Factors associated with continuing education needs in medication administration among school nurses.

AIM: To investigate the continuing education requirements and factors influencing school nurses' needs in relation to medication administration on school campuses. DESIGN: A total of 391 school nurses working in K-12 schools in Taiwan were invited to participate in an online questionnaire survey. METHODS: This cross-sectional study employed a probability proportionate to size technique along with a random sampling method. Data were collected from February to April 2023. RESULTS: School nurses reported a significant demand for continuing education and perceived moderate levels of stress and government support related to medication administration. Among the various dimensions, the highest demand was observed for 'definition of campus medication errors' and 'regulations for campus medical orders.' Moreover, the 'identifying drug interactions' and 'adverse drug effects and referrals' dimensions were identified as the most stressful aspects. Notably, perceived stress emerged as the sole predictive factor for continuing education demand, accounting for 16.1% of the variance. CONCLUSIONS: The study found that there was a significant demand for and moderate stress related to continuing education among school nurses. Therefore, it is crucial for the government and school nursing organizations to develop targeted programs focusing on medication administration. These initiatives should be designed to enhance nurses' capabilities and reduce their stress, thereby ensuring safe medication administration on campuses. IMPACT: Continuing education enables school nurses to acquire up-to-date knowledge and improve the workflow in their practice. This study highlights a strong need for education in medication administration with a focus on 'campus medication error definitions' and 'campus medical order regulations.' The government and relevant school nursing organizations should prioritize the development and implementation of continuing education programs to decrease the school nurses' stress related to medication administration. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. REPORTING METHOD: This study adhered to the relevant cross-sectional EQUATOR STROBE guidelines.

Empowering School Nurses: Enhancing Child Trafficking Awareness and Preparedness in American Public Schools.

Child trafficking poses a momentous public health threat to students in public schools. Although school nurses are exceptionally positioned to identify and respond to trafficking, most lack training and resources in this critical area. This project aimed to evaluate the impact of a multifaceted intervention on school nurse preparedness and practices related to child trafficking in an Oklahoma public school district. The project involved Unbound Now's nationally accredited training program for school nurses, implementation of the Fuentes et al.'s Toolkit for Building a Human Trafficking School Safety Protocol (HTSSP) funded by the U.S. Department of Health and Human Services, and facilitation of a roundtable discussion to initiate community collaboration. The results of the pretraining Fraley and Aronowitz School Nurses' Awareness and Perceptions Survey (SNAPS) illuminated variations in school nurses' knowledge and awareness of child trafficking, demonstrating the need for continued training. Post-training evaluations exhibited highly positive feedback, suggesting its effectiveness in meeting the training's objectives. Following the community stakeholder roundtable, the lead school nurse employed the HTSSP toolkit and directed efforts in successfully constructing and implementing a district-wide policy of procedures to respond to suspected cases of human trafficking. However, the project's limitations include a small sample and a single-school district focus. Despite these limitations, this project delivers valuable insights into the challenges and opportunities for enhancing school nurse preparedness in addressing trafficking. This project serves as a foundation for future initiatives to improve students' safety and wellbeing in public schools.

In Search of Evidence: A Scoping Review of School Nurse Leadership Training Programs.

This scoping review explores leadership training opportunities for school nurses. The review was conducted to inform the development of a new leadership training program for school nurses in Massachusetts. A search conducted across four databases (PubMed, CINAHL, ERIC, and Web of Science) yielded four articles meeting the search criteria published between 1993 and 2007, and no articles meeting the criteria after 2007. The four articles that were found discussed the approaches and evaluation methods of school nurse leadership training programs. They revealed varying training structures and evaluation approaches and covered a wide range of leadership competencies. Importantly, all of the programs reported enhancements in participants' leadership knowledge and practice upon completion of the training program. This review highlights the necessity of documenting and disseminating program outcomes in peer-reviewed literature to guide the development of new initiatives and recommends adopting standardized evaluation frameworks.

