bluuebunny/crossref_metadata_2025 huggingface dataset:
Recommended Minimal Emergency Equipment and Resources for Schools: National Consensus Group Report
Authors: Bobo Nichole , Hallenbeck Paula , Robinson Judith
Published: July 2008

Providing an environment that is responsive to emergency health needs of students is essential to creating a safe setting for children in schools. The question of what minimal essential emergency equipment and resources should be available in schools brings with it many and varied opinions, issues, and concerns. Through funding from the Emergency Medical Services for Children (EMSC), the National Association of School Nurses (NASN) was charged with the task of convening a consensus group to formulate a recommended list of minimal essential emergency equipment and resources that should be present in all schools. This article provides an overview of the issues surrounding minimal emergency equipment needs for schools, presents recommended minimal emergency equipment and resources, and recommendations for further actions.
The Impact of School Nursing on School Performance: A Research Synthesis
Authors: Maughan Erin
Published: July 2008

School nurses work in an educational setting. Due to budget cuts, different goals, and confusion between educators and nurses regarding the school nurse role, school nurses are being asked to demonstrate their effectiveness and justify their presence in elementary and secondary schools. Although school nursing was first initiated 100 years ago, a review of the literature published since 1965 indicates that 15 studies have been conducted that examine the impact of school nurses on academic performance. However, today many articles have recommended more research linking school nursing to educational outcomes. This article synthesizes the results of 15 research articles. Findings from these studies indicate that nursing interventions targeted at specific populations, including parents, have had significant effects. A relationship between school nurses’ interventions and absenteeism is also suggested. Limitations of these studies are discussed, along with suggestions for future research.
Measures of Overweight Status in School-Age Children
Authors: Skybo Theresa , Ryan-Wenger Nancy
Published: July 2008

Identifying and intervening with overweight children may decrease their likelihood of developing heart disease later in life. This secondary analysis of 58 children in the 3rd grade examined the prevalence of overweight children, methods for measuring overweight status, and the relationship among these measures and other risk factors for heart disease. Approximately one third of the 58 children were categorized as overweight. Several measures, such as weight, body fat percentage, body mass index (BMI), and skin-fold, are available to school nurses for measuring overweight status. The highest correlations were between BMI and weight and between BMI and body fat. Anthropometric measurements cannot predict cholesterol level, 24-hour diet recall, or family history. Blood pressure can be predicted by weight, body fat percentage, and BMI. BMI and body fat percentage highly correlate; however, body fat percentage is more liberal in identifying children at risk for overweight status. Therefore, body fat percentage is recommended for identification of overweight status in school-age children.
Type 2 Diabetes Mellitus in Youth
Authors: Quarry-Horn Jill L. , Evans Barbara J. , Kerrigan James R.
Published: July 2008

In the United States, the incidence of type 2 diabetes mellitus (DM) in children and adolescents has been increasing at an alarming rate. Early recognition and intervention can delay the onset of type 2 DM and prevent the long-term complications. School nurses have an essential role in implementing the American Diabetes Association (ADA) recommended screening guidelines to identify youth at high risk for type 2 DM and in implementing student health programs that focus positively on the importance of physical activity and healthy eating habits. The purpose of this article is to present an overview of the epidemiology, pathophysiology, complications, diagnosis, and treatment, as well as the recommended screening guidelines for type 2 DM in the pediatric age group. The information provided will enhance awareness, promote screening, and empower the school nurse to more effectively promote healthy lifestyle education.
The Impact of Elementary School Nurses on Student Attendance
Authors: Allen Gay
Published: July 2008

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.
The Prevalence of Sexual Abuse Among Adolescents in School
Authors: Saewyc Elizabeth M. , Pettingell Sandra , Magee Lara L.
Published: July 2008

Sexual abuse is a profound stressor that complicates the development and health of adolescents, yet its prevalence has been difficult to estimate among adolescents in school populations. This study explored the prevalence of both incest and nonfamily abuse in 2 cohorts of adolescents in Minnesota in the 1990s (1992: N = 77,374; 1998: N = 81,247). Findings indicate that sexual abuse was reported by both boys and girls and among students of all ethnic groups. Approximately 10% of adolescents reported sexual abuse in each cohort, with girls 5 times more likely to report abuse than boys. Ethnic variation was minor, with African American, Native American, and Hispanic teens slightly more likely to report abuse than White or Asian American youth. School nurses should routinely assess for a history of sexual abuse in adolescents and should be prepared to provide support and referral for abused students and their families.). Findings indicate that sexual abuse was reported by both boys and girls and among students of all ethnic groups. Approximately 10% of adolescents reported sexual abuse in each cohort, with girls 5 times more likely to report abuse than boys. Ethnic variation was minor, with African American, Native American, and Hispanic teens slightly more likely to report abuse than White or Asian American youth. School nurses should routinely assess for a history of sexual abuse in adolescents and should be prepared to provide support and referral for abused students and their families.
Teen Parents and Academic Success
Authors: Perrin Karen M. , Dorman Karen A.
Published: July 2008

