bluuebunny/crossref_metadata_2025 huggingface dataset:
Adolescent Parenting: Relationship to School Attendance and Achievement
Authors: Casserly Kathleen Rose , Carpenter Ann Seitz , Halcón Linda
Published: July 2008

School nurses often provide supportive services to pregnant and parenting teens. This study aims to describe the relationship between female secondary students’ attendance and achievement before and after childbirth. Among female students in the Minneapolis Public Schools who had a birth in 1994, there was a strong correlation between school achievement before and after the giving birth. Of those students not academically successful before the birth, over half were not successful afterward. Among those academically successful before the birth, 72% were successful after the birth. However, in the almost 40% with different academic success before, compared with after the birth, two thirds demonstrated greater academic success following the birth. Results show that attendance declines for adolescent female parents 1 year after a birth compared with 1 year before. Programs need to be examined to maximize each student’s potential and opportunities.
HIPAA Hoopla: Privacy and Security of Identifiable Health Information
Authors: Bergren Martha Dewey
Published: July 2008

The privacy and security provisions of the Health Insurance Portability and Accountability Act (HIPAA) are changing the standards for how identifiable health information is handled. This article explains HIPAA and how it interacts with the Family Educational Right to Privacy Act. The advent of HIPAA and the attention given to privacy and security of identifiable health information provides the opportunity for school nurses, school districts, and administrators to revisit and update how they handle student health information. Resources to assist in establishing policies, procedures, and practices that protect student and family health information are identified.
Professional Liability Insurance
Authors: Schwab Nadine , Pohlman Katherine J. , Schwab Nadine C.
Published: July 2008

The American Association of Nurse Attorneys recommends that all nurses engaged in the practice of nursing insure themselves against liability to third parties arising out of that practice. To make an informed decision whether to purchase individual insurance and how much to purchase, each school nurse must personally evaluate a multitude of factors. Each school nurse should also understand the various types of insurance policies available and how an individual policy is affected by coverage provided through the school district policy or self-insurance program. In certain states, school nurses also may be protected by the legal doctrine of sovereign immunity. This article provides answers to some of the questions frequently posed by school nurses about individual professional liability insurance.
Personal and Professional Characteristics of Exemplary School Nurses
Authors: Pulcini Joyce , Couillard Mary , Harrigan Judith , Mole Deirdre
Published: July 2008

This article describes a study conducted to identify the professional and personal characteristics of exemplary school nurses. During Phase 1 of the study, a content analysis was completed using nomination portfolios of 10 school nurses who were selected as School Nurse of the Year from 1986 to 1998 in the state of New York. Further content analyses were conducted using transcriptions of a focus group and individual open-ended interviews with exemplary school nurses. These analyses yielded 54 personal characteristics and 74 professional characteristics of exemplary school nurses. Using a Delphi technique in Phase 2 of the study, these characteristics were validated and refined by a national sample of exemplary school nurses who had been chosen to be their state nominees for the National Association of School Nurses’ School Nurse of the Year award. Descriptive data were collected on the organizational/structural characteristics of the school systems in which these nurses practiced and on the nurses’ individual characteristics. This article identifies areas for clinical and research use of the study’s findings.
Model For Community Health Nursing Care: Application To An Integrated Asthma Intervention Program
Authors: Nies Mary A. , Bickes Joan T. , Schim Stephanie Myers , Johnson Amy L.
Published: July 2008

The article describes the use of a model for community health nursing care applied to an integrated asthma intervention program in an inner-city context. Asthma is a chronic childhood disease with broad physical, social, and economic impact on children, families, and communities. Despite recent advances in asthma understanding and treatment, morbidity and mortality continue to rise. This model suggests ways to combine individual, family, school, and community interventions to enhance coordination and increase the impact of services. It outlines needs and opportunities for collegial collaboration between professional nurses in varied practice settings. Application of the model to the management of asthma in the urban setting demonstrates the potential to produce significant improvement in the management of conditions such as asthma and highlights the key role that school nurses play.
Quality Improvement Projects Related To Pediculosis Management
Authors: Hootman Janis
Published: July 2008

