School Nurses' Experiences and Roles in Promoting and Administering the HPV Vaccine: A Systematic Review Using the Socioecological Framework.

Understanding the school nurse's experience in human papillomavirus (HPV) vaccine promotion can reduce vaccine disparities. HPV vaccination is critical to cancer prevention. Despite the importance of the school nurse in vaccine promotion, there is a lack of understanding. This article aims to examine the knowledge, attitude, experience, and role of school nurses related to HPV vaccination and promotion in school settings. A systematic search for school nurses and their experiences related to HPV vaccination was conducted. A thematic synthesis was undertaken using the socioecological model. This review highlights the complexity of HPV vaccine promotion in schools over time. Multilevel factors impact nursing practice. Nurses have good vaccine knowledge and positive attitudes. Poor workflow processes, competing demands, and vaccine communication challenge school nurses. The themes that were synthesized informed the LEADS model. With the support of school nurses, reaching the goal of eliminating cervical cancer as a public health problem is possible.

Moving the Needle: A Qualitative Exploration of the School Nurses' Experience with Virginia's Human Papillomavirus Mandate.

In all US localities, students provide proof of compliance with vaccination requirements to attend school. Despite benefits, vaccine legislation remains contentious. The human papillomavirus (HPV) vaccine is recommended for adolescents and prevents cancer, but its inclusion in school immunization requirements is challenged. Virginia was the first state to mandate HPV vaccination. HPV is the only required vaccine in VA that allows caregivers to elect out. School nurses are trusted members of communities and enforce vaccine compliance. This study aims to understand Virginia school nurses' practice in implementing the HPV vaccine mandate through the exploration of their subjective experiences. Semi-structured interviews were conducted. Thematic analysis using the socioecological model guided data analysis. Factors that influence nursing practice were identified at all socioecological model levels The data from this study is intended to provide an understanding of school nursing practice so that interventions to improve HPV vaccination rates can be developed.

A Multilevel Analysis of School-Level Human Papillomavirus Vaccination Coverage in Virginia.

School nurses improve public health through vaccine promotion and mandate compliance. Despite recommendations and support for comprehensive adolescent HPV vaccination from organizations like the National Association of School Nurses as of 2023 only Virginia, Washington DC, Rhode Island, and Hawaii mandate HPV vaccine in schools. Virginia's mandate allows caregivers to opt out of vaccination. It is important to consider how school-level vaccine compliance is associated with school and community factors. A multilevel analysis explored the association between school and county-level factors and HPV vaccination rates. This study shows schools that report higher rates of economically disadvantaged students had higher HPV vaccine coverage. HPV vaccine rates increased from 2019 to 2021 after the implementation of a gender-inclusive mandate. Virginia HPV rates still lag behind states with no mandate. The results suggest that school nursing practice related to HPV vaccine compliance may be impacted by community factors like economic status.

The Role of School Health Services in Addressing the Needs of Students With Chronic Health Conditions.

Children and adolescents in the United States spend many hours in school. Students with chronic health conditions (CHCs) may face lower academic achievement, increased disability, fewer job opportunities, and limited community interactions as they enter adulthood. School health services provide safe and effective management of CHCs, often for students with limited access to health care. A systematic review to assess the role of school health services in addressing CHCs among students in Grades K-12 was completed using primary, peer-reviewed literature published from 2000 to 2015, on selected conditions: asthma, food allergies, diabetes, seizure disorders, and poor oral health. Thirty-nine articles met the inclusion criteria and results were synthesized; however, 38 were on asthma. Direct access to school nursing and other health services, as well as disease-specific education, improved health and academic outcomes among students with CHCs. Future research needs to include standardized definitions and data collection methods for students with CHCs.

Prevalence and Costs of Five Chronic Conditions in Children.

The objective is to examine the prevalence and health-care costs associated with asthma, epilepsy, hypertension, food allergies, and diabetes in children aged 0-18 years. Prevalence was calculated using 2005-2012 Medical Expenditure Panel Survey (MEPS) data, a population-based, nationally representative sample. Using MEPS, two-part models estimated the cost of each condition for all children while controlling for sociodemographic categories. Prevalence rates varied by race and ethnicity across conditions. Females had higher prevalence of all chronic conditions, except epilepsy. An additional US$1,377.60-US$9,059.49 annually were spent on medical expenses for children aged 0-18 years, with asthma, diabetes, or epilepsy compared to children without these conditions. This is the first study to examine the costs and prevalence of chronic health conditions in children and adolescents using a single data set. Understanding the odds of having a condition by sociodemographic categories highlights disparities that can potentially inform school nurses on the best allocation of resources to serve students.

Preparing for a School-Located COVID-19 Vaccination Clinic.

School-located vaccination events (SLVE) have a long history in the United States and have successfully contributed to lower morbidity and mortality due to vaccine-preventable diseases. The school is an ideal place to reach children from all cultures, socioeconomic groups, and age-groups and is conveniently situated in communities for ease of accessibility for students, parents, and staff alike. School nurses play an important role in planning for SLVE and are ideally positioned to initiate this process and provide accurate information, dispelling myths about vaccines. Because school nurses are considered a trusted source of health information by the school community, they can provide valuable education on the impact of vaccination on student and staff attendance. Conducting a successful SLVE requires research, planning, and partnerships, and these partnerships are needed both within the school setting and outside this setting, within the community at large. The proliferation of the current COVID-19 pandemic and the subsequent vaccine production has caused school nurses to take the lead in preparing for mass vaccination clinics in order to help mitigate this serious public health threat. This manuscript describes the process a group of school nurses used to develop SLVE plans in response to a pandemic.

A New Framework for School Nurse Self-Reflection and Evaluation.

The purpose of this article is to demonstrate how the Framework for 21st Century School Nursing Practice™ can provide a structure for evaluation using the School Nursing: Scope and Standards of Practice (3rd ed.), thus allowing the school nurse and school nurse evaluators to gain a better understanding of school nursing practice. According to NASN's Position Statement Supervision and Evaluation of the School Nurse, standards should be used to evaluate the clinical practice of school nurses. Our project accomplishes this integration of the Framework, the standards, and the evaluation of school nursing practice.

School Nursing Protocol for the Management of Human Bites.

Human biting is considered a common stage in pediatric infant growth and development. However, this stage is not considered appropriate once children enter group daycare and school settings, and such behavior can lead to injury, stress, and trauma for other students and staff. When biting occurs in the school setting, staff are often unprepared to respond appropriately, and may seek delayed care, if at all. The school nurse may also be ill-equipped to provide first aid and education if there are no standardized guidelines to follow. Having a protocol in place for human bite incidents in the school setting helps school nurses provide information to students, parents, and staff in a timely manner and assists them with following evidence-based practice. Accurate documentation of the incidents also allows school nurses to identify triggers and knowledge deficits, which can assist them in planning educational interventions and training in the school setting.