The purpose of this study was to explore the personal life stories of women who became mothers while still in their teen years. The focus was on themes that evolved as important in the lives of these women, including family support, partner support, mentor support, economic opportunity, resiliency, optimism, and spirituality. Each of the 22 women in the study offered her formulas for success that are useful for consideration by school nurses. Factors the women perceived to contribute to their success in achieving a master’s or doctoral degree are explored. This study helps to identify the support and community efforts necessary to improve the outcome for teen mothers today. Their unique stories are exemplars of resiliency and achievement.
Lung Cancer Awareness Week
Authors: Cooper Leslie , Glennon Catherine , Laczko Lori
Published: July 2008

Smoking is the most preventable cause of death in our society. Tobacco use is responsible for nearly one in five deaths in the United States and the cause of premature death of approximately 2 million individuals in developed countries. Smoking accounts for at least 30% of all cancer deaths and is a major cause of heart disease, cerebrovascular disease, chronic bronchitis, and emphysema. The North Carolina Triangle Oncology Nursing Society applied for a competitive grant through the national Oncology Nursing Society and Cancer Care, Inc., in partnership with the Wellness Community and Bristol-Myers Squibb. The grant could be used for any lung cancer issue or project. Because North Carolina is deep in the tobacco belt, it was decided to focus on the largest group of new smokers in the United States, children and teens, for the project. Over 80% of adult smokers surveyed in 1991 had begun smoking by the age of 18. The oncology nurses wanted to focus on prevention, not cessation. Therefore, grade school children were the population selected for this project. This age group is impressionable and able to understand the negative consequences of smoking. This article outlines the content of the educational intervention and evaluation of the program.
Using Peer Health Education to Enhance Family Life Education
Authors: Puentes William J. , Wassel Melanie
Published: July 2008

This article describes an intervention known as the Peer Family Life Education Project that was designed as an alternate delivery method of an established family life education curriculum in an urban middle school setting. The factors contributing to sexual risk behaviors by urban adolescent populations are identified. A review of previous efforts at peer health education is presented. Program development and implementation is described. The strengths and weaknesses of the program are discussed, and suggestions for improving future efforts at the incorporation of peer health education to reduce sexual risk behaviors by adolescent urban populations are presented.
Ethical Problems Experienced by School Nurses
Authors: Solum Linda L. , Schaffer Marjorie A.
Published: July 2008

This study explored school nurses’ experience of ethical conflict in school nursing through interviews with six school nurses. The study examined how school nurses resolved ethical problems and the rationale used to resolve them. Emergent themes of ethical problems were professional relationship conflicts, delegation to and supervision of health assistants, child protection reporting, maintaining confidentiality, Do Not Resuscitate policy, and pressure to work outside of nursing practice standards. School nurses did not use ethical decision-making models in resolving conflict but demonstrated the use of professional standards, ethical principles, and personal values as rationale to resolve ethical problems. Results of this study suggested that school nurses would benefit from additional knowledge about ethical decision-making models. School nurses would also profit from hearing each other’s voices through dialogue about ethical problems and decision making.
Combining Health Promotion Classroom Lessons With Health Fair Activities
Authors: Cooper Leslie , Eliason Kathy , True Alexandra
Published: July 2008

This article focuses on the important role of the school nurse in promoting healthy lifestyle choices through networking, resource identification, and working with community partners. “Everyone Is Healthy at Northeast” was a health promotion program designed and presented in two ways: classroom lessons and a health fair. There were interactive health promotion classroom lessons on topics such as proper hand washing, the effects of tobacco, and keeping one’s heart healthy. These lessons were enhanced by community partners in delivering the healthy lifestyle message through a variety of teaching methods: music, interactive games, and hands-on visuals. The health promotion education program culminated in a schoolwide health fair that showcased the healthy lifestyle choice information at various stations. “Everyone Is Healthy at Northeast” was a success and promoted healthy lifestyle choices through creativity, collaboration, and support from the entire school community.
War, Terrorism, and Children
Authors: DeRanieri Joseph T. , Clements Paul T. , Clark Kathleen , Kuhn Douglas Wolcik , Manno Martin S.
Published: July 2008

