School nurses intervene with students, parents, and school staff to advance the health and academic success of students. We conducted an integrative literature review of published research to describe the types of school nurse interventions and health and education outcome measures and to examine how school nurse interventions were linked to student outcomes. Sixty-five studies met the inclusion criteria. We used the National Association of School Nurses' Framework for 21st Century School Nursing Practice to categorize school nurse interventions and health and education outcome measures. The majority of interventions were categorized under the care coordination principle, most commonly, motivational interviewing and counseling. In 17 studies, school nurse interventions were linked to improved student outcomes. Most studies (80%) were descriptive. To advance school nursing science, researchers can build on this foundation with more rigorous research methods to evaluate the impact of school nurse interventions and activities on student health and education outcomes.

Faculty and practitioners who use the competencies value them, and rarely discontinued their use after adoption. Efforts to promote diffusion among faculty and especially practitioners need to continue. Professional organizations can actively provide and share examples of useable formats and best practices associated with the competencies.

Background Determination of adequate school nurse staffing is a complex process. School nurse‐to‐student ratios and the health services school nurses provide to students should be considered. The purpose of this study was to examine the impact of North Carolina school nurse‐to‐student ratios and school nurse health services on the health and education outcomes (eg, absences, grades, self‐management) of students receiving services for asthma and diabetes. Methods This study of all 115 school districts in North Carolina used the Annual School Health Services Report Survey from 2011 to 2016. Descriptive statistics for health services, programs and outcomes, and generalized linear modeling were used to estimate the association of ratios and health services with asthma and diabetes outcomes. Results By the 2015‐2016 school year, the average ratio decreased to 1:1086 in North Carolina public schools. Annually, 100,187 students received services for asthma, 3832 students received services for type 1 diabetes, and 913 students received services for type 2 diabetes. Lower ratios and nurse health services were associated with improved student outcomes, including decreased absences (p = .05), improved grades (p = .05), and student self‐management of their health condition (p = .05). Conclusions Lower school nurse‐to‐student ratios and services were associated with improvements in students' health and education outcomes.

School nurses are instrumental in delivering health services to children in schools. This study addresses the gap in school nurse health services data, examining patterns in health services and programs provided by school nurses between 2006 and 2016 for students in North Carolina public schools. This study focused on services and programs related to asthma and diabetes, two health conditions that affect millions of children in the United States. Over 1.46 million children attend North Carolina public schools. In 2006, the average school nurse-to-student ratio was 1:1,340. By 2016, the average school nurse-to-student ratio decreased to 1:1,086, a 19% improvement. Over the 10-year study time period, there were statistically significant increases in the rate of occurrence of all health conditions that students received health services for ( p < .001), asthma ( p < .001), type I diabetes ( p = .0003), orders for all health-care procedures ( p = .01), all school nurse–led health counseling ( p = .004), and diabetes health counseling ( p < .01).

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Sister Kenny made bold assertions, obtained scientific validation, learned from experience, used publicity, and opposed resistance. Although some strategies were unsuccessful (and Kenny faced many obstacles) medical practice changed in a relatively short time. Immobilization of limbs was largely discontinued in the acute stage of the disease. Kenny persisted in caring for children who otherwise might have sustained deformities.

Background: Antibiotic overprescribing for acute respiratory tract infections (ARTIs) commonly occurs and can lead to higher medical costs, antibiotic resistance, and health complications. Inappropriate prescribing of antibiotics for ARTIs has been shown to occur more frequently in urgent care than other outpatient settings. It is not clear whether antibiotic overprescribing varies between virtual and in-person urgent care.Objectives: Summarize published primary scientific literature on antibiotic prescribing patterns for ARTIs among adults in virtual urgent care settings. Data sources:We conducted a systematic review to compare antibiotic prescribing for ARTIs between virtual and inperson urgent care. Our review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. We assessed risk of bias using the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) assessment tool. We summarized study results from seven included retrospective cohort studies.Conclusions: Antibiotic prescribing frequency may be similar between virtual urgent care and in-person care for adult patients treated for ARTIs. However, variability existed in intervention characteristics, settings, and outcome measures. Additional studies are needed to better understand the conditions in which virtual care may be most effective.Implications for practice: Evidence suggests that giving providers direct access to evidence-based guidelines and electronic health records within the virtual visit may support diagnosis and management. Furthermore, practices that use telemedicine platforms for virtual urgent care visits should consider how to potentially improve diagnosis and management of conditions through the use of home-based point-of-care testing or accessory "e-tools."

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