School nurses' knowledge and beliefs about the management of children with ADD.

The purpose of this study was to examine school nurses' knowledge and beliefs about the management of children with attention deficit disorder (ADD). Seven hundred eighty-six school nurses responded to mailed surveys regarding their attitudes and knowledge about the management of children with attention deficit disorder. Surveys were mailed to school nurses randomly selected from the membership of the National Association of School Nurses. School nurses' knowledge of school management of ADD and their attitudes about physicians' participation as part of a team effort in this care were explored. School nurses responded that physicians should increase their efforts to educate children and parents about ADD. Recommendations for school nurses in the management of children with ADD are offered.     

Proportion of Swedish school nurses' time devoted to different health care activities

School nurses play an important role in the preventive health care of children and adolescents. This study aimed to describe and investigate the school nurses' different activities and time spent on these activities. By completion of a time study record form all 26 school nurses, in a medium-sized town in Sweden, documented their activities during 10 working-days. Altogether 635 record forms were received. It was found that almost half of the school nurses' time was used for individual pupil activities, 17% for groups of pupils and 34% for administrative activities. School nurses spent 17% of all their working time at the school clinic, which in some way may reflect the pupils' need of the nurse in the school. These results highlighted the importance of school nurses and resulted in internal structural changes of school nurses' working time.     

The experiences of school nurses caring for students receiving continuous subcutaneous insulin infusion therapy.

Diabetes mellitus is the most common metabolic disorder in childhood. Today, children with diabetes are receiving new technologically advanced treatment options, such as continuous subcutaneous insulin infusion (CSII) therapy. School nurses are the primary health caregivers of children with diabetes during school hours. Therefore, it is important to determine their perceptions, resources, and resource needs when caring for students with continuous subcutaneous insulin infusion or insulin pump therapy. This study uses a phenomenological approach to examine the experiences of school nurses caring for students receiving insulin pump therapy. Eleven school nurses were interviewed using semistructured taped interviews. The nurses' responses indicated that they were "scared" when first caring for students with continuous subcutaneous insulin infusion therapy. However, they were able to work through their fear by using their resources and gaining more knowledge and hands-on experience with insulin pumps. The data also revealed that school nurses who were able to learn the language of continuous subcutaneous insulin infusion therapy and successfully deal with pump problems developed trusting and knowing relationships with students, teachers, and parents.     

Computer mentoring for school nurses: the New York State model.

As computer use in the school health office is becoming a necessity, learning and upgrading technology skills is a high priority for school nurses across the country. The New York State Association of School Nurses and the Statewide Advocacy for School Health Services conducted a needs assessment to determine school nurses' perceptions of information technology skill level and the use of technology in the school health office. From these data, they have collaboratively developed a computer-mentoring program to be used throughout New York State. This program pairs standardized computer training with the assignment of peer mentors to support novice computer users during the adoption of technology into New York's school health services.     

Prevention of further weight gain in overweight school children, a pilot study

Background:  Involving school nurses in weight gain prevention activities in already overweight children may be a means to address childhood obesity prevention.
Objective:  To describe and evaluate a treatment method aimed for implementation in school care centres.
Methods:  Twenty families (20 overweight children aged 7 years) were interviewed at baseline with standardized questionnaires, received simple dietary and lifestyle advice. Weight was measured and advice/support by school nurses was available monthly during the 1-year period. A follow-up was made after 1 year. Changes in wellbeing, life style and body mass index (BMI) z -score were recorded and analysed. Experiences from parents and nurses were also examined.
Results:  A good (91%) or fair (54%) adherence to dietary advice was found in children who decreased or maintained their z -score respectively. Mean BMI z -score reduced [−0.16 (p = 0.03)] during the intervention period. Generally, parents and school nurses were satisfied with the programme, helping them to set limits and be more self-confident in their role as 'health adviser' respectively.
Conclusions:  Overweight progression in younger children is possible to modify by increased awareness of the problem, of their food habits and lifestyle practices. Providing school nurses with the knowledge to address the problem and working in collaboration with dieticians and a healthcare team can be an effective means to prevent further weight gain in overweight school-age children. Possibility of stigmatization was expressed thus efforts will need to be made to carry out such a programme to preserve the children's integrity and run activities in a discrete manner in the school environment.     

The nursing outcomes classification: its relevance to school nursing.