Many caregivers are encountering the issue of communicating with children and adolescents about current world events, specifically war and terrorism. As health care providers, it is important to raise awareness of how children may understand, interpret, and respond to related fears and concerns. Although honesty and reassurance are clearly the best approach, it is important to provide information that is developmentally appropriate. Providing education and guidance can reduce stress and enhance understanding of the chaotic events confronting our nation. It also provides a platform for communication and exploration should additional terrorist attacks or acts of war occur. It is important to examine how to approach children and adolescents to communicate with them about these sensitive issues.
Severe Acute Respiratory Syndrome (SARS) Prevention in Taiwan
Authors: Liu Hsueh-Erh
Published: July 2008

Severe Acute Respiratory Syndrome (SARS) is a newly identified respiratory disease that threatened Taiwan between April 14 and July 5, 2003. Chang Gung University experienced various SARS-related episodes, such as the postponement of classes for 7 days, the reporting of probable SARS cases, and the isolation of students under Level A and B quarantines. Ninety-eight percent of the students at the university live in dormitories; thus the prevention of SARS became an important issue. Preventive strategies are classified into primary, secondary, and tertiary prevention, with a different focus and strategy for each level of prevention. The university emphasized personal hygiene and a healthy lifestyle as the key to SARS prevention. Our experiences as school nurses during this crisis can help other school nurses to prevent the spread of SARS during similar situations.
A STUDY OF SCHOOL NURSE JOB SATISFACTION
Authors: Junious DeMonica L. , Johnson Regina Jones , Peters Ronald J. , Markham Christine M. , Kelder Steven H. , Yacoubian George S.
Published: July 2008

This study explored job satisfaction and changes needed to help boost levels of job satisfaction. Self-reported job satisfaction data were collected from 71 school nurses employed in elementary, middle, and high school settings via interactive focus groups. The subjects participated in a 30- to 45-minute focus group session that was audiotaped and transcribed by the principal investigator. Beliefs about job satisfaction were identified and classified into exclusive categories or themes. While the majority of school nurses expressed contentment with their jobs, certain factors that would increase job satisfaction, such as salary and control issues, were discussed. Overall, 83% of school nurses in this study were satisfied in their present positions; however, issues of coping and role strain were identified as major contributors to low morale. Only 17% of the school nurses voiced job dissatisfaction, primarily attributed to low salaries and lack of trust and support from administration. As school nurses face a diverse community with complex needs, adaptation is needed for job satisfaction to be maintained. For this to occur, school nurses must take the initiative to educate administrators, parents, and communities about their role in the school setting.
HIPAA-FERPA REVISITED
Authors: Bergren Martha Dewey
Published: July 2008

Since April 2003, school nurse and school health officials have been clamoring for guidance on how the Health Insurance Portability and Accountability Act (HIPAA) and the Family Education Rights Privacy Act (FERPA) interface in the school environment. This article provides an up-to-date explanation of how school health leaders are interpreting the practical implications of the federal privacy laws. With the attention and scrutiny given to personally identifiable health information in all settings, it is imperative for school nurses, school administrators, and school attorneys to revisit policies and procedures for protecting the privacy of student and family health information in schools.
Bibliotherapy: A Strategy to Help Students With Bullying
Authors: Gregory Katherine E. , Vessey Judith A.
Published: July 2008

Use of bibliotherapy to address childhood teasing and bullying is an innovative approach school nurses should consider as they work to promote a healthy school environment. Children’s books serve as a unique conduit of exchange between parents, teachers, and children. Bibliotherapy, using books to help people solve problems, involves three stages: identification, catharsis, and insight. These stages lend themselves well to coping with the sensitivities related to teasing and bullying. Salient research findings pertinent to teasing and bullying have made their way into the children’s literature and have been well received by children and their families over the course of the Child Adolescent Teasing in Schools (CATS) book review project and web site development. After exposure to a fictional story about teasing and bullying, children have shared their own nonfictional account of this often devastating experience and have come to develop successful coping strategies for dealing with the teasing and bullying that takes place in schools nationwide.
School Nurse Summer Institute: A Model for Professional Development
Authors: Neighbors Marianne , Barta Kathleen
Published: July 2008