Concern about student absenteeism related to repeated pediculosis infestations and the consequent risk for unsuccessful school achievement led to a quality improvement program comprised of 6 projects. The goal was to identify effective nursing interventions for children and families incurring repeated infestations. One project addressed the prevalence of infestation, frequency of school exclusion, and duration of consequential lost school days. Affirmed were low contagion in classrooms and multiple social and emotional challenges in students having chronic infestations. From other projects, the importance of establishing effective relationships with parents, students, and school staff to work toward effective management outcomes was apparent. Also identified was the need to better match hair texture with the selection of a lice comb for effective mechanical removal of lice and nits. There is a need to replicate these projects with larger numbers of students in different geographic locations. It is important to have evidence-based information about the communicability and management strategies for pediculosis to contribute to sound treatment and policy formation.
Autonomy In Practice: A Qualitative Study of School Nurses’ Perceptions
Authors: Simmons Darlene R.
Published: July 2008

Many who enter the specialty of school nursing find themselves faced with the challenge of practicing as the sole professional responsible for the health care of large numbers of students and school employees. In addition, the transition from the more familiar medical or nursing setting into the unknown territory of the educational environment can be daunting. This qualitative study examined the perceptions of 6 new and 6 experienced school nurses regarding the autonomy of their practices. Results identified sharp contrasts in the areas of role perception, comfort, and confidence between the two groups. It is imperative that the specialty initiate changes to nurture and support the novice during this transitional period.
Research Priorities in School Nursing: A Delphi Process
Authors: Edwards Linda H
Published: July 2008

As a follow-up to an Invitational Summit Conference in 1999, 27 nurse leaders representing school nursing and nursing research in child health were requested to participate in a Delphi study for purposes of prioritizing research issues in school nursing. The issues to be prioritized were identified during the Invitational Summit meeting. A three-round Delphi process was used to arrive at consensus on the most important research issues affecting school nurses today. Criteria for the rankings included policy support for the research, ability to be funded, magnitude and severity of the problem, likelihood of making a difference, and potential for partnership. The overall response rate for participation in all three rounds was 61%. Consensus was reached on the top-10 most important research issues. The two most important were consistent through all three rounds. These were (a) the impact of school nurse services on student health, and (b) the relationship between school nurse practice and educational outcomes.
Decision Support Tools Aid School Nursing Practice
Authors: Lewis Angela , Belmonte-Mann Fran
Published: July 2008

The purpose of this article is to explain the use of technology as a tool to aid the school nurse’s decision-making process. This article demonstrates how decision support tools improve school nurses’ decision making regarding client care and nursing practice. Various decision support systems are discussed, examples provided, and the underlying technology explained. A listing of decision support systems and specific applications for school nurses are reviewed.
Bring Your First Aid Kit: An Unannounced Mock Drill
Authors: Grant Theresa Wolf
Published: July 2008

Disaster preparedness has taken on new significance in our country since September 11. School nurses, advocates for school safety, must address new challenges in crisis management and emergency response. Our nation’s schools remain relatively safe places, yet well-known events in the last few years dictate the need for movement from attitudes of complacency and denial toward vigilance. Natural disasters, accidents, and violence can threaten the well-being and lives of students and staff, and in a few short minutes a peaceful learning environment can change into one of chaos with multiple casualties. Although schoolwide drills for events such as tornadoes, explosions, and shootings remain imperative, they do little to prepare the school nurse for her role in immediate response. Staging an unannounced mock disaster at a districtwide nurse meeting is one way to ensure a higher level of preparedness. It also acknowledges the legitimate concerns of crisis competency among school nurses who are often and understandably the most trusted first responders to health crises on campus.
A Program to Educate School Nurses About Mental Health Interventions
Authors: Hootman Janis , Houck Gail M. , King Mary Catherine
Published: July 2008

Concerned with the increasing incidence of mental health problems in children and adolescents and the impact of these problems on students’ school success and predisposition to self- and other-directed violence, the Multnomah Education Service District Department of School Health Services determined to become proactive by providing preventive interventions for students experiencing actual or potential mental health problems. An educational program was designed to assist school nurses in the identification of potential mental health problems. In addition, information about appropriate interventions for students at risk for aggression, violence, and other mental health pathology was presented. The program involved education on mental health assessment and intervention, as well as expert psychiatric clinical support for the development of student support groups. School nurses were then challenged to develop practice improvement projects incorporating this knowledge for a group of students in their work setting. This introductory article describes the project’s general rationale and implementation process. The four articles following in this issue of The Journal of School Nursing describe the goals, implementation, and outcomes of the practice improvement projects developed for early intervention with students exhibiting attention disorders, school absenteeism, social withdrawal, and depression.
Asthma Management, Part II: Pharmacologic Management
Authors: Baker Valerie O’Toole , Friedman Janet , Schmitt Rita
Published: July 2008