Two surveys were conducted to determine school nurses' perceptions of the relevance of 190 outcomes developed by the Nursing Outcomes Classification (NOC) research team to school nursing practice. First, a national random survey of members of the National Association of School Nurses was conducted. Participants were asked to identify the percentage of children and families for whom school nurses affect health outcomes. Usable responses were returned from 227 school nurses (22% response rate). Ninety outcomes were perceived as relevant for 30% or more of children and families; 8 outcomes were perceived as relevant for 50% or more of children and families. A second survey--targeting state representatives attending a school nursing leadership meeting--was conducted using a revised version of the instrument. The legend was changed to degree of relevance to school nursing practice, with a response scale of 0 to 10. Usable responses were returned from 31 state representatives (41% response rate). The means of 172 of 190 outcomes were above 5 (median point on the 10-point scale of relevance). The findings of both surveys indicate that a large number of NOC outcomes are useful for documentation of the effectiveness of nursing interventions in school settings.     

Perceptions of school nurses regarding obesity in school-age children.

Obesity is epidemic in the nation's school-age population with African American and Hispanic children and adolescents specifically at risk. School nurses at elementary and middle public schools in the Missouri 8th Congressional District were surveyed regarding their perceptions of childhood obesity. School nurses supported preventive interventions and were knowledgeable of the risks of childhood obesity but were less accepting of treatment and counseling for obese children in the school setting. One third of the school nurses did not recommend treatment for weight loss, and half of the nurses provided overweight children with counseling and referral only when parents asked for help. Perceptions of school nurses regarding childhood obesity identified in this study included the following: (a) counseling for obesity is difficult, (b) parental support is lacking, and (c) competence in providing counseling is low. These perceptions are barriers to school nurses taking a more active role in the prevention and treatment of childhood obesity.     

School nurses' experiences, concerns, and knowledge of growth disorders in children: development of a monograph.

Growth disorders may be associated with difficult psychosocial adjustment, learning problems, and specific health risks. Appropriate school health programming relies on school nurses who are skilled in growth assessment, management of psychosocial and behavioral problems, and effective communication with school personnel, children, families, and health care resources. A monograph and model individualized healthcare plans were developed for growth disorders in school-age children as an educational resource for school nurses. Knowledge of growth disorders among nurses receiving the monograph was evaluated in a random sample of 336 school nurses, members of the National Association of School Nurses. Knowledge of growth assessment and individualized health care plans for children with specific growth disorders was significantly higher in the group of school nurses who received the monograph. Specific obstacles to implementing school-based health care for children with growth disorders are discussed.     

School nurses' perceptions of family-centered services: commitment and challenges.

Family-centered service is a service delivery model that recognizes the central role of families, builds on their strengths, and seeks to fully involve them in all aspects of their child's health, learning, and development. Family-centered service has been associated with positive outcomes in health and education and has been viewed as best practice. This study examined school nurses' perceptions of their work practices with families and the implementation of family-centered services in the school health setting. An established instrument, the Measure of Processes of Care for Service Providers, was used to survey a convenience sample of school nurses practicing in California. Quantitative and qualitative results indicated that school nurses value family-centered service and use the core elements regularly in their work with families. Qualitative data further illustrated school nurses' solid commitment to families even in the face of challenges such as high student-nurse ratios, lack of time, and limited support. Suggestions for overcoming these barriers include development of parent centers, employment of school social workers/case managers, and advocating for changes in legislation to support the hiring of more school nurses.     

Development of a nursing data set for school nursing.

School nurses need to clearly identify how they promote the health and educational achievement of children. School nurses contribute to student health by providing health assessment and nursing interventions, advocating for healthy living, and contributing to prevention of illness and disease management. A Nursing Data Set for School Nursing can identify those data elements that are needed to prove that school nurses have a positive effect on children, families, and the community. The purpose of this project was to develop a Nursing Data Set for School Nursing that would describe and validate school nursing practice. Building on the Nursing Minimum Data Set developed by Werley, Devine, and Zorn, a Nursing Data Set for School Nursing was developed with guidance from experts in the field of school nursing. A Nursing Data Set for School Nursing has the potential to assist school nurses in documentation and validation of their nursing practice. It can validate the complexity of the role of the school nurse, the resources needed, and the effect school nurses have on improving the health and educational outcomes of students.     