The components of a professional development model designed to empower school nurses to become leaders in school health services is described. The model was implemented during a 3-day professional development institute that included clinical and leadership components, especially coalition building, with two follow-up sessions in the fall and spring. Coalition building is an important tool to enhance the influence of the school nurse in improving the health of individuals, families, and communities. School nurses and nursing educators with expertise in the specialty of school nursing could replicate this model in their own regions.
Using Expanded Individualized Health Care Plans to Assist Teachers of Students With Complex Health Care Needs
Authors: Heller Kathryn Wolff , Tumlin Jennifer
Published: July 2008

As special education teachers have increasing numbers of students requiring health care procedures in their classrooms, school nurses need to help these teachers maintain a safe, healthy environment for their students. Part of this consists of having teachers know the steps to take should certain problems arise. This article examines the receptivity of using an expanded version of an individualized health care plan (IHP) to provide critical information to address health care problems, as well as having individualized education program (IEP) objectives for instructional targets identified in the IHP. The findings of this study indicate that a high percentage of school nurses and special education teachers were in favor of an expanded version of the IHP. There was also support for teaching students to independently or partially participate in performing their own health care procedures and having this instruction formalized as IEP objectives.
Adolescent Smoking Cessation: Development of a School Nurse Intervention
Authors: Hamilton Greg , O’Connell Meghan , Cross Donna
Published: July 2008

The purpose of this study was to examine the feasibility of a range of strategies to engage and to enhance secondary school nurse involvement in teenage smoking prevention and cessation. School nurses were willing to assist students to quit smoking, but they felt unprepared. Information provided by nurses involved in a three-stage review, pilot-testing, and trial design resulted in the development of a resource for nurses. This resource comprised individual student approaches (brief intervention based on motivational interviewing and written activities designed to help students examine their smoking behavior), approaches to assist parents (letter of support for parents of students who smoke), and school newsletter items. Each component of the resource was found by school nurses to be appropriate, useful, and complementary to their other school-wide approaches to assist adolescents to quit smoking. Nurses also reported an interest to expand or to enhance their smoking cessation role in the school.
Access to School Health Services: Differences Between Full-Time and Part-Time School Nurses
Authors: Telljohann Susan K. , Price James H. , Dake Joseph A. , Durgin Joan
Published: July 2008

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.
Increasing Immunization Compliance
Authors: Toole Kimberly , Perry Cynthia S.
Published: July 2008

School nurses often have the responsibility to ensure that students meet all immunization requirements for school entry and school attendance. In large inner-city school districts, many obstacles exist which make this task daunting and often result in lengthy absences and exclusions for students. It is critical that school nurses find creative and systematic ways to meet these challenges, which include working parents, lack of access to primary care, lack of transportation, cost of immunizations, poor compliance and follow-up, myths regarding immunizations, and the impact of the Health Insurance Portability and Accountability Act (HIPAA) legislation. This article describes an immunization project that removed most of those barriers for high-risk students and gave the school nurses tools to succeed in achieving higher levels of immunization compliance in inner-city schools. Since the immunization project’s conception, compliance in the district has risen from an overall level of 50–60% to 90–100%, along with better record-keeping and the prevention of exclusions.
Teens’ Knowledge of Risk Factors for Sports Injuries
Authors: Ward Cynthia W.
Published: July 2008

Youth participation in sports has increased greatly over the past 20 years. Consequently, there has been a rise in the number of sports injuries. A study was conducted to determine teen’s level of physical activity, knowledge about risk factors for sports injuries, use of protective equipment, and parental involvement. Two groups of teens, one of which was required to take a physical education class, were given a self-administered, written survey. The study found that the teens in this small Virginia town have a high level of involvement in sports and other physical activity and good general knowledge of sports injury prevention. Improvement is needed in the use of protective equipment when participating in informal sports activities and in the provision of sports injury prevention education to parents. As advocates for student health, school nurses are in a unique position to educate students, parents, staff, and the community about prevention of sports-related injuries.
Data Integrity: Beware of Viruses
Authors: Bergren Martha Dewey , Bergren Martha Dewey
Published: July 2008