Part I of this two-part series described the pathophysiology, types, and risk factors associated with asthma. The role of the school nurse in the development, implementation, and evaluation of a comprehensive asthma management plan was outlined, as was the role of the school nurse in controlling factors that precipitate asthma symptoms or exacerbations. Part II reviews specific school nursing responsibilities associated with current pharmacologic therapy for the child with asthma. Issues related to nutritional supplements as well as complementary and alternative treatments used in asthma management are covered. Other topics discussed include issues related to access of asthma medication in the school setting by the student, involvement of the school team in the care of the child with asthma, and health education strategies for children with asthma and their families.
Developing a Nursing Protocol for Over-the-Counter Medications in High School
Authors: Awbrey Lucinda Mejdell , Juarez Sandra M.
Published: July 2008

Management of medications in school is one of the critical roles that school nurses carry out in the school setting. In recent years, parents have come to question the medication procedures that school districts follow. Parents question why a physician’s order is required for school personnel to provide over-the-counter (OTC) medications to their child at school. How do school districts balance the safety of students with the needs of parents wanting their children to have access to OTC medications at school? Following legal guidelines helps to reduce the risk for school nurses. Through the development and utilization of Nursing Standardized Protocols, high school nurses are able to provide nonprescription analgesics for specific common student complaints such as noninjury headaches and dysmenorrhea. On the basis of nursing knowledge and judgment, school nurses provide this service, which results in students returning to class quickly, feeling better, and being ready to learn.
Parents’ Perspectives on Homelessness And Its Effects on The Educational Development of Their Children
Authors: Morris Rita I. , Butt Rachael A.
Published: July 2008

This qualitative study explored parents’ perceptions of how their homelessness affected the development and academic achievement of their children. Grounded theory with symbolic interactionism was the framework for this study. Data were collected through semistructured interviews with 34 homeless families in a variety of settings. Multiple factors were found, including unstable relationships, abuse and violence, abdication of parental responsibility, poor parenting models, and resilient children. The findings present a case for supportive educational services for homeless school-age children. School nurses play a dual role. They can ensure that school personnel and resource providers understand the culture of homelessness, and they can develop and implement innovative programs for parents and school personnel to help homeless children.
A Lyme Disease Case Study and Individualized Healthcare Plan
Authors: Cavendish Roberta
Published: July 2008

The Atlantic and Pacific coasts are the boundaries of Lyme disease with the Northeastern and Midwestern regions of the United States continuing to report the majority of cases. New reported cases of Lyme disease doubled from 1991 to 2001 according to statistics published by the Centers for Disease Control and Prevention ( CDC, 2002 ). Within that population are more children between the ages of 5 and 9. The younger the child, the more difficult it is to diagnose Lyme disease. Children under the age of 19 are at high risk for Lyme disease because of the amount of time spent in outdoor activities during the late spring and summer. These months correlate with the tick breeding cycle and the peak time for outdoor recreational activities. Lyme disease can pose serious health risks in late stage illness. A Lyme disease case study on a school-age child provides comprehensive assessment data, interventions, and educational information for parents. A template of an individualized healthcare plan using standardized language is a guide for school nurses. The value of school nurses as guardians of the public’s health is addressed.
Development of a Skin Cancer Prevention Program
Authors: Hatmaker Grace
Published: July 2008

The Centers for Disease Control and Prevention (CDC) now categorizes skin cancer as epidemic. Nearly 90% of these deadly cancers start from sun exposure during the childhood years. This makes sun exposure in school-age children a serious public health risk, also one that school nurses can address. Solar radiation is now classified as a “known human carcinogen,” with ultraviolet rays joining the ranks of other known cancer-causing elements such as tobacco, arsenic, and radon. Sun exposure to unprotected skin results in painful burns, premature aging, cataracts, and weakened immune systems. School nurses can use the new CDC guidelines along with other local and state resources to develop a specific skin cancer prevention program for their schools. They are in a pivotal position to partner with students, parents, administrators, teachers, and coaches to reduce the occurrence of skin cancer in children. The article describes one high school’s skin cancer prevention project.
Evaluation of the SunWise School Program
Authors: Geller Alan , Rutsch Linda , Kenausis Kristin , Zhang Zi
Published: July 2008

