The impact of elementary school nurses on student attendance.

This study analyzed the impact of school nurses on economic efficiency. Public schools must provide resources such as books, teachers, and buses necessary to accommodate all enrolled students even if all students do not come to school every day and even if some leave school before the end of the school day. To the extent that resources are allocated but unused, there will be an increase in what is termed X-inefficiency. To investigate this phenomenon, data related to student absences and student checkouts were collected from 22 schools with a total student population just over 10,000 students during a 20-day period in the fall of 2001. This study found that fewer children checked out of school for medical reasons when a full-time school nurse was available at the school. Additionally, this study supports the contention that full-time school nurses might have a positive impact on the percentage of children with health care insurance coverage. However, a large number of students did check out for what appeared to be less than valid reasons. Thus, although the presence of a school nurse reduced the X-inefficiency, school policy and procedures allowed a degree of X-inefficiency to remain.     

Comprehensive Pediatric Care Includes Communication With the School Nurse

With complex pediatric diagnoses being cared for in primary care, it is essential for the nurse practitioner (NP) to communicate the plan of care for the child with the school nurse. Misconceptions regarding the law and the barriers to communication between NPs and school nurses are outlined to enhance continuity of care and to improve the health of children. Information outlined in this article will empower NPs to advocate for their patients and ensure that necessary school setting accommodations are in place to allow the child to fully participate in the educational experience in an optimal state of health.     

A day in the life of a school health nurse

Registered nurses Daria Del Prete, Cheryl Schroeder, Clare Sullivan, and Patti Scott all work with the Vanderbilt University School of Nursing School Health Program. They work in two Nashville elementary schools that serve primarily inner-city children who face many barriers to health care. Many of these school-children have special needs, including complex medical, social, emotional, and learning problems that require a variety of nursing and case management services during the school day. Current staffing at the health centers allows for full-time nursing coverage at each site. Some days, a school nurse and nurse practitioner work together. Other days, there is just a nurse or nurse practitioner working alone. This article is a composite of a typical day at the Fall-Hamilton Elementary School with a school nurse (Cheryl Schroeder) and pediatric nurse practitioner (Patti Scott) working together. (All students names have been changed.)     

Special needs children in the public schools: perceptions of school nurses and school teachers

Schools are faced with the challenges presented by special needs children (SNC) because the law requires that they must provide educational opportunities to all children--those who have no handicapping conditions as well as those who do, no matter how severe those conditions. The need exists for adequately prepared health care professionals in the school setting. Using a convenience sample of school teachers and school nurses, this investigation focused on the perceptions of school teachers and nurses regarding the challenges and demands of having these children in the public school. Two surveys were conducted to study those perceptions. Quantitative and qualitative data analyses showed that the needs of both groups of providers--school nurses and school teachers--can be summed up in three categories: information dissemination, communication, and resource integration. Infrastructure development involves the establishment of an effective information management system, effective use of such a system in establishing communications between all participants, and adequate administrative support to facilitate the development of the school providers' sense of competence in the care of SNC. A well-planned and adequately supported program goes a long way toward changing people's attitudes toward the inclusion of SNC in the classroom.     

Mental Health and Academic Achievement: Role of School Nurses

PURPOSE: This article discusses how school nurses promote mental health and subsequent academic achievement by screening and referral for children demonstrating mental health problems. Nursing interventions are discussed at the individual, systems, and community levels. CONCLUSION: Mental health problems can affect school performance and academic achievement. When mental health problems are not recognized, students may be unable to reach their academic potential. School nurses are in a key position to provide interventions to address mental health and academic achievement. PRACTICE IMPLICATIONS: The role of school nurses and examples of mental health collaborative activities are provided.     

Elementary school nurse interventions: attendance and health outcomes.

Regular school attendance is a necessary part of the learning process; student absenteeism has a direct association with poor academic performance. School nurses can influence student attendance. This study describes the impact of school nurse interventions on student absenteeism and student health. A retrospective review of 240 randomly selected elementary student health folders and attendance records was conducted. School nurses were involved with 75% of high-absence students as compared to 66% of low-absence students; they were also more involved with students who had previously identified health conditions. There were no referrals to the school nurse for absenteeism and school nurse interventions were not targeted to attendance, despite 17% of students missing 11 or more school days. Nursing documentation was sparse and primarily task related. Few records contained entries of nursing diagnoses, interventions, or outcomes. Of the 134 interventions provided, only 56 (41.2%) had some information about the condition outcome, but it was insufficient to determine the effectiveness of nursing interventions. Furthermore, the record system did not support the collection of standard information for interventions or outcomes from which effectiveness could be determined. Recommendations include establishment of an attendance referral policy and improved documentation systems, including the use of standardized nursing language to demonstrate student outcomes.     