School nurses and health office employees are the creators and caretakers of legal documentation. School nurses have an ethical and legal obligation to protect the integrity of electronic student health records. Although there are many threats to data integrity, from inadequate hardware to electrical surges, one of the most pervasive threats to data is computer viruses. There are many precautions that can be taken to protect electronic student health data from viruses in the school health office.
Records—The Achilles’ Heel of School Nursing: Answers to Bothersome Questions
Authors: Pohlman Katherine , Schwab Nadine , Schwab Nadine C. , Pohlman Katherine J.
Published: July 2008

This article addresses practice issues related to school health records and school nursing documentation. Because the issues have been posed by practicing school nurses, the article is in Question and Answer (Q&A) format. Specifically, the questions addressed concern the following: ownership and storage location of student health records when the school nurse is contracted from a community health agency rather than employed by the school district; documentation of sensitive health information on students’ health records including pregnancy, drug and alcohol abuse, mental illness, history of suicide attempt, and HIV status; inclusion of medical diagnoses and current medications on a student’s Individual Educational Program (IEP); and Health Insurance Portability and Accountability Act (HIPAA)-permitted communications between school nurses and health care providers related to students’ immunization status, regarding a student’s treatment needs in school, and via facsimile (e.g., records of immunizations, completed physical examination forms, and medical orders). HIPAA, the Family Educational Records and Privacy Act (FERPA), and other laws are addressed as appropriate, and resources for obtaining further information are included.
Impact of Food Allergies on School Nursing Practice
Authors: Weiss Christopher , Muñoz-Furlong Anne , Furlong Terence J. , Arbit Julie
Published: July 2008

Food allergies affect 11 million Americans, including 6–8% of children. The rate of peanut allergies in children doubled from 1997 to 2002. There is no cure; therefore, strict avoidance of the allergen is the only way to avoid a reaction. Fatalities are associated with delays in or lack of epinephrine administration. Severe reactions, called anaphylaxis, have occurred in schools. In a nationwide telephone survey of 400 elementary school nurses, 44% reported an increase in children with food allergies in their schools over the last 5 years; more than one third had 10 or more students with food allergies; 78% did staff training as a preventive strategy, with 74% developing their own training guidelines; and 90% stated students’ epinephrine was stored in the nurse's office. Standardized training in food allergies as well as timely access to epinephrine is needed to respond appropriately to an anaphylactic reaction in the school setting.
Spyware
Authors: Bergren Martha Dewey
Published: July 2008

School nurses access an enormous amount of information through the Internet. Although most avid computer users are savvy to the threat of viruses to the integrity of data, many who surf the Web do not know that their data and the functioning of their computer is at risk to another hidden threat—spyware. This article will describe spyware, why it is a problem, how it is transmitted to a personal or business computer, how to prevent spyware infestation, and how to delete it.
The Significance of Herpes Simplex for School Nurses
Authors: Ensor Deirdre
Published: July 2008

Herpes simplex is a common recurrent viral infection caused by the herpes simplex virus. The two closely related but distinct viruses that cause herpes simplex infections are herpes simplex 1 (HSV-1) and herpes simplex 2 (HSV-2). HSV-1 is commonly associated with infections around the oral mucosa and is the cause of herpes labialis, often referred to as a fever blister or cold sore. HSV-2 infections are usually acquired sexually. Genital herpes is a sexually transmitted disease with the highest prevalence among adolescents and young adults. Knowledge of viral activity, disease management, and community resources will assist the school nurse in developing and implementing strategies to prevent and manage this chronic disease.
The School Nurse Role in Asthma Management: Can the Action Plan Help?
Authors: Borgmeyer Anne , Jamerson Patricia , Gyr Patricia , Westhus Nina , Glynn Emily
Published: July 2008

Asthma is the most common chronic disorder in American schoolchildren, and school nurses play a valuable role in its management. A study was conducted in which school nurses were asked to describe their role in caring for students with asthma and their use of Asthma Action Plans (AAPs). The nurses indicated that they frequently provided direct care and education. They were comfortable with providing care to students with asthma and familiar with AAPs. Having an AAP increased their confidence in managing students with asthma. This emphasizes the need for continued education regarding the AAP and the development of policies that direct care and encourage use of an AAP at school.
Coping and Social Support for Parents of Children with Autism
Authors: Luther Edith H. , Canham Daryl L. , Cureton Virginia Young
Published: July 2008