Melanoma, the most fatal form of skin cancer, is rising at rates faster than all other preventable cancers in the United States. Childhood exposure to ultraviolet (UV) light increases the risk for skin cancer as an adult, therefore, starting positive sun protection habits early may be key to reducing the incidence of this disease. The Environmental Protection Agency’s SunWise School Program, a national environmental and health education program for sun safety of children in primary and secondary schools (Grades K–8), was evaluated. Pretests ( n =4,559) and posttests ( n =4,016) were completed by students from 85 schools in 35 states. Significant increases were noted for the three knowledge variables. Intentions to play in the shade increased from 70% to 76% ( p <0.001) with more modest changes in intentions to use sunscreen. Attitudes regarding the healthiness of a tan also decreased significantly. Brief, standardized sun protection education can be efficiently interwoven into existing school curricula and result in increases in knowledge and positive intentions for sun protection.
Correlates of Young Adult Tobacco Use: Application of a Transition Framework
Authors: Lenz Brenda K.
Published: July 2008

Anticipatory guidance is a traditional nursing intervention. The purpose of this study was to identify factors to serve as targets for anticipatory guidance prior to high school graduation to reduce tobacco initiation among young adults after graduation. A sample of 203 randomly selected freshmen and sophomore students at a major midwestern university completed a survey that included questions about tobacco use, drug use, mental health issues, stress, smoking environment, and other lifestyle choices. The prevalence rate for tobacco use was 32%. Multivariate analyses indicated that students who had used marijuana and alcohol were more likely to use tobacco. Implications for health promotion starting at the high school level were drawn from the study findings.
School Nurses’ Knowledge and Beliefs About the Management of Children With ADD
Authors: Kwasman Alan , Tinsley Barbara , Thompson Sharon
Published: July 2008

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.
Identifying and Intervening in Relational Aggression
Authors: Raskauskas Juliana , Stoltz Ann D.
Published: July 2008

Chronic victimization by bullies has been associated with academic failure in adolescence, as well as adjustment difficulties, depression, and suicidal ideation. Relational aggression is a form of bullying that is a problem for adolescent girls. It often takes the form of damaging peer relationships and includes verbal assaults such as teasing or name calling, as well as psychological attacks such as gossip, social exclusion, and strategic friendship manipulations. A girl’s ability to identify these indirect attacks may be imperative for her to enact an effective defense. Because many students do not recognize relational aggression as a form of bullying, their experiences often go unreported to parents or teachers. School nurses may be the front line of defense. With this in mind, school nurses must be informed about bullying behaviors, equipped to identify these behaviors, and prepared to intervene with victims as well as perpetrators of bullying.
The STARS Program: Social Empowerment Training for Preadolescents with Attention Deficit Hyperactivity Disorder (ADHD)
Authors: Frame Kathleen
Published: July 2008

According to the National Institutes of Health (NIH), there has been a dramatic increase in the number of children being diagnosed with attention deficit hyperactivity disorder (ADHD) in the last several years. School nursing interventions need to be developed, implemented, and evaluated to address complexities experienced by this population. The STARS curriculum (Social Empowerment Training and Responsibilities for Students with ADHD) is a nursing intervention designed to improve perceptions of scholastic competence, social acceptance, and behavioral conduct in preadolescents diagnosed with ADHD. It consists of eight sessions with the theme of social empowerment training woven throughout the curriculum. The support group concept, with children helping children, initiated dynamic conversation as the participants creatively problem-solved and developed solutions to their difficulties.
Evaluation of an Anaphylaxis Training Program for Unlicensed Assistive Personnel
Authors: Litarowsky Jean A. , Murphy Susan O. , Canham Daryl L.
Published: July 2008

This study evaluated a training program designed to prepare unlicensed assistive personnel (UAP) in high school settings to recognize and respond effectively to an anaphylactic emergency. Subjects included 53 adults employed by a high school district in the San Francisco Bay Area of California. A training model was developed based on Bandura's theory of sources of self-efficacy Knowledge and perceived self-efficacy of participants were measured before and after the training program to determine if a theory-based anaphylaxis recognition and epinephrine auto-injector training program would increase participants’ knowledge and self-efficacy in responding to an anaphylactic emergency. Paired t tests revealed significant improvement in scores for both knowledge and perceived self-efficacy following the intervention ( p < .001). This theory-based training program offers a valuable model for other school nurses in providing knowledge and skill training for unlicensed assistive personnel in other health emergencies.
Privacy Questions from Practicing School Nurses
Authors: Pohlman Katherine , Schwab Nadine , Bergren Martha Dewey
Published: July 2008

This Question and Answer (Q&A) article addresses practice issues related to school health records and school nursing documentation that were posed by school nurses in the field. Specifically, the questions addressed concern the following: education records, medication privacy issues, sharing of sensitive health information, privacy of individual student logs, use of record access logs, and the use of spreadsheets and home computers for creating student records. The Health Insurance Portability and Accountability Act (HIPAA), the Family Educational Records and Privacy Act (FERPA), and other laws are addressed as appropriate.
Effect of Full-Time versus Part-Time School Nurses on Attendance of Elementary Students with Asthma
Authors: Telljohann Susan K. , Dake Joseph A. , Price James H.
Published: July 2008

