School-based Nurses Research Articles

Addressing School Connectedness, Belonging, and Culturally Appropriate Care for Newly Immigrated Students and Families

School connectedness is the degree to which students experience acceptance, inclusion, and care by school personnel and peers. A sense of belonging incorporates an emotional connection to the community. School connectedness and belonging are protective factors that promote student engagement, accomplishment, and community performance. Despite the rise in students from immigrant families in the United States, belonging and connectedness for youth from diverse cultural and linguistic experiences are understudied. School-based nurses, our term, is inclusive of advanced practice pediatric, family, and psychiatric nurse practitioners, are well-positioned to support school connectedness for youth who may encounter hurdles to health care because of cultural and linguistic differences. We present practice suggestions for language, culture, and inclusion using three health conditions experienced by youth: anxiety, asthma, and obesity. School-based nurses and other school personnel who provide linguistic and culturally appropriate care can support students in feeling connected and included in their school communities.

An interprofessional school-based initiative to increase access to oral health care in underserved Florida counties.

To examine and describe the effect of an oral health education program on school-based nurses' acquisition of oral health knowledge. Three-hour synchronous videoconference sessions provided training for nurses to conduct oral health risk assessments, screen for oral diseases, deliver oral health education, apply fluoride varnish, and refer children identified in need of further assessment and treatment to a dentist. Oral health knowledge acquisition was assessed by comparing pre-training and post-training examination scores. Analyses included descriptive statistics and the Wilcoxon signed-rank test. Seventeen nurses from Suwannee, Lafayette, and Hamilton counties participated in the oral health education training program. Analyses of the school-based nurses' test results showed a significant increase in correct answers on the post-training test (93%) compared to the pre-training test (56%). Six hundred forty-one children from six elementary public schools received oral health education, oral screenings, and fluoride varnish applications. Fifty-eight percent of the children had untreated caries, 43% had treated caries, 15% had sealant on permanent molars, and 3% required urgent care. Nurses successfully referred children identified in need of further assessment and treatment to a dentist. The synchronous videoconference oral health training program was effective in improving school-based nurses' oral health knowledge. The knowledge acquired by school-based nurses via oral health training programs can be leveraged to increase access to oral health care for vulnerable and unserved school-aged populations.

Reducing Diabetic Ketoacidosis Readmissions with a Hospital-School-Based Improvement Partnership.

Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in pediatric type 1 diabetes mellitus (T1D). Baseline data showed 139 of 182 DKA readmissions (76.4%) were due to missed basal insulin dosing. The team used quality improvement tools to implement a process change around basal insulin. The project utilized insulin degludec and school-based nurses when missed basal insulin was noted as a main driver for readmission. The DKA readmission rate averaged 5.25 per month from January 2017 to April 2019. The rate decreased to 3.64 per month during the intervention from May 2019 to March 2020, a 31% reduction over 11 months. This standardized approach for patients with T1D readmitted with DKA, using a school-based intervention and insulin degludec, reduced the number of DKA readmissions. This method is safe and effective for lowering DKA readmissions due to missed basal insulin in areas with reliable school nursing.

Embedding public health advocacy into the role of school-based nurses: addressing the health inequities confronted by vulnerable Australian children and adolescent populations.

There has been a growth in Australian school-based nurses to address the inequities confronted by vulnerable students and school populations. Failure to address inequities can be evidenced in intergenerational poverty, poorer health and educational attainment and diminished life opportunities. School-based nurses are ideally located to advocate for public health policies and programs that address social determinants that detrimentally affect the health of school populations. However, school-based nurses can confront professional and speciality challenges in extending their efforts beyond individual student advocacy to effect change at the school population level. Guidance is required to redress this situation. This paper describes public health advocacy, the professional and speciality advocacy roles of school-based nurses and the barriers they confront in advocating for the health of school populations and strategies that can be used by key stakeholders to enhance school-based nursing public health advocacy efforts. School-based nurses who are competent, enabled and supported public health advocates are required if we are to achieve substantial and sustained health equity and social justice outcomes for vulnerable school populations.

Suicide Prevention Experiences, Knowledge, and Training among School-based Counselors and Nurses in King County, Washington - 2016.

Few studies have assessed the suicide-specific perceptions and awareness of school-based nurses and counselors. This project assessed the self-reported training, beliefs, and professional experiences of school counselors and nurses towards suicide prevention, and identified areas for enhancing efforts to respond to student suicidality. A self-report needs assessment survey was conducted with school-based nurses and counselors in King County, Washington. Group comparisons and descriptive statistics were calculated to characterize providers' perceptions and experiences. Most training experiences reported by counselors and nurses corresponded with greater perceptions of comfort in applying suicide prevention knowledge and skills. Fewer respondents endorsed means safety and safety planning as regularly implemented interventions for at-risk students compared to other interventions. Means safety and safety planning appeared to be areas for enhancing existing suicide prevention efforts.