Autism in children has increased significantly in the past 15 years. The challenges and stressors associated with providing services and caring for a child with autism affect families, educators, and health professionals. This descriptive study used a survey to collect data on parents’ perceptions of coping strategies and social support. Instruments included the Social Support Index and the Family Crisis Oriented Personal Evaluation Scales. One half of the families identified serious stressors in addition to autism. Acquiring social support and reframing were the most frequently used coping strategies. The school nurse is in a position to identify needs and refer families to local support groups and agencies, facilitating social support and development of coping strategies.
Data Integrity: Backup
Authors: Ann Murphy Elizabeth , Bergren Martha Dewey
Published: July 2008

School nurses and health office staff have an ethical and legal obligation to protect the integrity of electronic student health records. Various sources, both accidental and malicious, can threaten student health data. School nurses must employ regular and reliable methods to back up student health data.
Perceptions of School Nurses Regarding Obesity in School-Age Children
Authors: Moyers Pamela , Bugle Linda , Jackson Elaine
Published: July 2008

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.
Better Bones Buddies: An Osteoporosis Prevention Program
Authors: Schrader Susan L. , Blue Rebecca , Horner Arlene
Published: July 2008

Although osteoporosis typically surfaces in later life, peak bone mass attained before age 20 is a key factor in its prevention. However, most American children’s diets lack sufficient calcium during the critical growth periods of preadolescence and adolescence to achieve peak bone mass. Better Bones (BB) Buddies is an educational program targeting children ages 9–15 years in an effort to improve their knowledge of bone health and to increase their intake of calcium-rich foods, thereby reducing the risk for osteoporosis later in life. In the 1998–1999 school year, Better Bones Buddies was given to more than 2,200 school children in southeastern South Dakota and southwestern Minnesota. Posttest results ( N = 900) indicate participants improved in their knowledge of osteoporosis, and half reported modifications in their dietary habits to increase calcium consumption. Implications of the Better Bones Buddies program are discussed, with recommendations for future use of this program to increase children’s knowledge about bone growth and osteoporosis.
Girls’ Experiences in Physical Education: Competition, Evaluation, & Degradation
Authors: van Daalen Cheryl
Published: July 2008

School nurses are often asked to participate in the health component of many physical education (PE) programs in schools. With this opportunity comes an ability to invite a model of physical education that enables physical, mental, and relational health. A pilot study was initiated to explore why girls’ enrollment in physical education was dwindling once the compulsory credits were achieved. What emerged was the reality that for many girls, physical education was a source of constant shaming regarding their athletic ability and eventually themselves. Forced competition, degrading evaluation, and sexuality- and size-related harassment by both peers and teachers led the participants in this study to opt out of any further physical education classes. Within school-based physical education exists an opportunity to promote the health of adolescent women. School nurses, in partnership with physical education teachers and girls, can construct a model of physical education that is neither based on competition nor athletic ability, but rather on building a positive self-esteem and a positive relationship with one’s body. This model would be rooted in participation, fun, and female friendship.
Lessons Learned: One Experience With Focus Groups in a School Setting
Authors: Patterson Barbara J. , Kelly Lynn E.
Published: July 2008

Focus group research is an effective way for school nurses to gain knowledge about a diverse range of issues that children in schools may face. It is a means to gather information about perceptions, feelings, points of view, and manners of thinking from a group of individuals about a specific topic. This article overviews focus groups as a research methodology and describes an experience of using them to gain information about low-income caretakers’ knowledge of childhood nutrition. Several important lessons were learned from this study. These included the need to be flexible during the research process, to be creative in recruitment strategies, to maintain open communication with all the involved parties, and to share enthusiasm for the study. Learning more about children and their families can assist school nurses in planning and implementing interventions that enhance health and school achievement.
Understanding and Managing Neurally Mediated Syncope in the Adolescent
Authors: Rollinson Nancy L.
Published: July 2008

Syncope and near-syncopal symptoms are common events in the adolescent population. Syncope is defined as the transient loss of postural tone and consciousness with spontaneous recovery. Although most syncopal events are benign, they can generate extreme anxiety in the adolescent and his or her family. The reoccurrence of these events can have a negative impact on an adolescent’s participation in daily activities. Understanding the process of assessment, diagnosis, and management of these teens can enable the school nurse to augment initial assessment and to support the prescribed treatment plan. This knowledge then can be used to help allay the adolescent’s anxiety and to support efforts at self-management. This article explores current literature in regards to etiology, diagnosis, and medical treatment, and advocates a self-management protocol for neurally mediated syncope in the adolescent population with support of that plan by the school nurse.
The New Mexico School Nurse and Emergency Medical Services Emergency Preparedness Course: Program Description and Evaluation
Authors: Elgie Robert , Sapien Robert E. , Fullerton-Gleason Lynne
Published: July 2008

