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Background: The threat of a disaster or potential for a disaster is something that may be experienced by individuals globally. Schools are places of daily mass gatherings which make them an ideal target for mass casualty, natural disasters, and biological incidents. Methods: An integrative review using Whittemore and Knafl's model was conducted to explore peer-reviewed publications about K-12 schools and natural disasters and pandemic preparedness and planning. Results: Themes identified from the systematic review of 12 articles reflected determinants and level of school preparedness, disaster plan components, compliance with government requirements, emergency equipment, supplies, drills, and training, collaboration with outside agencies, and perceptions of school preparedness. Preparedness for disasters and biological events among schools varies and multiple factors contribute to the level of preparedness. Perceptions of school preparedness differ among school community members. Schools perceive more preparedness for disasters than their actual level. Conclusions: Our nation's schools are not adequately prepared for disasters. There is a need for further research in schools to identify and understand preparedness for disasters.

Schools often offer injury prevention (IP) programs, but little is known about the types of programs provided or how school nurses decide which to choose. Nurses in the Missouri School Health Services Staffing Survey Database were sent a survey in spring, 2011, to describe school-based IP efforts being offered. A multivariate linear regression was conducted to delineate factors associated with offering IP programs. In total, 522 school nurses participated (33% response rate). The highest priority for selecting an IP program was perceived program effectiveness (92.3% agreement, n = 482). Determinants of offering IP programs included being asked to identify a speaker, being a high school, receiving funding in the last year, prioritizing evidence-based programs, perceiving that administrators support professional development, and knowing how to address patterns of injuries. School nurses should be competent in planning, implementing, and evaluating IP programs, and additional training may be required to accomplish this.

Working while ill (presenteeism) with symptoms of influenza-like illness can contribute to outbreaks, but little is known about school nurse presenteeism. Missouri Association of School Nurses members (N = 396) were sent a survey in 2013/2014. A chi square test was conducted to compare having a school culture that encourages presenteeism versus actual sick leave policies. Multivariate logistic regression was conducted to delineate factors associated with presenteeism. In total, 133 school nurses participated (33.6% response rate). Almost half (42.1%, n = 56) reported presenteeism. Nurses were more likely to feel pressure to engage in presenteeism than reported punitive sick leave policies (14.3% vs. 3.8%, ?[superscript 2] = 18.3, p < 0.001). Presenteeism was associated with perceived pressure, odds ratio (OR) = 4.8, confidence interval (CI) = [1.5, 15.8], p < 0.01, and having a mild illness, OR = 3.6, CI = [1.4, 9.7], p = 0.01. Many school nurses engage in presenteeism, and this appears to be associated with organizational cultural norms rather than established sick leave policies.

Background:A 2011 nationwide school pandemic preparedness study found schools to be deficient. We examined the impact of a school nurse educational intervention aimed at improving K-12 school biological event preparedness. Mehods: Missouri Association of School Nurses (MASN) members were e-mailed a survey link in fall 2013 (ie, preintervention), links to online education modules (ie, intervention) in late fall, and a postintervention survey link in spring, 2014. School biological event readiness was measured using 35 indicators, for a possible score range of 0-35. A paired t-test compared pre- to postintervention preparedness scores. Results: A total of 133 school nurses (33.6% response rate) completed a survey; 35.3% of those (N = 47) completed both pre- and postintervention survey that could be matched. Pre- and postintervention preparedness scores ranged from 5 to 28.5 (x-bar = 13.3) and 6.5 to 25 (x-bar = 14.8), respectively. Postintervention scores were significantly higher than preintervention scores for those who watched at least 1 module (t = -2.3, p < 0.05). Conclusion: The education intervention was effective at improving school preparedness, though the impact was small. The education intervention needs to be reassessed, especially in regard to providing a longer intervention period.