The Role of the School Nurse in E-Cigarette Prevention and Cessation: A Scoping Review.

E-cigarettes have rapidly gained popularity among youth in recent years. This scoping review identifies opportunities for school nurses to incorporate e-cigarette prevention strategies into their practice and identifies gaps for future research in school nursing evidence-based practice. Using the methodological framework developed by Arksey and O'Malley and advanced by Levac et al., a literature review was conducted using PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), and Education Resources Information Center (ERIC) databases. A total of 15 articles were included in the final review. Articles for inclusion addressed interventions aimed at reducing e-cigarette use in K-12 schools. The results highlight two general types of school-based interventions: (1) universal e-cigarette prevention education and (2) targeted e-cigarette use-cessation programs. Each of these types of interventions presents a leadership opportunity for school nurses to engage within all domains of their scope of practice.

Listening to School Nurses' Voices: A Mixed Methods Study on the Continued Impact of COVID-19 on School Nursing Practice.

School closures in March 2020 due to the COVID-19 pandemic precipitated losses of critical student resources as physical, mental, emotional, and social needs escalated. Identifying the challenges, strategies, and changes in school nurse (SN) practice in Massachusetts during this pandemic is fundamental to understanding how to manage future anticipated pandemics while protecting children, communities, and SNs. The purpose of this mixed-methods descriptive study in the second year of the global pandemic was to (a) listen to SN voices through a novel online survey including the prompts of challenges, strategies, and practice changes and (b) describe the SN experience of COVID-19 response in Massachusetts schools, including identification of intent to leave school nursing. Responses were analyzed using descriptive qualitative analysis (n = 73). The prompts each elicited subthemes that coalesced to a cohesive theme: Finding one's way required the support of others to pave untraversed roads.

Period Product Resources and Needs in Missouri Schools: Focus Group Discussions with School Nurses.

This study explored period product resources and needs in Missouri schools from the perspective of school nurses. We conducted eight focus groups with school nurses (n = 51) across Missouri using purposive sampling. Focus group data were analyzed in Dedoose via multiple coders and achieved strong inter-rater reliability (Cohen's Kappa = 0.92). Several interconnected themes with associated sub-themes were identified. First, school nurses do not have sufficient resources to help students manage menstruation and minimize menstruation-related absenteeism. Second, schools' heavy reliance on donations can lead to inconsistencies in supply and a mismatch between what is donated and what is most needed. Third, school nurses desire additional educational resources around menstruation management for students and caregivers. Nurse-identified themes can help inform recommendations for improving schools' response to students' menstrual hygiene needs by highlighting priorities for educational content, resources, and product acquisition with a goal of ensuring the suitability and sustainability of MHM in schools.

School nurses' experience of communicating growth data and weight development to parents of children 8 and 10 years of age.

INTRODUCTION: The prevalence of overweight and obesity among children has risen sharply during recent decades. School nurses are key health professionals in interventions targeting the early onset of overweight and obesity during childhood. Understanding how school nurses experience communication with parents concerning their child´s growth and weight development are essential. The aim of the study is to describe school nurses' experience of communicating growth data and weight development to parents of school children ages 8 and 10 years. METHOD: The design of the study is a descriptive, qualitative design with purposive and snowball sampling. Sixteen interviews with school nurses were conducted and analysed with qualitative content analysis. RESULT: The analysis resulted in three main categories including subcategories. In Challenges in the professional role, the school nurses expressed a lack of knowledge, skills and tools in communication, described a perception of parental responsibility and stated using several different approaches in communicating growth data and weight development to parents. In Sustainable communication with parents, the school nurses described the value of creating a dialogue, a supportive approach to the parents, and the building of a relation between them and the parents as essential. In Barriers in communicating the child´s weight, the school nurses described the experience of stigma concerning the subject of overweight and obesity, increased concern when they detected underweight as well as an ambivalence towards measuring weight. CONCLUSION: The study highlights an educational challenge concerning the need for training, skills, and strategies for communication with parents. A variety of ways in school nurses' communication with parents were identified in the present study and this shows an inconsistency in how School health services was offered and a need for the development of evidence-based procedures for communicating growth data and weight development to parents.