Asthma, the most common chronic disease in children today, is the leading cause of absenteeism among students. It accounts for nearly 20 million lost school days annually. This study examined whether full-time (5 days per week) or part-time (2 days per week) school nurses would have a differential effect on the frequency of absences among elementary school students with asthma. This study found that students with asthma who were poor or who were African American and in schools with full-time nurses missed significantly fewer days (3 days, or 23% fewer missed days) than did their counterparts with asthma in schools with part-time nurses.
Section 504 of the Rehabilitation Act: Determining Eligibility and Implications for School Districts
Authors: Pohlman Katherine , Schwab Nadine , Moses Marsha , Gilchrest Cynthia , Schwab Nadine C.
Published: July 2008

Today, school districts are challenged in meeting the health and educational needs of students with chronic health conditions. One of the challenges school districts face is determining when students with health-related disabilities are eligible for services under Section 504 of the Rehabilitation Act of 1973. This article reviews Section 504 and its regulations as they apply to public schools, particularly with respect to eligibility criteria for students with special health care needs. The article also reviews recent case law and explores the implications of these legal standards for school district practice, including the need for clear policies and procedures, consistent Section 504 teams, training, and alternatives for meeting the needs of students who are found not to be eligible for services under Section 504.
Improving the Quality of Students’ Dietary Intake in the School Setting
Authors: Malone Susan Kohl
Published: July 2008

The dramatic increase in our understanding of the brain’s development throughout childhood has increased our knowledge of the significance of micronutrients, such as iron and vitamin B-12, for this development. Deficiencies of these micronutrients have been shown to have an impact on students’ cognitive development. Regardless of this knowledge, students continue to make unhealthy food choices and develop poor dietary habits. School environments are places where there is an opportunity to practice healthy eating habits. Yet many school policies fail to address the sale of foods of minimal nutritional value in the school setting. School nurses can play a vital role in planning policies at the local and national level that support and encourage healthy food environments, performing assessments of the nutritional status of students, and spearheading the implementation of evidence-based health promotion programs. It is time for school nurses to take the lead in efforts aimed at improving the quality of students’ dietary intake in the school setting.
Fetal Alcohol Spectrum Disorder
Authors: Caley Linda M. , Kramer Charlotte , Robinson Luther K.
Published: July 2008

Fetal alcohol spectrum disorder (FASD) is a serious and widespread problem in this country. Positioned within the community with links to children, families, and healthcare systems, school nurses are a critical element in the prevention and treatment of those affected by fetal alcohol spectrum disorder. Although most school nurses are familiar with fetal alcohol syndrome (FAS) and the problems it poses, they may not be familiar with the newer term, fetal alcohol spectrum disorder. This article summarizes the most recent information about FASD and recently published guidelines on diagnostic criteria for FAS. Also outlined are primary, secondary, and tertiary prevention activities school nurses can take to help assure that children, families, and communities work to prevent the problem and to treat the children affected by it.
School Phobia
Authors: Tyrrell Maureen
Published: July 2008

School phobia is a serious disorder affecting up to 5% of elementary and middle school children. Long-term consequences include academic failure, diminished peer relationships, parental conflict, and development of additional psychiatric disorders. Hiding behind such common physical symptoms as headaches, stomachaches, and fatigue, school phobia evades diagnosis with ease. Unraveling the problem of school phobia is challenging for the school nurse and is complicated by an overall lack of knowledge regarding the serious potential outcomes. The purpose of this article is to define school phobia, differentiate it from truancy, and highlight some interventions useful in the treatment of this increasingly common and potentially serious disorder.
Recommendations for Constructing School Nurses’ Offices Designed to Support School Health Services
Authors: Cooper Leslie , McKibben Cynthia S. , DiPaolo Sonja J. , Bennett J. Scott
Published: July 2008

When attempting to locate guidelines for designing school nurses’ offices, one finds there are minimal resources that address this need. In an effort to solve this concern, the authors were instrumental in writing an article for The Journal of School Nursing published in April 1997. The current article is an updated perspective that defines recommendations to be utilized in new construction or renovation of school nurses’ offices. It encompasses information on square footage, design, utilization of space, location, and necessary equipment. Prototypes are provided that apply to elementary, middle school, and high school settings. The article outlines the importance of continued collaboration between the school nurse and key people involved in the planning and construction process, such as the school principal, administrators, and the district engineer.
The Relevance of Standards of Professional School Nursing Practice
Authors: Rice Susan K. , Biordi Diana L. , Zeller Richard A.
Published: July 2008