Health Promotion in Child and Family Health Care: The Role of Finnish Public Health Nurses

Abstract Starting from a theoretical model for the work of public health nurses, we explored the knowledge, skills, and decision making of Finnish public health nurses in the context of their efforts to maintain and promote child and family welfare. The results indicate that the nurses' knowledge basis and skills cover the concepts included in the theoretical model. The nurses tackle existing situations in the lives of children and their family, attempt to solve the current problems, and together with parents, make collaborative decisions. No attempts are made to produce long-term health care plans. The model seemed to work fairly well in promoting children's welfare, but less so in the case of families. Finnish public health nurses follow the official guidelines governing the work of child welfare clinics, but they set fewer individual goals for children and families.     

School nursing today: a search for new cheese.

The practice of school nursing must change with the times. School nurses must develop new leadership and collaborative skills to work within the interdisciplinary school and community teams that will be required to put changes in place. This article defines current trends and their implications for the search for the most efficient and appropriate school health services. It explores preparation and competencies for school nurses, legal and ethical concerns, and financing needed to provide adequate school health services. Many support systems exist today, and new ones are being developed to expand the range of health services provided in schools. The National Association of School Nurses encourages strategic planning for the new school health environment, and the Office of School Health at the University of Colorado provides extensive resources to help school nurses develop and put their plans in place.     

Asthma management efficacy of school nurses in Taiwan

As the key health care providers in school settings, the school nurses' asthma management efficacy is crucial to children's health and their continued participation in school learning activities. This article describes the psychometric testing of the asthma management efficacy scale (AMES) for use with school nurses. A cross-sectional survey design was used to assess the asthma management efficacy of 60 school nurses in Taipei, Taiwan. Factor analysis resulted in four factor domains including asthma medication administration, asthma pattern identification, school management behaviour, and monitoring peak expiratory flow rate which explained 76.4% of the variance in school nurses' asthma management efficacy. The school nurses' experience in performing school asthma management activities was positively correlated to their asthma management efficacy (r=0.33, p<0.05). School nurses who had experience with the inhaled asthma medicines had significantly higher efficacy scores on the medication administration subscale (t=-2.89, p<0.01) than did the school nurses who lacked this experience. School nurses who had experience in using peak expiratory flow meters had significantly higher efficacy scores on the total AMES (t=-1.90, p<0.05) and on the monitoring peak expiratory flow rate subscale (t=-5.37, p<0.001) than the school nurses who lacked this experience. Given the need to have nurses who are well prepared to provide asthma care in school settings, implications for nursing education, practice, and further research are discussed.     

Power up your presentation with PowerPoint.

School nurses have the experience, insight, and passion to speak in pubic forums on issues regarding the health and education of children. They are seeking opportunities to inform district decision makers and the general public about student needs and about the importance of having adequate resources to meet these needs. Nurses may be called upon to speak both formally and informally to parent and community groups, the school board, and to their peers. To be credible and to communicate their messages effectively, nurses must hone their presentation and speaking skills, which may include the use of up-to-date technology.     

School nurses' perceptions of empowerment and autonomy.

The purpose of this study was to explore Kanter's Theory of Structural Power in Organizations, using school nurses and to answer the research question of whether there is a relationship between empowerment and autonomy in school nurses. This study found a positive relationship between the nurses' perceptions of empowerment and autonomy. The school nurses surveyed perceived themselves to have a high degree of autonomy and a moderate degree of empowerment, and they reported that their access to informal power structures was higher than their access to formal power structures in their school systems. School nurses can benefit by understanding factors that can increase their empowerment in the workplace. They need to understand the organizational structure of their workplace to increase their effectiveness and job satisfaction.     

Adolescents' attitudes about obesity and what they want in obesity prevention programs.

Obesity is a major pediatric public health problem. Adolescents are a priority population for intervention strategies. School nurses are in key positions to design intervention strategies to promote healthy lifestyles and prevent adolescent obesity in the students they serve. To design effective programs, school nurses need to know what components their students perceive as important. This study involved the development and administration of a questionnaire to middle school students to determine their attitudes about overweight/obesity and what they felt would work for them. Adolescents are willing to exercise more, to change eating habits to include more fruits and vegetables, drink more water, and eat less junk food. They are not willing to give up soda, video/computer games, and watching television to improve their health. School nurses can use this questionnaire to collect data that will assist in the development of effective programs for their students.