A qualitative study of school nurses' moral distress related to COVID-19.

OBJECTIVE: To understand school nurses' perceptions and experiences of moral distress related to COVID-19 case management in the school systems. DESIGN: A descriptive qualitative study guided by Braun and Clarke's reflexive thematic analysis. SAMPLE: Twelve school nurses practicing in Colorado from December 2021 to January 2022. MEASUREMENTS: Semi-structured interviews about school nurses' experiences of COVID-19. Investigators utilized an iterative reflexive thematic analysis process engaging the participants' and researchers' subjective experiences. RESULTS: Four themes were created: (1) keeping kids and the community safe, (2) caught in the middle of the "tug of war" between health and politics, (3) distress amid an ocean of COVID-19 uncertainty, and (4) visibility as a bright spot shining through the COVID-19 cloud. CONCLUSIONS: Two research questions examined school nurses' experiences of moral distress and their role and scope of practice that affected their relationships in the educational and public health systems. The results of this study confirm the important role of school nurses and interprofessional case management in school environments in the fight against infectious diseases and pandemics. Building stronger relationships between school nurses and public health is imperative for future collaborative and cohesive public health responses to pandemics.

Schools and Wastewater Surveillance: Practical Implications for an Emerging Technology to Impact Child Health.

Since the start of the COVID-19 pandemic, wastewater surveillance has emerged as a public health tool that supplements traditional surveillance methods used to detect the prevalence of the SARS-CoV-2 virus in communities. In May 2020, the Houston Health Department (HHD) partnered with a coalition of municipal and academic partners to develop a wastewater monitoring and reporting system for the city of Houston, Texas. The HHD subsequently launched a program to conduct targeted wastewater sampling at 52 school sites located in a large, urban school district in Houston. Data generated by this program are shared with school district officials and nurses from participating schools. Although initial feedback from these stakeholders indicated that they considered the wastewater data valuable, the emergency nature of the pandemic prevented a systematic evaluation of the program. To address this gap in knowledge, the HHD and Rice University conducted a study to determine how wastewater data are used to make decisions about COVID-19 prevention and mitigation practices in schools. Our findings indicate that maximizing the utility of wastewater data in the school context will require the development of communication strategies and education efforts tailored to the needs of specific audiences and improving collaboration between local health departments, school districts, and school nurses.

Effectiveness of Virtual Resilience Training on Assertiveness in Student Girls Aged 9-10 Years: A 1-Month Follow-Up.

Girls between the ages of 9 and 10 begin to experience physical, physiological, and hormonal changes that may lead to internal stress. At this age, children are struggling for autonomy; on the other hand, they may experience emotional instability, and for these reasons, they may be vulnerable in many ways. This experimental study aimed to investigate the effect of resilience training on assertiveness in student girls aged 9-10. Data were collected before, immediately after, and 1 month after the intervention in the control (n = 40) and intervention (n = 37) groups. There was a significant difference between the assertiveness of the intervention immediately (26.80 ± 3.73) and 1 month after the intervention (27.05 ± 3.73), and assertiveness significantly increased in the intervention group (p = .0001). Resilience training leads to improvements in assertiveness in student girls aged 9-10.

Parents' Experiences of Communication With School Nurses About Their Child's Weight Development in Sweden.

This study aimed to describe parents' experiences of communication with school nurses concerning the growth data and weight development of their children aged 8 and 10 years old in Sweden. Eighteen interviews with parents were conducted and analyzed through qualitative content analysis. The result showed a need for improved dialogue where the parents viewed the health visit's purpose as unclear and lacked feedback. The parents desired access to their child's growth data and described the need for an improved channel for receiving information. The parents moreover experienced the lack of a child-centered perspective, described the child's context as not in focus, and desired collaboration around their child. This study shows the need for the development of evidence-based methods for communicating growth data and weight development between School Health Service (SHS) and parents, as well as the need for a reformed SHS perspective towards parents and children.