Holistic care in the school setting for students living with long-term conditions

Marie Quinlivan looks at the different needs of children and young people with long-term conditions and how these can be met in the school setting. While this article is written with school-based nurses in mind, it is important that all school nurses work towards addressing those needs.

Creating connections: Strategies to improve adolescent boys’ access and engagement with school-based health services

The aim of this grounded theory study was to investigate strategies used by school-based nurses to promote adolescent boys’ access to and engagement with school-based health services. Interviews were conducted with 10 school nurses in South-East Queensland, Australia. The central process identified was creating connections, encompassing three inter-related sub-processes: facilitating communication, mediating contextual issues and bridging cultural issues. These processes incorporate strategies that highlight ways school nurses can engage with boys, individually and collectively, to promote and facilitate help-seeking from school-based health services. Findings inform practice and guidelines for improving boys’ access to school-based health services.

UNDERGRADUATE NURSING STUDENTS' Perceptions of Service-LearningThrough a School-Based Community Project

Service-learning (SL) is an experiential teaching method that combines instruction with community service, with the aim of enriching students' academic learning, interpersonal skills and sense of responsibility while making meaningful contributions to the community. However, measuring outcomes of service-learning projects is difficult. This article reports on the perceptions of 18 third-year undergraduate nursing students who took part in a pilot service-learning project targeting tobacco use in a local elementary school. Faculty members evaluated the program's outcomes by engaging students in structured reflection on the program about its relevance to their future careers as practicing professionals, especially in community-based settings. The students' perceptions were elicited through three sets of reflective assignments following the project. Findings from the reflective assignments suggest that the pilot program was successful in enhancing the students' academic, social, and personal development while building a partnership between the school of nursing and key players in the community, including school-based nurses, teachers, administrators, families, and community leaders. The author suggests that service-learning projects can help nursing students accomplish key developmental tasks of the college years (such as building their competence, autonomy, and integrity), while helping impart the skills and values they will need as they graduate and seek professional nursing roles.

Sexual assault prevention programs for college-aged men: A critical evaluation

An unacceptably large percent of women experience sexual assault during their collegiate years and efforts to eliminate sexual assault exist in various forms at numerous universities. The only way to effectively decrease the occurrence of rape on college campuses is to stop the perpetrators. This review examined established sexual assault prevention programs designed for college men to determine if an ideal educational program exists, or if one can be established, to effectively change male attitudes and behaviors about sexual assault. A library search of scientific databases yielded seven studies, published from 2000 to 2007, that met inclusion criteria. Through a variety of interventions, a measurable number of formerly held attitudes about rape myth and the role of the bystanders in an assaultive situation were effectively changed immediately postintervention in several studies. In addition, one study demonstrated sustained behavioral change. These results can effectively be used to provide education for forensic and school-based nurses to guide practice for development of educational programs to successfully change harmful attitudes and beliefs that contribute to rape.

Parental alcoholism and adolescent ego identity.

Using the Eriksonian theory of ego development, this study focused on the ego identity of adolescents with one alcoholic parent. Fifty adolescents with and 87 adolescents without one alcoholic parent were purposively sampled to respond to a 72-item survey questionnaire. Forty-four adolescents with one alcoholic parent were then matched on age, sex, and socioeconomic level and were compared with 44 adolescents in the sample without an alcoholic parent. Adolescents with one alcoholic parent scored significantly lower on ego identity than did those without an alcoholic parent. This difference was particularly evident in younger adolescents. The groups also differed significantly on extended school absences due to illness. No significant differences between groups were observed relative to the personal use of alcohol. Findings from this study point to important assessment and intervention strategies for community and school-based nurses. Children of alcoholics are at risk for developing intellectual, physical, and psychosocial problems (El-Guebly & Offord, 1977; Gabrielli & Mednick, 1983; Halmi & Loney, 1973; Hegedus, Alterman, & Tarter, 1984; Hughes, 1977; Midanik, 1983). Isolation of the alcoholic family; magnified negative family interactions; and an unpredictable, unstable household environment are major contributors to decreased academic achievement, increased physical abuse, school absenteeism, and drug/ alcohol use in the adolescent. Although significant issues in their own right, these problems also potentially contribute to and interfere with a major developmental task