School Nurses Matter: Relationship Between School Nurse Employment Policies and Chronic Health Condition Policies in U.S. School Districts

Abstract

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.

School Nurses as Vital Members of 504 and Individualized Educational Program Teams: Do District-Level Policies Make a Difference in School Nurses’ Involvement?

“…School districts in the Northeast were more likely to have policies on maintaining such teams than districts in other U.S. regions, with the West region being the least likely to have such policies. Consistent with our findings, investigators have reported that the West region of the United States has the lowest proportion of various school policies (Demissie & Brener, 2017; Jones et al., 2019; McCabe et al., 2020). The reasons for such regional variation need additional research.…”

“…Other research has demonstrated locale differences in school districts’ policies. For example, a recent study found that schools in suburban districts had more case management policies for students with disabilities than those in city, town, and rural districts, and schools in rural districts generally had fewer case management policies for students with CHCs than those in urban, suburban, and town districts (McCabe et al., 2020).…”

“…From this, we hypothesized that U.S. school districts with policies on school nurse participation in IEP and 504 development would also have policies on the participation of counseling, psychological, and/or social services staff (hereafter, referred to as school counselors) in this development and in the maintenance of student support teams. Secondarily, as prior research examining school health policies demonstrated differences by region and locale at the school district-level (McCabe et al., 2020), we examined such potential geographic differences (a) in having policies on nurses’ participation in IEP development and 504 development, (b) in the participation of school counselors in this development, and (c) in the maintenance of student support teams to assist students with disabilities and other challenges. Overall, we aim to fill a research gap concerning IEP and 504 school policies and the involvement of school team members in support of students with CHCs and other challenges.…”

Learning from the Past and Moving Forward: Implementing School Nursing Research Priorities

“…School health policies that require standards for the structure and processes of care reinforce the commitment to equity, non-discrimination, and inclusivity for all students. McCabe et al (2022) found that US school districts with policies on school nurse employment were more likely to have policies on chronic health condition management. This work stresses the practicing school nurse is essential to developing school-based health policies and monitoring the implementation of such policies.…”

Using Local School Wellness Policies to Build a Culture of Health for Students With Chronic Health Conditions: The School Nurse Role

“…lack of the school nurse voice ‘at the table’ to provide the message that prioritizing student health supports the academic mission of schools (Cygan et al, 2020; McCabe et al, 2020).…”