Friday

The undeniable benefits of having a school nurse present every day for students, families, schools, and communities are evident. However, numerous obstacles still hinder the realization of this goal in every school. This panel presentation aims to delve into the strategies that school nurses can employ to overcome these hurdles effectively. Join us as we examine various avenues for tackling challenges in funding, workforce availability, educational administration, legislative backing, and community engagement. From exploring funding opportunities through avenues like Medicaid to advocating for state legislative action, investing in workforce development, rallying grassroots community support, and fostering robust administrative relationships, we will explore a spectrum of actionable solutions. Attendees can expect to gain valuable insights and practical strategies that they can readily implement in their professional practice. Together, let's empower school nurses to navigate and conquer the barriers standing between them and their vital role in fostering healthy school environments.

The power of advocacy and systems-level leadership are foundational principles of NASN’s School Nursing Practice Framework™ and valuable assets within the school nurse skill set. This session will help energize and organize your ability to empower school health and the school nursing profession by engaging policymakers, legislators, and leaders at local, organizational, state, federal, and global levels. School nurses support an inclusive, safe environment for all students and accomplish this through actionable advocacy at all levels and include interactions in the health room, school board meetings, proposing policy, and testifying before state and federal level legislators. Maximize and leverage how, when, and where to have your professional nursing voice heard. Interactive learning strategies will help you better understand how to identify opportunities, develop key talking points, reflect on your strengths and areas of improvement, collaborate, and anticipate challenges. Plan to walk away with greater confidence in your ability to influence the health and well-being of diverse school-age populations, communities, and the school nursing profession.

Growing up is hard enough, but kids today live with the added pressure of social media and the aftermath of a global pandemic. The crisis in pediatric mental health is one of the factors contributing to students missing school. What can be done to help get students back in the classroom? With an emphasis on mental health, this panel discussion will review the current state of school attendance and chronic absenteeism, discuss the connection between school attendance and student, family, and staff health, highlight care coordination including the role of school staff, and review evidence-based models from school and community settings to support student wellbeing and school attendance.

School nurses can improve educational outcomes with reduced absenteeism and missed class time (Yonder, 2020). Unfortunately, nurses are seen as a costly intervention. Leach et al. (2023) estimated a cost of $115,707 per school in a licensed practitioner nurse program. According to the Centers for Disease Control (Berrios-Torres et al., 2017), 83.3% of school health services are funded through the school district. Like other prevention programs, the existence of a school nurse might provide cost savings. Wang et al. (2014) estimated a return on investment (ROI) of $2.20 for every dollar invested in hiring a full-time nurse per school, through medical care and productivity savings. More recently, research on an urban school district indicates a ROI of at least $1.50 (Ohneck et al., 2019). This study is a cost-benefit analysis of the Arizona School Nurse Access Program (ASAP), which hires school nurses across Arizona. The nurses participating in the program (Nf31) took a quarterly survey during the 2022-2023 school year assessing their involvement in health interventions, emergency response, and health promotion. Furthermore, benefits related to teacher and parent time savings were assessed. Preliminary analyses suggest substantial benefits accrued to both the parent and payer in the form of reduced emergency care use and earlier identification of acute and chronic diseases. Additional analyses will continue to add dollar values highlighting the program’s ROI for parents, teachers, and schools. The nurses were placed in rural and underserved areas, diversifying research and creating new avenues for health equity.

The prevalence of Type 1 and Type 2 diabetes during childhood is increasing nationwide, including in New York City where approximately 5,500 children have diabetes. Diabetes nurse educators and school nurses can work collaboratively to support best practices for diabetes care, to ensure that students with diabetes can flourish and that school nurses have the resources to provide excellent diabetes care. The session’s purpose is to 1) Describe the goals, structure, responsibilities, and impact of the Diabetes Nurse Team implemented in New York City schools in 2020, 2) Provide examples of the training the Diabetes Nurse Team provided to the multi-disciplinary school environment, and 3) Assist participants in identifying action steps they can take towards implementing similar diabetes support in their setting. The session will open with a didactic presentation of the Diabetes Nurse Team’s evolution and impact. The presentation will also highlight alignment with NASN clinical practice guidelines for students with Type I Diabetes and the School Nursing Practice Framework™. The presentation will showcase the focus on diversity, equity, and inclusion in diabetes care management and resources. Additionally, it will guide us to bridge the gap in diabetes outcomes in underserved communities. After the presentation, participants will be placed into small groups to brainstorm how to incorporate similar diabetes supports in their school settings. Teams will report to the larger group. The session will end with a closing summary presentation. Participants will be given time to draft action steps to improve diabetes care in their school setting.