This descriptive correlational study assessed school nurses’ knowledge of and perceived relevance of the Standards of Professional School Nursing Practice. Of the 1,162 Ohio school nurses sent questionnaires, 345 returned usable questionnaires (30%). The typical respondent was a 50-year-old Caucasian woman with 24 years of nursing experience, 12 years of school nursing experience, and a caseload of 3 public schools serving 1,500 students. Factors that positively related to the school nurses’ knowledge and perceptions of the relevance of the standards were age, advanced degree preparation, school nursing experience, and practicing in a metropolitan area. Factors that negatively related to knowledge and perceived relevance were practicing in a rural area and caseload of special needs students. Standards of practice provide a mechanism for defining and supporting practice roles for nurses. Thus, it is important to increase awareness and use of the standards, especially among school nurses practicing in rural areas.
Depression in Children and Adolescents
Authors: Davis Noel M.
Published: July 2008

During the past 20 years, depression has been recognized widely in children and adolescents. However, even with what is known today about depression, many children and adolescents remain undiagnosed. Early recognition is imperative to prevent further episodes that may continue into adulthood. Depression in children and adolescents affects social development, academic performance, and ultimately, success as an adult. This article describes risk factors for depression, diagnostic criteria, medications, psychosocial interventions, and implications for school nursing practice.
Sports Nutrition for Young Athletes
Authors: Cotugna Nancy , Vickery Connie E. , McBee Sheldon
Published: July 2008

Nutritional needs for peak athletic performance include sufficient calorie intake, adequate hydration, and attention to timing of meals. Student athletes and their advisors often are misinformed or have misconceptions about sports nutrition. This paper identifies nutritional needs of young athletes, reviews common misconceptions, and examines the nutrition knowledge of athletes and their sources of nutrition information. Topics covered include energy, carbohydrate, protein, fat and micronutrient needs, hydration requirements, timing of meals, and issues related to age, gender, and specific sports. Other issues addressed include “making weight” and ergogenic aids. Proper nutrition for young athletes is critical not only to their athletic success, but more importantly to their growth, development, and overall health. Nutritional recommendations should be based on the most current scientific data; we provide information about appropriate resources for the school nurse when advising student athletes and their coaches and parents.
School Nurses’ Perceptions of Self-Efficacy in Providing Diabetes Care
Authors: Fisher Kelly L.
Published: July 2008

The purpose of this study was to measure school nurses’ perceived self-efficacy in providing diabetes care and education to children and to identify factors that correlate with higher self-efficacy levels in the performance of these tasks. The results of this study revealed that the surveyed school nurses perceived a moderate level of self-efficacy in providing diabetes education. Significant findings in this study were positive relationships between self-efficacy and 3 variables: (a) participating in the care of children with diabetes, (b) having type 1 diabetes children in the school system, and (c) supervising children with blood glucose meter testing. There was a significant relationship between higher self-efficacy scores and having a diabetes curriculum. However, only nine school nurses reported having a diabetes curriculum. School nurses can benefit by understanding what factors increase self-efficacy related to diabetes education designed to enhance school-age children’s knowledge of diabetes and its management.
Gender Differences in Health Risk Behaviors and Physical Activity Among Middle School Students
Authors: Wu Tsu-Yin , Rose Sherry E. , Bancroft Joanna M.
Published: July 2008

Adolescence is a period of accelerated growth and change, bridging the complex transition from childhood to adulthood. This period offers adolescents an opportunity to begin planning for their futures and to adopt healthy attitudes about risk behaviors that can continue into adulthood, thus setting the stage for a lifetime of desirable health behaviors. This study used the Youth Risk Behavior Survey on middle school students and examined the gender differences of health risk behaviors among 674 8th-graders from an urban setting. The results showed that males were more likely to be involved in fights, to initiate alcohol use, and to participate in physical activity; whereas females were more likely to try to lose weight with unhealthy practices, such as fasting and laxatives. School nurses are in a prime position to promote adolescent health in the school setting by providing health-related services and teaching to help students initiate and maintain healthy lifestyles.
Reducing Hunger-Associated Symptoms: The Midmorning Nutrition Break
Authors: Sweeney Nancy M. , Tucker Joanne , Reynosa Brenda , Glaser Dale
Published: July 2008

