Data Sharing.

The data life cycle starts with defining what data are needed, to collecting, storing, protecting, using, sharing, retiring, and destroying data. A May 2019 NASN School Nurse article, "Data Governance and Stewardship," addressed who is accountable for the data life cycle within a school system. This article will discuss data sharing, the ethics, and the steps that must be taken to share data responsibly. As discussed in the previous article, policies and procedures about data sharing are available in every school district. Frequently, the guidelines pertain only to sharing personally identifiable student information and do not address the sharing of aggregated information for the purposes of needs assessments, priority setting, outcomes measurement, or for advocating for resources or policy changes at the district, state, or national level. Fortunately, guidance of sharing data and crafting data sharing agreements is provided by the Privacy Technical Assistance Center at the U.S. Department of Education. This is the sixth article in the series on data.

Ethical challenges of conducting health research in UK school setting.

This paper offers guidance for novice nurse researchers on the ethical and methodological challenges of conducting health research in high school settings. Over the course of two studies in UK high schools with students aged 11-16 years, the authors encountered common ethical and methodological challenges. This article draws on these studies to build a critique of approaches to health research in school settings. Issues of consent and assent, confidentiality and participation can highlight tensions between the expectations of schools and health researchers. In this context, feasible research designs raise complex ethical and methodological questions. Ethical and methodological norms for health research may not be suitable for high school settings. Successful school-based health research designs may need to be flexible and responsive to the social environment of schools.

Ethical principles as a guide in implementing policies for the management of food allergies in schools.

Food allergy in children is a growing public health problem that carries a significant risk of anaphylaxis such that schools and child care facilities have enacted emergency preparedness policies for anaphylaxis and methods to prevent the inadvertent consumption of allergens. However, studies indicate that many facilities are poorly prepared to handle the advent of anaphylaxis and policies for the prevention of allergen exposure are missing essential components. Furthermore, certain policies are inappropriate because they are blatantly discriminatory. This article aims to provide further guidance for school health officials involved in creating food allergy policies. By structuring policies around ethical principles of confidentiality and anonymity, fairness, avoiding stigmatization, and empowerment, policy makers gain another method to support better policy making. The main ethical principles discussed are adapted from key values in the bioethics and public health ethics literatures and will be framed within the specific context of food allergy policies for schools.

Tied up and isolated in the schoolhouse.

In 1999, the United States General Accountability Office (USGAO) investigated restraints and seclusion use in mental health settings and found patterns of misuse and abuse. A decade later, it found the same misuse and abuse in schools. Restraints and seclusion are traumatizing and dangerous procedures that have caused injury and death. In the past decade, restraints and seclusion have gone from being considered an essential part of the psychiatric mental health toolkit to being viewed as a symptom of treatment failure. In most mental health settings, the use of restraints and seclusion has plummeted due to federal regulations, staff education, and concerted effort of psychiatric national and local leadership. The purpose of this article is to provide a background to and an overview of the present imbroglio over restraints and seclusion in public and private schools, articulate their dangers, dispel myths and misinformation about them, and suggest a leadership role for school nurses in reducing the use of these procedures.

State regulations for school nursing practice.

The purpose of this article is to present a state-by-state summary of rules and regulations governing school nursing practice in the United States. Official government and agency sites were reviewed to determine providers of services in schools, criteria for becoming a school nurse, protection of titling, mandates for school nursing, and the requirements for continuing to practice as a school nurse. Trends were identified after verifying regulatory information. The majority of states credential school nurses for practice, with Departments of Education being the most frequent authorizing agency. Almost half (n = 23, 45%) of the states refer to the role of licensed practical nurses in the school setting. Requirements for becoming a school nurse range from licensed practical or vocational nurse (LPN) to registered nurse-bachelor of science degree in nursing with additional education and experience. Limitations related to data collection issues and implications for practice, education, and leadership are discussed.

Developing a policy for delegation of nursing care in the school setting.

School nurses are in a unique position to provide care for students with special health care needs in the school setting. The incidence of chronic conditions and improved technology necessitate care of complex health care needs that had formerly been managed in inpatient settings. Delegation is a tool that may be used by registered nurses to allow unlicensed assistive personnel to perform appropriate nursing tasks and activities while keeping in mind that the registered nurse ultimately retains accountability for the delegation. The legal parameters for nursing delegation are defined by State Nurse Practice Acts, State Board of Nursing guidelines, and Nursing Administrative Rules/Regulations. Delegation becomes more challenging when carried out in a non-health care setting. School administrators may not be aware of legal issues related to delegation of nursing care in the school setting. It is crucial for school nurses to have a working knowledge of the delegation process. Development of a specific delegation policy will ensure that delegation is carried out in a manner providing for safe and appropriate care in the school setting.