Health education has been a key component of school nursing since the inception of the specialty. One-on-one teaching in the health office occurs all day, every day. When school nurses provide education for classes or groups, this is an effective way of reaching larger numbers of students with important information about wellness, disease prevention, human growth and development, mental health, and other crucial subjects. School nurses can evaluate health and sexuality education curricula and advocate for policies to ensure that students receive age-appropriate, evidence-based health information, which is critical in making schools more equitable and inclusive. School nurses are well-positioned to teach topics that require health and scientific knowledge. As trusted professionals in schools and communities, school nurses have traditionally fulfilled these roles for generations, although many of these subjects are now deemed controversial by some. School nurses are uniquely qualified to inform trauma-sensitive health and sexuality education and are well-versed in complex issues such as gender diversity, racial inequities, and disability rights. When school nurses do not have time or resources that allow them to teach such topics in the classroom, they can spearhead a variety of approaches to facilitate the process and monitor the quality of such educational efforts. In this session, we will outline why health education remains an important role of the 21st-century school nurse, and how it relates to leadership and public health. We will discuss how traditionally marginalized groups such as LGBTQ+ people, disabled people, and racial/ethnic minorities are frequently excluded from traditional health and sex education, and why that matters. We will relate methods that school nurses can utilize to evaluate their schools’ current curricula and describe specific steps they can take to effect change.

School nurses are positioned to positively impact the health and wellness of their school community, especially for students with chronic illnesses. Yet, a national shortage of school nurses has exacerbated the need for emergency certifications, placing school nurses in an increasingly challenging role with little support. Two school nurse mentorship programs have emerged to address these needs. In 2023, Penn State PRO Wellness, in partnership with the Moses Taylor Foundation and the Pennsylvania Association of School Nurses and Practitioners (PASNAP), launched a two-pronged approach to provide mentorship and professional development to Pennsylvania school nurses. Similarly, Children’s Nebraska and the Nebraska Department of Health and Human Services partnered to develop a program for school nurses in their region in 2020. The mentorship programs facilitated information sharing between school nurses emerging in their careers, and experienced school nurse mentors. Both programs were designed in alignment with the School Nursing Practice Framework™. This session will highlight the Pennsylvania and Nebraska-based programs, sharing information about program development, participation, and evaluation. Special attention will be provided to overcoming barriers at each stage of program development and growth, from startup to later program years. Attendees will explore successes and lessons learned from each program and participate in discussions and activities to build leadership capacity for school nurse mentorship programs in their networks. Activities will also incorporate considerations for diversity, equity and inclusion, as it relates to program design and implementation, and the field of school nursing.

Chronic health conditions affect almost 20% of the school-aged population. Given the rising chronic condition prevalence and the linkage between health and academic performance, schools play an important role in helping students manage their conditions. Chronic condition management is especially needed in schools with large numbers of students impacted by health disparities. High-quality care coordination can improve health and academic outcomes for children with chronic conditions and should be accessible to all students. Optimizing the short and long-term outcomes for children with chronic conditions requires an integrated, intentional, and interdisciplinary approach that engages multiple sectors. Partnerships between school nurses, pediatricians, and non-physician clinicians can create powerful linkages between schools and medical homes and can lay the groundwork for system-level school-based care coordination approaches. Given school nurses role in direct care provision and their expertise in both education and healthcare, school nurses often serve as the primary liaisons between school and healthcare teams. Beyond this facilitation role, professional school nurses’ training and scope of practice position them well as leaders of care coordination efforts.

School connectedness and belonging are protective factors that promote student educational engagement, accomplishment, and community performance. School nurses are well-positioned to support school connectedness for newly immigrated students, who may encounter hurdles to healthcare due to cultural and linguistic differences. This session will open with introductions to school connectedness, belonging, and culturally appropriate care, and how they align with NASN’s School Nursing Practice Framework™. Participants will break into small groups to discuss how they have observed school connectedness and belonging among newly immigrated students. Next, the session leaders will present practice suggestions for addressing school connectedness and belonging, including language, culture, and inclusion, using three health conditions: anxiety, asthma, and obesity. Then, action steps for improving school connectedness and belonging among newly immigrated students will be discussed using the Nominal Group Technique, a structured method for group brainstorming. Groups will be given time to independently list ideas for action steps. Following this, each group will report one action step to the larger group. As groups report out, session leaders will document in a live word cloud generator shown on the presentation screen. Groups will brainstorm strategies for identifying and overcoming barriers to school connectedness and belonging. Each group will report one strategy to the larger group. The session will conclude with a wrap-up and time for questions. This session is grounded in the belief that school nurses who provide linguistic and culturally appropriate care can support students’ connectedness and inclusion in school communities.