This study measured the effectiveness of a 9 a.m. nutrition break after it had been implemented for 1 academic year at an inner-city high school. Effectiveness was measured by student participation rates, student and teacher evaluations of hunger-associated symptoms experienced by students, and teacher evaluations of the effects on the learning environment. Sixty-nine percent of students participated. The most frequently cited reason for nonparticipation was dislike of the food offered (53%), with an additional 15% citing problems with food distribution. As the frequency of participation rose, the frequency of inability to focus, tiredness, stomachache, headache, and midmorning hunger fell. All of the associations were statistically significant except for headache. Seventy-four percent of staff stated that the nutrition break had positive effects on the learning environment, and 71% referred fewer students to the school nurse.
School Nurses’ Support for Bereaved Students: A Pilot Study
Authors: Lohan Janet A.
Published: July 2008

Children may have difficulty with schoolwork because of grief over the death of an important person in their lives. School nurses provide support to these children. This pilot study consisted of a Web-based survey completed by 6 school nurses in a 3-county area in Washington state. The purpose of this pilot study was to assess the need for additional support for bereaved children and the extent to which school nurses meet the needs of these students. Results indicated that many school nurses have large caseloads that preclude spending as much time with bereaved students as the nurses feel is necessary. Bereaved students exhibit a wide variety of grief symptoms that may interfere with learning. In addition, rural areas do not have adequate community bereavement resources that nurses can use to refer students who need help beyond that offered at school. Nurses must be more active in supporting students within the school setting despite limited resources.
Methamphetamine: Putting the Brakes on Speed
Authors: Gettig Jacob P. , Grady Sarah E. , Nowosadzka Izabella
Published: July 2008

In only recent history, illicit use of methamphetamine, once isolated to urban areas on the West Coast, has spread into rural areas of the Midwest and southern United States. Although past and current methamphetamine legislation has increased penalties for methamphetamine manufacturers and tightened restrictions on sales of known precursors, the problem still persists. In fact, a 2004 survey indicates that an alarming 6.2% of high school seniors have tried methamphetamine. A number of biological, genetic, and environmental factors influence children's and adolescents’ paths to substance abuse. Nurses should recognize the symptoms of methamphetamine abuse, which include agitation; aggressive behavior; rapid mood swings; hypertension; tachycardia; and eventually lesion-marked skin, clinical depression, and paranoid psychosis. Treatment for methamphetamine addiction includes behavioral therapy. Research on pharmacologic therapy is lacking. Educating youth on methamphetamine prevention appears to be the best approach to curb the spreading use of this addictive and deadly drug.
Implementing an Over-the-Counter Medication Administration Policy in an Elementary School
Authors: Foster Lori S. , Keele Rebecca
Published: July 2008

A major focus of school nursing interventions is to improve school attendance. In many schools, parents are required to leave work and/or to arrange transportation to bring their children over-the-counter medicines. Many times these children went home, missing class and making it difficult to keep up with class work. The purpose of this study was to examine the impact of a new policy and procedure allowing school nurses to administer certain over-the-counter medications in elementary schools in a southern New Mexico public school district. “Sent home” rates before implementation of the new policy were compared with sent home rates for 2 years following implementation. Although not statistically significant, findings indicated that over-the-counter medication administration by school nurses does show a trend toward sending fewer students home and, therefore, keeping them in the learning environment.
Medication Administration Practices in Pennsylvania Schools
Authors: Ficca Michelle , Welk Dorette
Published: July 2008

As a result of various health concerns, children are receiving an increased number of medications while at school. In Pennsylvania, the School Code mandates a ratio of 1 certified school nurse to 1,500 students, which may mean that 1 school nurse is covering 3–5 buildings. This implies that unlicensed personnel are administering medications, a violation of licensing laws in Pennsylvania. The purpose of this study was to determine the policies and practices that Pennsylvania public schools have in place regarding medication administration. The sample consisted of 314 state-certified school nurses who returned a 71-question survey. Findings indicated that school nurses are very concerned about issues related to medication administration. Additional findings identified the lack of standing orders to administer over-the-counter medications, the increase in medication errors when the school nurse had responsibility for multiple buildings, and the lack of understanding of the ramifications of the Nurse Practice Act on school nursing practice in regard to delegation. Recommendations for practice include development of detailed policies and procedures and collaboration among all stakeholders in the development of policies that address legal issues.
The Cognitive and Academic Impact Of Sickle Cell Disease
Authors: Day Sara , Chismark Elisabeth
Published: July 2008

