nurse) bridges education and healthcare and delivers quality, cost-effective healthcare in the school setting that is vital to supporting student learning and academic achievement (Maughan et al., 2018). Ensuring sufficient funding so that all children have access to necessary healthcare services provided by a school nurse is a matter of equity (Department of Health and Human Services and Centers for Medicare and Medicaid Services, 2022a). This document provides the background and rationale for NASN's position. [This Position Statement was initially adopted in June 2013 and revised in January 2018 and in June 2023.]

While school nurses are accountable for their own practice, stipulations in individual employee contracts may require supervision and evaluation. Like teachers and others who provide services for students, school nurses can benefit from self-assessment, peer review, and supervision and performance evaluations that focus on fostering continuous development of practice competencies and professional growth. Appropriate clinical supervision and evaluation of school nurses is essential for delivery of high quality and safe care in school communities everywhere. Developing and strengthening school nursing clinical competencies such as responding to students' healthcare needs and implementing evidence-based protocols and best practices positively impact student health and academic success. [This Position Statement was initially adopted in July 1970 and revised in June 2023.]

It is the position of the National Association of School Nurses (NASN) that all students, including those with disabilities or special healthcare needs, must have equal opportunity to safely take part in school-sponsored before, after, and extended school year programs and activities, also known as Out of School Time (OST). The registered professional school nurse (hereinafter referred to as school nurse) has the knowledge, skills, and expertise required for assessing, planning, coordinating, implementing, and evaluating student healthcare needs so that all students may fully participate in OST programming and activities. This statement provides the background and rationale for NASN's position. [This Position Statement was initially adopted in January 2014 and revised in June 2018.]

It is the position of the National Association of School Nurses (NASN) that prevention, early identification, intervention, and care of child maltreatment are critical to the physical/emotional well-being and academic success of students. As professionals who bridge education and health, registered professional school nurses (hereinafter referred to as school nurses) are vital team members in collaborating to prevent and manage child maltreatment. This statement provides the background and rationale for NASN's position. [This Position Statement was initially adopted in June 2018.]

It is the position of the National Association of School Nurses (NASN) that schools and districts should establish DNAR policies, protocols, and practices that enable each student to receive best practice care, as designated by clear and specific directives for the individual, throughout the entire course of their condition while they are in school. Each student with a Do Not Attempt Resuscitation (DNAR) order benefits from having an Individualized Healthcare Plan (IHP) and an Emergency Action Plan (EAP), developed by the registered professional school nurse (hereinafter referred to as school nurse). As professionals who bridge education and health and who advocate for students, school nurses work closely with school teams, families, and students' healthcare providers to appropriately meet the special healthcare needs of students with a DNAR. This statement provides the background and rationale for NASN's position. [This Position Statement was initially adopted in 2014 and revised in June 2018.]

It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse is an essential member of a multidisciplinary education team that identifies, evaluates, and monitors students who may be eligible for services through the Individuals with Disabilities Education Improvement Act (IDEIA; 2004) or Section 504 of the Rehabilitation Act of 1973. This statement provides the background and rationale for NASN's position. [This Position Statement was initially adopted in January 2018 and revised in January 2023.]