Burnout and Mental Health and Well-Being of School Nurses After the First Wave of the COVID-19 Pandemic: A National Cross-Sectional Survey.

The aim of this study was to examine the associations between job stressors, COVID-19-related concerns, burnout, and mental health and well-being among school nurses, and whether any of these associations are mediated by burnout. Based on stratified proportional sampling, data collection was conducted by an online questionnaire distributed to 600 school nurses in Taiwan. A total of 256 participants aged between 27 and 62 years (mean = 47.08; standard deviation = 7.28) returned questionnaires. Results showed that burnout was the main mediating variable that fully mediated the relationship between COVID-19-related concerns and mental health and well-being. The effects of job stressors on mental health and well-being included direct negative effects (ß = -.29) and indirect negative effects (ß = -.67) through mediating factors. School health managers should be more aware of burnout and mental health and well-being among school nurses under the impact of COVID-19.

School-Based Hemorrhage Control Training.

The number one cause of preventable death in trauma is uncontrolled bleeding. Considering the burden of injury and fatality from motor vehicle collisions, accidental injury, and now increasing school shooting incidents, more should be done to prepare and protect students from this preventable cause of death. A school-based hemorrhage control training program is one approach to improve survivability, school preparedness, injury prevention strategies, and to increase access to this life-saving training. As advocates and health educators, school nurses can play an important role in developing strategies to coordinate and implement hemorrhage control training curricula giving our youth the greatest chance for survival. To maximize the impact of school-based hemorrhage control training this project aims to understand student and faculty perceptions to help direct and inform future implementation and dissemination of hemorrhage control training.

School Nurses' Experiences and Needs in COVID-19 Pandemic Response: A Qualitative Study.

The coronavirus disease 2019 pandemic drastically shifted the public health burden onto the school health system. We, therefore, explored the school nurses' experiences and needs for confronting the pandemic in school settings across Korea. This qualitative investigation enrolled 30 participants after their written consent. A written interview conducted through email and focus group interviews using an online meeting application verified participants' opinions and experiences. Collected data were subjected to text-mining and content analysis. The school nurse was found to be responsible for many tasks, including education on preventive measures with unclear quarantine guidelines. Content analysis identified three key themes: "aggravated difficulties owing to lack of support resulted in burnout," "reflection on supportive resources; direct provisions were helpful," and "needs and suggestions to safeguard students' health in the event of another pandemic." Recommendations should all be considered to keep schools and students safe from future pandemics.

Facilitators and Barriers to Implementing COVID-19 Prevention Strategies in K-12 Public Schools.

To meet the educational needs of students, most schools in the United States (U.S.) reopened for in-person instruction during the 2021-2022 school year implementing a wide range of COVID-19 prevention strategies (e.g., mask requirements). To date, there have been limited studies examining facilitators and barriers to implementing each of the recommended COVID-19 prevention strategies in schools. Twenty-one semistructured interviews were conducted with public school staff from across the U.S. responsible for overseeing prevention strategy implementation. MAXQDA was used for thematic analysis. Findings identified key facilitators including utilizing Centers for Disease Control and Prevention guidance and district policies to guide decision-making at the school level, possessing financial resources to purchase supplies, identifying key staff for implementation, and having school health services infrastructure in place. Key barriers included staff shortages, limited resources, and community opposition. Findings from this study provide important insight into how schools can prepare for future public health emergencies.

Adaptation and Validation of the Korean Version of the Scope of School Nursing Practice Tool.