Bridging Cultures for Latino Children: School Nurse and Advanced Practice Nurse Partnerships

TOPIC:  Barriers to use of mental health services by Latino families include stigma, service costs, and disparity of services with cultural values and traditions. School nurses are in key positions to recognize mental health needs of Latino children and form relationships that facilitate family connections with mental health services. Advanced practice psychiatric nurses may be contracted by school districts to provide consultation to school nurses or may be available to school nurses through connections with school-based health centers. Case examples are provided to illustrate the value of school nurse consultation with an advanced practice psychiatric nurse in promoting awareness of cultural influences on children's symptoms and behaviors and developing culturally sensitive approaches to engage Latino children and families in school and health services.
PURPOSE:  This paper aims to review literature on Latino mental health and present rationale for school nurse and advanced practice nurse partnerships to promote culturally sensitive approaches that facilitate Latino family access and utilization of health services.
SOURCES:  Published literature and case scenarios.
CONCLUSIONS:  With advanced practice nurse consultation, school nurses identify mental health needs of Latino children and develop culturally sensitive approaches that bridge Latino families' access to and utilization of health services.     

Access to school health services: differences between full-time and part-time school nurses.

This study examined differences in student access to health services between schools with nurses 2 days/week (n = 7) compared to schools with nurses 5 days/week (n = 7). The study found statistically significant differences in numbers of nurse visits per 100 students. Of the 30 health conditions/activities investigated, 28 were statistically significantly higher with full-time school nurses than with part-time school nurses. It would be expected that 5-day/week nurses would be involved in health service activities 2.5 times as often as 2-day/week nurses. However, this study found that 21 of the 30 health service activities in schools with 5-day/week nurses were accessed by students more often than the expected 2.5 times that of the schools with nurses 2 days/week. This suggests a significant unmet need for access to health care services in schools with only 2-day/week nurses.     

School nursing services: the early years.

This is the first in a series of three articles devoted to school nursing practice past, present, and future. This article highlights development of school health programs in the late 1800s to 1950. Since its inception, school nursing service has paralleled events and developments in society. Nursing services were introduced to treat minor illnesses or injuries of children at school, to provide health education to children in school, and to provide follow-up care and teaching in the home setting in order keep the children healthy enough to attend school. As health care moved away from the home into physician-directed hospitals, nursing services in schools shifted from a focus on the public health nurse to the notion of a nurse-teacher with emphasis on health education. By exploring the practice of the early visionaries in school nursing, one realizes that today's nurses have similar challenges and opportunities in providing quality health care to the school community.     

A Health-awareness Program for Elementary School Teachers

The health-awareness program conducted by school nurses was an in-service program for elementary school teachers. Effects of the program on the teachers' referrals, school nurses' management of referrals, and pupils' absence patterns were studied. Four pairs of schools participated; one pair each for schools with predominantly white and Hispanic students and two pairs for mostly black students. The schools in each pair were matched by predominant enrollment of pupils' race or ethnicity and randomly assigned to the experimental or control group. Referrals for pupil health services form and Pupil's daily class attendance record were used as instruments. Results showed that (1) the program significantly increased referral rates, (2) in seven of the eight schools at least 50 percent of reported health problems remained unsolved by the end of the 1982–1983 school year, and (3) the program had little impact on absence patterns. Collaboration between teachers and nurses played a key role in the success of the health-awareness program.     

A World Wide Web-based health resource. Survey of Missouri school nurses to determine priority health information resources for SchoolhealthLink.

Two hundred ninety-two school nurses in Missouri participated in a mailed survey to aid in the design of SchoolhealthLink, a World Wide Web (WWW)-based information service for Missouri school nurses and children. The nurses identified specific health information resources likely to benefit school nurses and school children and prioritized these resources. The school nurses assigned high priority to 11 types of health information resources: individualized health care plans, emergency care plans, communicable disease control plans, acute illness, injuries, communicable diseases, hotline numbers, medications in schools, immunization protocols and standards, community-based health care resources, and Department of Elementary and Secondary Education regulations that affect school nurse practice. The four most common health problems school nurses identified were asthma, attention deficit disorder, diabetes, and head lice. SchoolhealthLink will provide a one-stop WWW-based resource for school nurses and school children.     

School nurse case management: achieving health and educational outcomes.