Illness and injuries are common among students and school staff. Therefore, school nurses must be prepared. In this study, a 16-hour scenario-based emergency preparedness course for school nurses was evaluated for its effectiveness. Effectiveness was measured by (a) traditional methods (written exams and confidence surveys) and (b) skills and performance evaluations in simulated emergencies called On-site Mock Emergency Scenarios. School nurses who completed the emergency preparedness course showed significant improvement in knowledge, confidence, and On-site Mock Emergency Scenarios scores that measured each nurse’s ability to apply knowledge in simulated emergencies.
Rampant Caries
Authors: Guzmán-Armstrong Sandra
Published: July 2008

Although dental caries in the pediatric and adolescent population has consistently declined in the United States, it is still the most common childhood disease. Dental problems are the number one reason for missing school next to the common cold. Dental caries are an infectious, communicable disease resulting in destruction of tooth structure by acid-forming bacteria found in dental plaque, an intraoral biofilm, in the presence of sugar. The etiology of rampant disease is very complex. It is multifactorial and has a close relationship to a number of risk factors. It is important that school nurses identify patients at risk for dental caries early to determine their risk and refer them for disease prevention and control.
Assessing the Capability of School-Age Children With Asthma to Safely Self-Carry an Inhaler
Authors: Flower Jane , Saewyc Elizabeth M.
Published: July 2008

The purpose of this descriptive study was to pilot test an Asthma Assessment Interview (AAI) and to determine the approximate age a child with asthma is capable to self-carry an inhaler. A random sample of 34 students with asthma (Grades K through 10) from a midwestern school district were interviewed by the school nurse using the AAI, which assesses knowledge of asthma, symptoms, coping strategies, medication administration skills, triggers, and judgment about when to use an inhaler including the ability to tell time. Only 38% passed the AAI. No students ages 5 to 7 passed, fewer than 50% of students ages 8 to 10 passed, and half or more of students age 11 or older passed the AAI. Results suggest a school nurse should supervise elementary students when using an inhaler; most should not self-carry. The AAI can be a useful part of the school nurse’s assessment.
Oral Health Screening Using a Caries Detection Device
Authors: Tetuan Theresa M. , McGlasson Dawn , Meyer Ileen
Published: July 2008

Children from low-income families are more likely to have dental disease and less likely to have regular dental care. Children’s dental-related illnesses are responsible for more than 880,000 lost school days each year. The lack of reliable state-level data often makes monitoring the oral health of children a challenge. By conducting oral health screenings, school nurses could promote prevention and early identification of dental problems and could aid in the collection of data. This innovative project used a convenience sample of students to test a caries detection device. Children in Grades 3 and 6 ( n = 2,622) received oral health screening by the school nurse using a noninvasive laser fluorescent dental device. Findings revealed that 82% of students referred to the dentists received dental care. School nurses can contribute to improving the oral health status of the school-age population by early detection of dental caries and referrals for a dental evaluation.
Boys With Eating Disorders
Authors: Hatmaker Grace
Published: July 2008

Although commonly associated with girls and women, eating disorders do not discriminate. School nurses need to be aware that male students also can suffer from the serious health effects of anorexia nervosa, bulimia, anorexia athletica, and eating disorders not otherwise specified. Sports that focus on leanness and weight limits can add to a growing boy’s risk of developing an eating disorder. Issues of body image and sexual development can complicate and can distort previously normal eating habits. Students may use powerful and dangerous drugs readily available via the Internet, including growth hormone, creatine, testosterone, and aminophyl-line, to build muscle and to eliminate fat, potentially causing serious health consequences. School nurses can partner with health and physical education teachers, coaches, school staff, parents, and students to identify and to support boys with eating disorders
Use of the Preparticipation Physical Exam in Screening for the Female Athlete Triad Among High School Athletes
Authors: De La Torre Dena M. , Snell B. J.
Published: July 2008