School nurses report spending more than 25% of their time managing children with mental health problems. Depression and anxiety are frequently diagnosed in children, affecting 2.7 million (4.4%) and 5.8 million (9.4%) of children aged 3-17 years in the U.S. Prevalence of these disorders varies according to ethnicity, age, and gender. Depression and anxiety both negatively impact school performance, engagement, and peer relationships. Children are screened for depression at primary care visits; however, the screening results are not routinely shared with school nurses. Many school nurses report limited training in assessment, recognition of signs and symptoms, interventions, and medications commonly prescribed for mental health problems in children. Risk factors, symptoms, common underlying complaints, assessment tools, and an update on medications for the school nurse will be reviewed. NASN's School Nursing Practice Framework™ identifies clinical competence and evidence-based practice as necessary skills for school nurses. This session will help school nurses increase their knowledge to meet current standards of practice, coordinate care, and implement appropriate screening, referral, and follow-up for children with mental health problems.

The Human papillomavirus (HPV) vaccine is a safe and effective measure to prevent HPV infections regardless of gender, race, or sexual orientation. Evidence-based practice guidelines recommend the completion of the HPV series before age 13 for adolescents. For two decades, the United States' target goal for HPV vaccination has been 80%, yet Alabama’s rate is 62.5%. One out of three parents felt the HPV vaccine was unnecessary and communicated apprehension, factoring into subpar vaccination rates. This presentation addresses several components of NASN’s School Nursing Practice Framework™, including standards of practice, care coordination, leadership, community/public health, and quality improvement. The aim of this presentation is to demonstrate the effect of an internet-based HPV training module targeting parents of adolescents aged 9 to 13 years. The pre- and post-surveys used the Parental Human Papillomavirus Survey and the Vaccine-Related Attitudes and Beliefs Measure. Parents completed a pre-intervention survey, watched an informational video about HPV, and then completed the post-intervention survey. Data was analyzed and results showed statistically significant differences in pre- and post-survey data indicating a decrease in negative perceptions (t (19) = 4.40, p < .001) regarding the HPV vaccine, along with an increase in parental confidence regarding vaccine benefits, and parental perceived self-efficacy regarding vaccination decision-making (t (19) = 7.96, p < .001). The intervention was effective in improving parental attitudes and reducing parental hesitancy regarding the HPV vaccine. Nurses are encouraged to recommend the HPV vaccine and provide education to combat parental hesitancy.

Vision health and clear vision have a critical role in every child’s physical, cognitive, and social development, yet up to one in 17 young children and one in four school-age children has an undiagnosed vision disorder requiring treatment. Racial disparities in access to eye care disproportionately impact Latino and Black children, who are two to three times more likely to have unmet vision needs leading to unnecessarily higher rates of visual impairment. Without early detection and treatment, uncorrected vision disorders can cause a delay in child development, interfere with learning, and even lead to permanent vision loss, yet families in poverty face significant barriers to accessing eye care. Early detection of risk factors for vision disorders, uniform systems of vision screening and accessible care for all children, and receipt of eye care and treatment are critical components of an equitable system. This session will explore the 12 components of a strong vision health system for children and the important role of school nurse leaders in educating families about the importance of eye care, facilitating referrals to eye care in the community, and leading efforts to establish school-based or community eye care systems. These important strategies have proven to improve access and equity in vision and eye health. Successful educational and referral strategies and diverse models of care will be presented and discussed, providing school nurse leaders with the confidence and skills to initiate efforts to address a significant cause of learning challenges for students.

