School Nurses’ Role in Self-Management, Anticipatory Guidance, and Advocacy for Students With Chronic Illness

Abstract

This article offers tangible support for school nurses to understand, recognize, and integrate self-management promotion, anticipatory guidance, and advocacy into practice. The article utilizes the chronic condition of asthma as a case exemplar, but many of the recommendations apply to other aspects of chronic illness self-management promotion. School nurses are in an ideal position to advocate for students and families and to support evidence-based self-management promotion. In the school setting, gaps currently exist regarding best practices for the promotion of self-management and anticipatory guidance for children with chronic illnesses. Future interventions within school settings should focus on multisystem level collaboration with care coordination efforts between providers and social support systems, internal and external, to the school system. These policies and this resource development will ultimately support the promotion of self-management for children with chronic illness in the school environment and maximize health outcomes.

School nurses' perceptions regarding barriers and facilitators in caring for children with chronic diseases in school settings: A mixed studies review

“…Additionally, the SEM provides a more comprehensive approach that acknowledges interactions among multiple levels of influence that impact health outcomes (McLeroy et al, 1988; Stokols, 1996). Indeed, school health care interventions require multi‐level collaborations among individuals, school systems, the community, and public policymakers (McCabe, 2020). School‐centered programs with coordinated care among students, families, health care providers, and school representatives can facilitate successful management of students with chronic diseases (Cicutto et al, 2020).…”

An Evidence-Based Framework for Implementation of a School–Community Partnership

“…These organized and prearranged partnerships offer youth, families, and communities the prospect of developed, deliberate, and reinforced social and emotional health experiences, care coordination, and academic support in the school setting (Institute for Local Government, 2015). Regarding care coordination, a key principle of the National Association of School Nurses' Framework for 21st Century School Nursing Practice, SCPs are ideal for assisting youth with acute and chronic illness by providing evidence-based interventions and offering skills and education to support youth selfmanagement and academic success (Gray et al, 2020;McCabe, 2020). These partnerships allow for the mutual exchange of knowledge and collaboration of resources and strive for sustainability.…”

“…The mutually beneficial nature of SCPs aids in the sustainability of programs. While asthma was the intended focus in the examples offered, school nurses can advocate for partnerships based on other pressing needs of the school community and community partners (McCabe, 2020). They can assess these needs by utilizing publicly available data (e.g., Youth Risk Behavior Surveillance System) or conducting a needs assessment of the school and school community, followed by the establishment of priorities, and the subsequent selection of an optimal program for partnership.…”

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

“…During the academic day, children with CHCs and other disabilities may require additional educational or health services, some of which may include nursing care (Brown et al., 2019; McCabe, 2020; McClanahan & Weismuller, 2015). Legislation protecting children’s rights dates to the mid-1970s, when Congress enacted the Education for All Handicapped Children Act (Public Law 94-142).…”

“…For children with and without CHCs, school nurses perform fundamental roles in delivering school-based health care through their expertise in quality improvement, care coordination, leadership, and community/public health (McCabe, 2020; NASN, 2017). Current societal issues facing children, such as access to consistent health care and rising rates of CHCs (American Academy of Pediatrics Council on School Health, 2016), make the landscape covered by a school nurse quite expansive.…”