School Nurse Workload

Abstract

The purpose of this scoping review was to survey the most recent (5 years) acute care, community health, and mental health nursing workload literature to understand themes and research avenues that may be applicable to school nursing workload research. The search for empirical and nonempirical literature was conducted using search engines such as Google Scholar, PubMed, CINAHL, and Medline. Twenty-nine empirical studies and nine nonempirical articles were selected for inclusion. Themes that emerged consistent with school nurse practice include patient classification systems, environmental factors, assistive personnel, missed nursing care, and nurse satisfaction. School nursing is a public health discipline and population studies are an inherent research priority but may overlook workload variables at the clinical level. School nurses need a consistent method of population assessment, as well as evaluation of appropriate use of assistive personnel and school environment factors. Assessment of tasks not directly related to student care and professional development must also be considered in total workload.

Factors Related to School Nurse Workload

“…There was also a recognition that community-based nurses spend a significant amount of time in procedural work, care planning, and traveling (Jackson et al, 2015), factors that were not as central to tools used in acute care settings. Endsley (2017) found in a review of acute care, community health and public health workload literature that there were five themes including patient indicators, the role of assistive staff, environmental factors, missed nursing care, and nurse satisfaction.…”

School Nurse Perspectives on Collaboration With Primary Care Providers

“…They perceived that this overly restrictive interpretation of HIPAA leads to prohibitive administrative processes, such as practice-specific consent forms, that tax an already inefficient paper-based system stretched thin by insufficient personnel and increased work demands. 6 As highlighted in prior work, additional potential contributors to information sharing inefficiencies include health system apprehension about linkages with potentially less secure data systems in other sectors, lack of interoperability between health and education information systems, and the tendency of attorneys to advise conservatively when faced with ambiguous health care laws. 5 Poor understanding of school nurse roles among the larger health care sector and PCPs, including failure to conceive of and integrate school nurses as part of the health care team, compounds this issue.…”

“…1,3 However, school nurses are rarely integrated into primary care teams to their full potential, 1,3-5 limited by large caseloads, inadequate staffing, administrative burden, and barriers to effective communication with PCPs. [6][7][8][9][10][11][12][13] School nurse engagement in primary care can be cost-effective, 14 lead to improved health and academic outcomes, 15,16 and advance health equity by improving access to care for students with barriers to care in traditional settings. 5,17 Incorporating school nurses into collaborative care teams with PCPs may be especially beneficial in improving management and outcomes of chronic physical and mental health conditions.…”

School Nurses and Student Academic Outcomes: An Integrative Review

“…Johnson and colleagues (2017) have suggested uniform data points for school nurses to collect appropriate data to measure their work. An important variable to measure is school nurse workload, which is much more than school nurse to student ratios (Combe et al, 2015;Dolatowski et al, 2015;Endsley, 2017) and includes student health and achievement, social determinants of health, staffing mix, and indirect activities. Finally, the impact of school nursing on longitudinal academic outcomes is critical because one proposed mechanism for school nurse impact on academic outcomes is through reducing absenteeism.…”