Educators and health care professionals alike understand that healthy students are likely to be successful learners. The goal of school nurse case management is to support students so that they are ready to learn. This article describes the outcomes of a 4-year process improvement project designed to show the impact of school nurse case management on attendance, behavior, academic performance, quality of life, and health compliance in a large southeastern urban school district. Recognizing a need for standardized practice, the School Health Leadership Team created a case management policy, procedures, forms, a data collection process, and ongoing education and mentoring. The policy enabled school nurses to select students with health and learning needs, target specific outcomes, implement interventions, and document the gains made. In the 4 years of this project, 84% of the students case managed improved in 1 or more of the 5 target areas.     

School nurse book clubs: an innovative strategy for lifelong learning.

Recognizing the ongoing need for continuing education for school nurses, the authors discuss the use of school nurse book clubs as an innovative lifelong-learning strategy. Current research supports the use of literature in nursing education. This article discusses the benefits of book club participation for school nurses and includes suggested fiction and nonfiction books that can be used to enhance nursing knowledge and practice. Through reading and discussion, school nurses can increase their knowledge of nursing history and current health care issues, thus becoming better prepared to address challenging issues that arise in practice. In addition, the use of literature as a learning strategy allows school nurses to broaden their understanding of unique cultural factors that influence the health beliefs and practices of students and their families. Book club participation can also assist school nurses in honing leadership and communication skills and becoming energized to become better advocates for children and families.     

The everyday realities of the multi-dimensional role of the high school community nurse.

The traditional role of the high school based community community health nurse has changed considerably over recent decades. This article describes a qualitative study, in which nine community health nurses from eight different high schools completed a diary of the interventions and events during the course of two working days in order to identify the dimensions of their role. A short demographic questionnaire was also completed by the nurses and included two open-ended questions concerning their main professional issues and concerns. The researchers sought verification of the interpretation of the data through a focus group interview with the high school nurses. Data analysis indicated that the role of the high school community health nurses (CHN) consisted of seven categories. These were provider of clinical care, counsellor/ mediator, advocacy and support, liaison/referral, health promotion/education and resource agent, and professional management and research role. The findings highlight the complex and demanding aspects of the role of the high school nurse and articulate the importance of describing the contribution of such practitioners in to the promotion of health among adolescents.     

社区老年护理人才现状及需求调查

目的：了解社区老年护理人才现状及需求,为高校培养社区老年护理人才提供依据。方法自设问卷对浙江省284家社区卫生服务中心（站）进行调查。结果72．5％认为现有社区老年护理人才数量不能满足老年护理工作需求,67．6％认为专业素质不能满足工作需求;现有老年护理人才大专学历占44．5％,中专学历占39．8％,未来2年招聘以大专学历为主,达61．2％;社区老年护理人才需要老年护理和技术等12方面知识,社区老年护理人才应具备老年常见病和用药反应护理观察能力等9项核心能力。结论目前社区老年护理人才数量和专业素质不能满足老年护理需求,需以社区老年护理知识、核心能力需求为导向,通过专业设置、构建课程体系,改革教学及实践方式等进行培养,以适应人口老龄化需求。     

Predictors of patient satisfaction with telephone nursing services

Patient satisfaction has been shown to be a factor in clinical outcomes, health care quality, and patient follow-through. Thus, a high level of satisfaction is a desired outcome of patient care. This article examines predictors of patient satisfaction with telephone nursing services among a sample of 1,939 respondents, using a conceptual model derived from the literature and preliminary work. The study was conducted in medical offices and call centers of a large national health maintenance organization. Calls were taped and content coded and then matched with caller questionnaire data. In the final multivariate predictive models, patient health status; caller ratings of expectations met by the nurse for listening, clarity, and collaboration; and nurse competence were the strongest predictors of satisfaction. Consistent with the literature, findings suggest that nurses should expand interpersonal communication skills, and systems should reduce barriers to effective listening, clarity, and collaboration with callers.     

Recruitment, retention and matriculation of ethnic minority nursing students: a University of Mississippi School of Nursing approach

According to Bednash (2000), the future of health care pivots on an adequate supply of appropriately educated and skilled professional registered nurses. Recognizing the long history of and the struggles by African-American (AA) nurses for education and equality in the nursing profession, it is essential that more African-American students be recruited, retained, and matriculated into the profession of nursing. African-American nurses have always contributed to the care of the poor and the sick and played a decisive role in the improvement of the health of their communities. The Bureau of Health Professions Division of nursing (March 2000) reported that 86.6 percent of the registered nurse population were white while 12.3 percent represented racial and ethnic minority groups. Given the current racial/ethnic background of the registered nurse population in the United States, there is an obvious disparity in the representation of minorities in the nursing profession, in spite of the increasing number of minorities represented in the general population. Thus, the purpose of this paper is to document strategies that are used to actively recruit, retain, and graduate ethnic minority students from the University of Mississippi Medical Center (UMMC) School of Nursing (SON).