Have you heard about diversity, equity, and inclusion (DEI)? Are you interested in learning more about DEI? Recently, considerable attention has been devoted to this hot topic, and is an increasingly important one, especially in the school nursing profession. Staying abreast with today's school nursing issues and trends requires an understanding of diversity, equity, and inclusion. This session provides participants with a journey into the development and evolution of the importance of DEI, and its relevance in shaping the school nurse’s understanding of the DEI role in school nursing practice. Inclusive workplaces, such as the school setting, are challenged to be the heart of innovation and are the key to optimizing the health and well-being of students and staff. The capacity for school nurse leaders and colleagues to model diversity, equity, and inclusive attitudes, language, and practices is the litmus test of the collective commitment to empowering ourselves and each other using NASN’s School Nursing Practice Framework™. Failure to effectively demonstrate inclusivity in healthcare drives people away, harbors discrimination, normalizes inequity, and has a direct impact on the mental health of our profession. In this interactive session, participants review case studies, share experiences, and set personal goals for fostering inclusivity that not only produces innovation but results in a happier healthier school community. It’s time we have the talk that sets the record straight on the importance of meaningful delivery of diversity, equity, and inclusion in school nursing practice.

COVID-19 increased the strain on a fragile national school system. We highlight specific challenges for K-12 school health staff and educators, including barriers to implementing Centers for Disease Control and Prevention (CDC) guidance and consequences for these interventions. These insights are informed by our research. In a review of nearly 500 U.S. media coverage articles from February 2020 to September 2021 on school nurse experiences during COVID-19, we characterized new job tasks and occupational risks for school health staff (Lowe et al., 2022). In focus groups held with 48 school health staff in Pima County, Arizona, we identified sources of stress and challenges in implementing CDC guidance (Wilson et al., 2023). Major findings included the fact that increased job tasks during COVID-19 interfered with school health staff’s ability to manage ongoing tasks, such as hearing screening, or respond to students with chronic health conditions (Wilson et al., 2023). This is concerning since >40% of school-aged children have a chronic disease (Managing Chronic Health Conditions, 2021). Current efforts include the development of a risk calculator tool to aid school nurses in comparing different interventions for reducing the school transmission of respiratory viruses. This tool uses quantitative microbial risk assessment (QMRA) (Haas et al., 2014), a framework that allows for comparisons of interventions’ risk reductions (Wilson, Jones, et al., 2021; Wilson, Weir, et al., 2021). This session will include an introduction to QMRA and opportunities for discussion regarding types of risk-based tools that would benefit school nurses. Our topic especially serves those working in underrepresented minority communities who may face increased infection transmission risks due to lacking financial and community support and addresses community /public health and school nurse leadership during public health emergencies. QMRA as an infection control tool addresses community/public health and quality improvement.

This presentation will provide the professional school nurse with evidence-based recommendations to improve the care of students with seizure disorders and epilepsy, based on the newly revised NASN Clinical Practice Guidelines and accompanying Toolkit. The complex needs of these students and the management of their care are not consistently followed in school settings, and this presentation will provide school nurses with the knowledge and resources and change their school nursing practice. Children with epilepsy have ethnic and racial differences as a larger proportion are black, non-Hispanic (18.2% versus 13.2%). In the US, after adjusting for age and race, children with epilepsy had 1.47 times the odds of having lower income than their peers (Muthiah et al, 2023). The average total annual direct healthcare cost of epilepsy per person in the United States is estimated to range from $10,000-$48,000 (Begley & Durgin, 2025). Participants will identify CPG & Toolkit components to align the plan of care for students with epilepsy with NASN’s School Nursing Practice Framework™.

School districts across the country have implemented school-based suicide prevention programs. Despite being well-positioned to identify at-risk students, programs often fail to include school nurses. Findings from research with school districts in North Carolina echo this exclusivity. School nurses reported being kept “out of the loop” and limited collaboration concerning student mental health. These exclusive practices cripple the ability of school nurses to support mental health equity for students and reduce disparities in youth suicide. Practical strategies from one lead school nurse will provide an exemplar of how to dismantle stay-in-your-lane mindsets to advocate for inclusivity. This part of the presentation will unpack best practices to situate school nurses as integral contributors in supporting students with mental health needs. Selected as one of six districts to pilot the NC Project Aware initiatives, this opportunity has the momentum to change perceptions of school nurses and that they offer more than ‘Band-Aids and ice.’ Using NASN’s School Nursing Practice Framework™, we will link contributions to suicide prevention within the key principles and identify opportunities to advance school nursing practice. Both presenters will share how to leverage community-academic partnerships to co-create research projects and explore grant opportunities. We will share our current efforts in developing and measuring school nurse data indicators related to suicide prevention. These ongoing efforts are aimed at demonstrating how school nurses are equally pivotal in mitigating youth suicide and advocating for inclusivity in school-based programs.