Introduction Little is known about childcare staff's and parents' uptake of and attitudes towards pertussis vaccine. Methods Questionnaires were distributed to St. Louis parents and childcare staff in fall, 2014. Parents versus staff and vaccinated versus unvaccinated individuals' beliefs regarding pertussis vaccine were compared using chi square tests. Multivariate logistic regressions were run to develop predictive models for staff's and parents' vaccine uptake. Results Overall, 351 parents and staff from 23 agencies participated (response rate = 32%). Parents were more likely than staff to have received pertussis vaccine (66.5 vs. 45.8%, X.sup.2 = 12.5, p < .001). Predictors for staff vaccination included willingness to get vaccinated even if there was a cost (OR 6.6; CI 1.8-24.6; p < .01), awareness of vaccination recommendations (OR 5.2; CI 1.2-22.8; p < .05), and healthcare provider recommendation (OR 4.2; CI 1.2-15.1; p < .05). Parents' predictors of vaccination included perceived importance of vaccination (OR 9.9; CI 4.1-23.8; p < .001), healthcare provider recommendation (OR 4.6; CI 1.7-12.6; p < .01), believing vaccination is effective (OR 4.4; CI 1.1-18.0; p < .05), and knowing where to get vaccine (OR 3.5; CI 1.5-8.1; p < .01). Among unvaccinated staff (n = 52), 74.5% (n = 38) and 70.0% (n = 35) would receive pertussis vaccine if it were offered free of charge and onsite, respectively. Conclusions for Practice Childcare staff's and parents' pertussis vaccine uptake was higher than overall U.S. rates, though significantly lower than the Global Pertussis Initiative target. Implementing an education campaign and providing free vaccine on-site are likely to result in increased vaccine uptake., Author(s): Terri Rebmann [sup.1] [sup.3] , Travis M. Loux [sup.2] , Daphne Lew [sup.2] , Mary Wakefield [sup.1] Author Affiliations: (1) Institute for Biosecurity, Epidemiology & Biostatistics, College for Public [...]

Objective: To determine whether modified K–12 student quarantine policies that allow some students to continue in-person education during their quarantine period increase schoolwide SARS-CoV-2 transmission risk following the increase in cases in winter 2020–2021. Methods: We conducted a prospective cohort study of COVID-19 cases and close contacts among students and staff (n = 65,621) in 103 Missouri public schools. Participants were offered free, saliva-based RT-PCR testing. The projected number of school-based transmission events among untested close contacts was extrapolated from the percentage of events detected among tested asymptomatic close contacts and summed with the number of detected events for a projected total. An adjusted Cox regression model compared hazard rates of school-based SARS-CoV-2 infections between schools with a modified versus standard quarantine policy. Results: From January–March 2021, a projected 23 (1%) school-based transmission events occurred among 1,636 school close contacts. There was no difference in the adjusted hazard rates of school-based SARS-CoV-2 infections between schools with a modified versus standard quarantine policy (hazard ratio = 1.00; 95% confidence interval: 0.97–1.03). Discussion: School-based SARS-CoV-2 transmission was rare in 103 K–12 schools implementing multiple COVID-19 prevention strategies. Modified student quarantine policies were not associated with increased school incidence of COVID-19. Modifications to student quarantine policies may be a useful strategy for K–12 schools to safely reduce disruptions to in-person education during times of increased COVID-19 community incidence. [ABSTRACT FROM AUTHOR]

Objective: To assess non-pediatric nurses' willingness to provide care to pediatric patients during a mass casualty event (MCE). Methods: Nurses from 4 non-pediatric hospitals in a major metropolitan Midwestern region were surveyed in the fall of 2018. Participants were asked about their willingness to provide MCE pediatric care. Hierarchical logistical regression was used to describe factors associated with nurses' willingness to provide MCE pediatric care. Results: In total, 313 nurses were approached and 289 completed a survey (response rate = 92%). A quarter (25.3%, n = 73) would be willing to provide MCE care to a child of any age; 12% (n = 35) would provide care only to newborns in the labor and delivery area, and 16.6% (n = 48) would only provide care to adults. Predictors of willingness to provide care to a patient of any age during an MCE included providing care to the youngest-age children during routine duties, reporting confidence in calculating doses and administering pediatric medications, working in the emergency department, being currently or previously certified in PALS, and having access to pediatric-sized equipment in the unit or hospital. Conclusion: Pediatric surge capacity is lacking among nurses. Increasing nurses' pediatric care self-efficacy could improve pediatric surge capacity and minimize morbidity and mortality during MCEs. [ABSTRACT FROM AUTHOR]