Sickle cell disease (SCD) affects over 30,000 students in the United States. Central nervous system complications are widespread among students with SCD and include stroke, silent cerebral infarction, and cognitive impairment. The effects of these complications may lead to academic failure, limited career options, and for some, total disability. Despite studies describing the significant academic and cognitive impact of sickle cell disease, reports describing interventions are limited. There is a lack of awareness among educators of the academic risks associated with sickle cell disease and a lack of appropriate resource allocation. The school nurse, as community health advocate, will be called upon to bridge the gap among healthcare providers, parents, students, and educators. This article provides a review of both recent and landmark studies describing the cognitive and academic impact of sickle cell disease and discusses the role of the school nurse as an advocate, liaison, and educator.
Childhood Nutrition: Perceptions of Caretakers in a Low-Income Urban Setting
Authors: Kelly Lynn E. , Patterson Barbara J.
Published: July 2008

The incidence of overweight and obese children, especially those from low-income and minority backgrounds, continues to rise. Multiple factors contribute to the rising rates. In order to gain an understanding of factors contributing to obesity in low-income families, a qualitative study was conducted with the purpose of gaining knowledge of low-income urban caretakers’ understanding and attitudes regarding children’s nutrition. A focused ethnography was used as a means of understanding behavior within the context of a person’s cultural environment. The sample was 17 caretakers of children in the 1st–3rd grades. Four focus groups were conducted. Two themes emerged from caretakers’ perceptions: knowing the right things children should eat and balancing healthy nutrition with unhealthy choices. Four categories emerged regarding influences on food choices: tradition, finances, time constraints, and role models. Lastly, five barriers and three facilitating factors emerged. Implications of the study findings for school nurses include the need, when implementing healthy eating programs for school children, to gain information from caretakers about their perceptions of childhood nutrition.
Parental Perceptions of the Schools’ Role in Addressing Childhood Obesity
Authors: Murphy Maureen , Polivka Barbara
Published: July 2008

As childhood obesity has increased, schools have struggled with their role in this epidemic. Parents with a school-age child in a suburban latchkey program were surveyed regarding their perceptions of childhood obesity, body mass index, and the school’s role in prevention and treatment of obesity. More than 80% of participants identified inactivity, poor eating behavior, lack of parental control in what children eat, and eating too much as the main causes of childhood obesity. Parents preferred receiving information about their child’s body mass index from the school via a letter from the school nurse. Participants agreed that physical education classes, as well as units on nutrition and weight control, should be present in schools. Parents also supported eliminating junk food machines and offering special low-calorie meals. By supporting these strategies, parents indicated that schools should have a role in childhood obesity. School nurses can advocate for parental preferences in their school district.
An Evaluation of a School-Based Teenage Pregnancy Prevention Program Using a Logic Model Framework
Authors: Hulton Linda J.
Published: July 2008

Teenage pregnancy and the subsequent social morbidities associated with unintended pregnancies are complex issues facing school nurses in their daily work. In contemporary practice, school nurses are being held to higher standards of accountability and being asked to demonstrate the effective outcomes of their interventions. The purpose of this article is to describe a logic model framework and how it can be used by school nurses in the development, implementation, and evaluation of school-based programs. A logic model framework that is dynamic and responsive will help to build consensus and be a “map” of the program goals, activities, and outcomes. An example of a teenage pregnancy prevention program will be reviewed to demonstrate how a rural community used this framework for ongoing program evaluation and outcome identification in a school-based setting. Specific recommendations for school nurses who wish to use a logic model framework will also be discussed.
Elementary School Nurse Interventions: Attendance and Health Outcomes
Authors: Weismuller Penny C. , Grasska Merry A. , Alexander Marilyn , White Catherine G. , Kramer Pat
Published: July 2008

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.
Evidence-Based Practice Guidelines and School Nursing
Authors: Adams Susan , McCarthy Ann Marie
Published: July 2008

The use of evidence-based practice (EBP) has become the standard of health care practice. Nurses are expected to use best evidence on a wide range of topics, yet most nurses have limited time, resources, and/or skills to access and evaluate the quality of research and evidence needed to practice evidence-based nursing. EBP guidelines allow nurses and other health care workers to have research information collected, analyzed, and condensed into specific practice recommendations by experts. This article defines EBP guidelines and discusses the process of guideline development, including identification of topics, systematic literature searches, and evaluation and rating of research. Criteria for determining the quality of existing guidelines are reviewed. The steps needed to develop EBP guidelines specifically for school nursing are discussed.