Video Interaction Guidance: a practitioner's perspective.

School nurses are being encouraged to consider a more preventative agenda, and Video Interaction Guidance (VIG) is a tool to enhance communication between people that can be used effectively within community nursing. VIG involves a short piece of film taken by the professional--the guider--that is edited to highlight the participant's strengths and fed back in discussion between the guider and participant. This article describes the theoretical background and practical use of VIG by a school nurse seconded to a Children's Fund project, in a county where this method is being used across a number of agencies. The implications for ethical working are also considered.

Ethics and the HPV vaccine: considerations for school nurses.

School nurses are at the forefront of health care providers for many families of junior high and high school students and are used as primary sources of information and guidance about recommended student vaccinations. In the case of the relatively new vaccine for human papillomavirus (HPV), school nurses must be both knowledgeable about the infection itself and unbiased when asked to give students and families information about the vaccine. This article explores the development and current status of HPV and the HPV vaccine and the ethical principles of autonomy, utilitarianism, beneficence, nonmaleficence, justice, and cultural and religious issues as they relate to discussions with students and families about HPV vaccinations. School nurses are advocates for the health of students. Therefore, they must critically evaluate the application of these ethical principles when providing information and recommendations about the HPV vaccination.

Ethical challenges for school nurses in documenting schoolchildren's health.

This study explored Swedish school nurses' experiences of school health record documentation. Fifty per cent of a representative sample of Swedish school nurses (n = 129) reported difficulties with documenting mental and social health problems in family relationships, schoolchildren's behaviour, and school situations. Ethical considerations concerning fears of misinterpretation and practical barriers to documentation were expressed as reasons for their worries. Mental and social ill health is an increasing and often dominating problem among schoolchildren, thus proper documentation is a basic issue, both for individuals and for the population as a whole. School nurses obviously need professional guidance regarding documentation and ethical challenges. Systematic effort should be directed towards recognition and support of these nurses' unique opportunities to consider, follow and promote all aspects of schoolchildren's health.

School nurses and sex education: surveillance and disciplinary practices in primary schools.

AIM: This paper is a report of a study to explore how school nurses perceive the influence of schools on their role in delivering sex and relationship education in primary schools. BACKGROUND: School nurses play a key role in sex education in English schools. However, sex education is a contentious issue meaning the sex education of children is often an area of tension within the curriculum. However, the impact of these tensions upon school nursing practice is poorly described. METHOD: Three focus groups with a convenience sample of 16 nurses experienced in conducting sex and relationship education were conducted during 2006. Focus groups were audio-taped, transcribed verbatim and subjected to a thematic analysis. FINDINGS: Four themes were identified in the data: 'covert surveillance' refers to school staff conducting clandestine surveillance of the classroom actions of the nurse; 'overt surveillance' reflects how nurses felt they were being openly monitored by teachers in the classroom; 'Teacher attitude' refers to the interventions of the supervising teacher in the classroom during the sex education session and 'resistance practices' detailed how nurses attempted to manage the disciplinary practices of the school. CONCLUSION: School nurses need to be pragmatic about the fact that there will be some attempts by the school to regulate sex education. Developing an early dialogue with the school can mediate this. Closer working practices and the involvement of school nurses in the development of sex education policy and practice is vital to ensure that they continue to make a valuable contribution to sex education in schools.

Development of a school nursing research agenda in Florida: a Delphi study.

Research is important to the image, visibility, and viability of school nursing. Each state school nursing association should evaluate member commitment to school nursing research based on their unique set of financial, educational, and organizational resources. A 3-round Delphi study was conducted in which Florida school nurses identified research priorities. The 10 priority research topics were (a) obesity/nutrition, (b) role of the school nurse, (c) legal/ethical issues, (d) emergencies, (e) health education, (f) absenteeism/attendance, (g) diabetes and insulin, (h) injuries, (i) health services, and (j) asthma. These topics form the state research agenda and will be used to guide the development of multisite school nursing studies.

Data integrity: backup.

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.