Recognizing the need for a school nurse workload model based on more than the number of students in a caseload, the National Association of School Nurses issued recommendations related to measuring school nurse workload. Next, a workforce acuity task force (WATF) was charged with identifying the steps needed to further the recommendations. As a first step, the WATF focused on identifying existing literature and practices related to school nurse workload. The purpose of this article is to synthesize and categorize the factors that were identified, delineate sources for collecting and retrieving these factors, and make recommendations for clinicians and researchers interested in developing instruments to measure school nurse workload.

Previous research regarding burnout in acute care settings revealed that positive work environments increase job satisfaction, decrease staff turnover, and improve patient outcomes. However, few studies address burnout among school nurses. The purpose of this study was to describe the relationship between the school nurse practice environment, school nurses’ levels of burnout, and perceived sources of work stress. A cross-sectional sample of 100 registered nurses completed a web-based version of the Maslach Burnout Inventory and Areas of Worklife Survey. Identified stressors were entered into regression models to determine associations with levels of burnout. Burnout is significantly associated with all Areas of Worklife subscales. School nurses who reported satisfactory work environments experienced little to no burnout. This study provides insights into the domains of work that can cause burnout among school nurses and provides evidence that can inform school leadership and policy makers on ways to promote healthy work environments.

Many school districts rely on caseload or student to school nurse ratios that are not grounded in evidence-based research. There is a need for a comprehensive workload instrument to describe the work of school nurses that incorporates the complexities of the role and includes acuity, care processes, and social determinants of health. The purpose of this qualitative study was to identify workload activities from a previous Delphi study that can be empirically measured as items for a workload instrument. A nationally representative sample of 27 school nurses participated in four focus groups, describing activities important to the measurement of workload. Focus group input resulted in identification and confirmation of workload activities that impact school nurse workload. Use of the National Association of School Nurses’ Framework for 21st Century School Nursing Practice™ was integral in capturing gaps and important workload activities for a potential workload instrument.

The increasing prevalence of chronic health conditions (CHCs) in school-aged children highlights the need to better understand school health services’ role regarding CHCs. Using U.S. nationally representative district-level data from the 2016 School Health Policies and Practices Study, we examined whether having policies on school nurses’ employment was associated with having policies on CHCs and whether having such policies varied by geographic location. Compared to districts without such employment policies, districts with such policies (52.3%) were significantly more likely to have CHC management policies. For each CHC policy examined, more than 20% of school districts did not have the CHC policy, with Northeast districts having the greatest proportion of such policies and West districts having the least. Thus, many students’ CHC needs may not be met at school. It is important for school nurses to play a key role in advocating for the development of school-based policies on CHCs.

ObjectivesThe objectives of this systematic review of literature include: (a) describe the intervention strategies; (b) examine the outcomes as they pertain to the child (individual level), families (interpersonal level), and community or culture (organizational level); and (c) develop a foundation of interventional approaches that specifically target obesogenic behaviors in Hispanic preschool‐aged children.DesignA systematic review of literature was performed. The theoretical framework was the Socioecological Model.SampleTwenty‐four total articles were used for this review.MeasurementsThe method used was the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines.ResultsOf the 24 studies reviewed, 36% focused on the individual, 56% were interpersonal (focused on parents), and 9% focused on the organizational level.ConclusionInterventions that are culturally competent, directed at families, and include healthy dietary intake along with a physical activity component are most effective at lowering obesity in Hispanic preschool children.

During May we celebrate School Nursing Day. We are often asked—What does a school nurse do? This article is a response to a recently asked request and describes the role of the school nurse in the 21st century, working in one school. The description is not meant to be all inclusive—but rather give examples of the complex role and need for a school nurse.

Background: More than 20% of school districts in the United States do not have policies on identification and case management for students with chronic health conditions (CHCs), suggesting that these students’ health needs may not be met during the school day. Prior research reports a gap in policy implementation and the actual provision or operationalization of the policy into action. Significance: While there is limited research on school health policies, little is known about the actual provision of the services that such policies indicate should be provided. Notably, the actual provision of health services in U.S. schools, particularly regarding CHC management and its association with school nurse employment, is underreported. Methodology: Using data from the 2018 School Health Profiles (SHP) Survey, health services including administering daily medication, providing stock rescue medication, providing case management, facilitating community partnering, and providing disease-specific education were examined in California public secondary schools together with school nurse employment. Complex sampling analysis and chi-square statistics were used to examine the statistical associations. Results: A significantly greater proportion of schools with a full- or part-time nurse compared with schools with no nurse provided: (1) daily medication administration (82.1% vs. 68.1%; p = .014); (2) case management services (75.8% vs. 62.0%; p = .031); (3) disease-specific education for parents and families (44.9% vs. 25.7%; p = .016); and (4) parent and student connection to health services in the community (83.7% vs. 72.2%; p = .035). Conclusion: Findings suggest that nationally representative data, such as SHP, contain important information for states to review regarding school health policies and provision of services. Further research needs to expand these findings to better understand school health policy and practice and its alignment with state and federal laws to support all children, especially those with CHCs.

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