The scope of the school nursing practice tool (SSNPT) is needed to apply and explore the gap between what school nurses perceive as important and actual practices. This study adapted and validated the Korean version of SSNPT (K-SSNPT) among 360 Korean school nurses in January 2022. The reliable and valid K-SSNPT can inform school nurses' workforce policies by capturing the current scope of school nursing practice and setting priorities for improving school health in South Korea.

Effects of the COVID 19 Pandemic on School Nurses' Resiliency and Ability to Cope: A Mixed Methods Study in the State of Hawaii.

This mixed-method study examined school nurses' experiences during the Coronavirus Disease 2019 pandemic related to role change, psychological feelings, and coping/resiliency in the State of Hawaii. A total of 30 school nurses completed a Brief Resilience Coping Scale plus a series of open-ended questions in January 2022. On the coping scale, over 40% of participants scored high, 52% scored medium, and 7% scored a low resilient/coping level. We did not identify any association between coping level and participant characteristics. Three qualitative themes emerged: 1) school nurses experience chronic negative emotions related to the pandemic, 2) school nurses demonstrate attributes of resilience, and 3) school nurses utilize positive coping techniques. The pandemic created significant stresses and negative emotions among school nurses. Yet, school nurses reported effective coping strategies and demonstrated strength/resilience. Support and open communication between school nurses, their employers, and other school-based stakeholders is needed to provide continued support for school nurses.

Physical Activity on Prescription "Not a Quick Fix": School Nurses' Experiences of Promoting and Tailoring Physical Activity to Children in Swedish Compulsory School.

This study aimed to explore school nurses' experience of using physical activity on prescription with children in Swedish compulsory school. Semistructured interviews were conducted with 24 school nurses who had the educational qualification to prescribe physical activity. The analysis resulted in one overarching theme, "A delicate process of tailoring physical activity on prescription to a child's social context," and two categories: "Promoting joyful physical activity through individualization and support" and "Dealing with dilemmas and challenges," with related subcategories. The results demonstrate the importance of tailoring prescribed physical activity to each individual child, their living conditions, and the school context. In addition, they highlight the nurses' working conditions and collaborations as important prerequisites when initiating physical activity on prescription. In conclusion, the results suggest that school nurses perceive physical activity on prescription as a useful tool in the school context, but it needs to be tailored to each individual child.

Implementation of Concussion Management Policies in High Schools: The Critical Role of School Nurses.

Evidence-based practices in concussion management (CM) have been codified into legislation. However, legislation is varied, and implementation is narrowly evaluated. School nurses hold a unique position to assess the implementation of health policies. The implementation of concussion management policies across Massachusetts high schools was evaluated by the school nurse. A cross-sectional survey was sent to school nurses (N = 304), and responses (n = 201; 68.1% response rate) were tallied whereby higher scores indicated more practices being implemented. One open-text question was included to encourage nurses to provide context regarding implementation in their school. Descriptive statistics and thematic analysis were used to assess current implementation and nursing perspectives. Findings indicate that the degree of implementation varies, and some nurses reported difficulty with mobilizing clinical uptake of concussion management practices in their schools. Further implementation research is needed, and school nurses are an important stakeholder to include when assessing the clinical uptake of concussion management policies in schools.

School Nurses' Experiences With Health Dialogues: A Swedish Case.

The aim of this study was to describe school nurses' experiences with health dialogues and elicit their thoughts about how schools can reach the full potential in promoting students' health literacy and learning. The phenomenological analysis resulted in four themes: (i) A golden opportunity…or not, (ii) Like a double-edged sword, (iii) Able or unable organizations, and (iv) Visions of good conditions for health and learning. School nurses' experiences revealed that health dialogues are beneficial and can be valuable tools in promoting health and learning when (1) the health dialogues are an important part of the educational assignment, (2) school nurses are valued for fulfilling the educational assignment, and their work conditions are reasonable, (3) the results from the health dialogues and health questionnaires are used systematically to promote health and learning, (4) a "whole-school approach" is used to build enabling relationships among all school staff and students.