The female athlete triad comprises 3 individual but interrelated conditions associated with athletic training: disordered eating, amenorrhea, and osteoporosis. Each condition is of medical concern, but when found within the triad, they can have serious medical consequences. The purpose of this study was to evaluate the effectiveness of preparticipation history and physical forms in high school athletic programs to screen for the triad, and to determine the prevalence of educational programs related to the female athlete triad. Results suggest that a majority of high school athletic programs are not adequately screening girls for the components of the triad, and schools lack educational programs targeting athletes and coaches. School nurses have the potential to play a vital role in the prevention and early identification of the triad through a preparticipation physical exam that specifically screens female athletes and in the implementation of educational programs for athletes and coaches regarding the disorders of the female athlete triad.
Teachers’ Knowledge of Normal and Abnormal Elimination Patterns in Elementary School Children
Authors: Boyt Margaret A.
Published: July 2008

Dysfunctional elimination may be learned, to some degree. Because children spend nearly half of their waking hours at school, there is the potential for school to have a significant impact on their elimination patterns. Surveys were mailed to 1,000 randomly selected Iowa public elementary school teachers; 467 of the surveys were returned. Findings indicate that most elementary school teachers are unaware of the potential health problems of elimination dysfunction. One third of respondents indicated that they ask children to wait to go to the bathroom. Suboptimal conditions exist in most of the school bathrooms, with only 35% of the boys’ restrooms and 48% of the girls’ restrooms reported as “always clean.” Those teachers with more experience were more likely to report information about abnormal elimination to the school nurse. Very few teachers (18% of respondents) reported having received information about abnormal elimination and even fewer (8% of respondents) were aware of specialists trained to treat children with these problems. School nurses can have a significant impact on the development of healthy bladder habits in children. Teachers need information about normal and abnormal elimination patterns in children.
The Impact of Mass School Immunization on School Attendance
Authors: Wiggs-Stayner Kathleen S. , Purdy Teresa R. , Go Gailya N. , McLaughlin Natalie C. , Tryzynka Penny S. , Sines Joyce R. , Hlaing Thein
Published: July 2008

The purpose of this study was to assess the impact a free, on-site influenza immunization program could have on attendance in Title 1 schools. Four Title 1 elementary schools participated in the study. Students at 2 schools were offered free FluMist® immunizations on site, and students at 2 control schools were not. Compliance on receiving FluMist® was measured on the percentage of students participating after evaluating for medical exclusions. Documentation on the reason for absences at all 4 schools included self- or parent-reported influenza. Attendance rates for the year also were compared with the previous year for all 4 schools. A comparison was done of total days absent versus total days enrolled between schools receiving FluMist® and schools not receiving the vaccine. Despite the fact that FluMist® is a new vaccine and is not required for children, 57% of those medically eligible to receive it had parental permission and received the vaccine. The 2 schools receiving FluMist® increased their attendance rates from 95.3% and 93.9% to 96.1% and 95.8%. Previously, the comparison schools each had a 94.6% attendance rate; one fell to 94.4% and the other rose very slightly to 94.7%. The differences in self- or parent-reported influenza absences were not significant. However, the difference in days absent between individual vaccinated and nonvaccinated schools was statistically significant.
Continuing Education: A National Imperative for School Nursing Practice
Authors: Vought-O’Sullivan Victoria , Meehan Nancy K. , Havice Pamela A. , Pruitt Rosanne H.
Published: July 2008

Competency-based continuing education is critical to the professional development of school nurses to ensure the application of timely, age-appropriate clinical knowledge and leadership skills in the school setting. School nurses are responsible for a large number of students with a variety of complex and diverse health care needs. Benner’s theory of novice to expert provides a framework for the development of roles and competencies in the practice of school nursing. This manuscript synthesizes research reviewed in 15 articles. Common themes found in the articles include the importance of continuing education and identified barriers to attainment. In response, methods to access continuing education and financial resources are presented.
Assessing Prevalence of Emotional and Behavioral Problems in Suspended Middle School Students
Authors: Stanley Mary Jo , Canham Daryl L. , Cureton Virginia Young
Published: July 2008

Schools are seeing an influx of disruptive behaviors related to an increase in emotional and behavioral issues. In the adolescent population, emotional and behavioral problems are manifested in a variety of forms and often result in some form of discipline within the school setting. Although discipline punishes the unwanted behavior, it does nothing to address the reason for the behavior. This study examined the prevalence of emotional and behavioral problems among middle school students who have been suspended. Students who are suspended are the very children at risk for social, emotional, and mental health problems. Results from the study indicate significance in some of the 14 subcategories of the Student Behavior Survey tool, lending support toward the conclusion that emotional and behavioral problems may be associated with suspensions. Advocating for assessment of emotional and behavioral needs should be considered for students with discipline problems that lead to suspension.