Making the Case for School Nurses: A
Literature Review and Summary
Decreased
absenteeism for medical reasons
Allen, Gay.
“The Impact of Elementary School Nurses on Student Attendance.”
The Journal of School Nursing.
August 2003. 19(4): 225-231.
The study analyzed the
impact of school nurses on absenteeism.
Eleven elementary schools in
The study found that fewer
children checked out of school for medical reasons when a full-time school nurse
was available at school. The study
also made the following hypotheses but was unable to find significant results:
1) Schools with a full-time nurse would have higher average daily
attendance rate than schools without a school nurse, 2) Schools with a full-time
school nurse will have higher all-day
attendance than those without one, and 3) Schools with a full-time school nurse
will have a higher percentage of students enrolled in health care coverage than
those without a school nurse.
Parent
satisfaction
“Parents Speak Out on
Health and Health Care in Schools.” The
Center for Health and Health Care in Schools.
2004. www.healthinschools.org/pubs/paper/parentpoll.asp
The national survey of
1,101 parents of school-aged children found that parents strongly support health
care in schools. Highlights of the
survey include:
 | 83%
say they support health care in schools.
|
| 88%
find the argument that “teaching kids about how to keep themselves healthy
is as important as teaching them about reading, writing and math.” |
| 81%
of parents are convinced by the argument that school may be the only source
of care for |
| As
for arguments against health care in schools, the only one which the
majority found convincing was a financial one.
56% agree that “money for education is limited and health care
would take money away from more important priorities.” |
| Parents
feel health care in schools can meet many needs.
Some of the most important needs are providing care in case of
injuries (96% say important), caring for children with chronic illnesses
(90%), administering medications (85%).
|
| 85%
support having programs in school to help fight the nation’s childhood
obesity epidemic. |
School
staff satisfaction
Winland, Julie and Amy
Shannon. “School Staff’s
Satisfaction With School Health Services.”
The Journal of School Nursing.
2004. 20(2):101-106.
This study examined staff
satisfaction with school nurses. Using
a random sample from Columbus Public Schools, they surveyed staff members about
their satisfaction. 441 staff
members (23%) responded to their survey. The
first part of the survey asked staff to rate their satisfaction with the
following on a scale of 1 to 4: staff health, safety and environment,
classroom/education, medication, school system collaboration, and program
management. With all elements, staff
from a school who had a school nurse present in their building 80% or more of
the time rated their satisfaction higher than those from buildings who had a
school nurse 20-70% of the time.
Another part of the survey
allowed staff members to provide anecdotal comments.
“An overwhelming response for more nurse time in a building was an
ongoing theme in the anecdotal section. The
schools with the least amount of school nurse time were the most adamant
supporters of increasing health services support.”
Additionally, “26% of respondents mentioned the need for more nurse
time in their building. Fifty-four
percent of respondents [with a school nurse present in their building only 20%
of the time] expressed that more nurse time was needed in their building.
None of the questions in the survey directly asked if the respondent
thought that more nurse time was needed.”
Increased
health education and health services
Guttu, Martha, Martha
Keehner Engelke, and Melvin Swanson. “Does
School Nurse-to-Student Ratio Make a Difference?”
Journal of School Health.
2004. 74(1): 6-9.
The study looked at data
from 19 school districts over a three year period.
Schools were stratified into 2 categories: districts with a
nurse-to-student ratio of 1:1,000 or less and districts with a ratio of more
than 1:1,000. Results are as
follows:
| Districts
with a lower nurse-to-student ratio (more school nurses per number of
students) were more likely to identify students with chronic illnesses
(asthma and diabetes) and more likely to be involved in their care. |
| Districts
with a lower nurse-to-student ratio reported more counseling services such
as for depression, teen pregnancy, and learning difficulties.
|
| Districts
with a lower ratio were more likely to have a person appointed to be a first
responder for accident or injuries (70% compared to 30%).
Also, a significant relationship existed between percent of students
with serious injuries reported, documented, and referred to a school nurse
for follow-up care upon returning to school in districts with a lower ratio.
|
| There
was no significant relationship between nurse-to-student ratio and percent
of students referred for follow-up vision services.
However, students in a district with a lower ratio who actually
sought follow-up care were higher.
|
Child
well-being
Fryer, George E. and Judith
B. Igoe. “A Relationship Between
Availability of School Nurses and Child Well-Being.”
Journal of School Nursing.
October 1995. 11(3):12-18.
Several things were looked
at in this study. Although
questionnaires were sent out to school nurses, not much was obtained from the
responses that is useful for our purposes. Instead,
what is interesting, is that they noticed a strong association between the rank
of states on the ratio of students to nurses and the well-being of children.
Hence, schools with a higher rate of nurses per student (as obtained
through the 1994 National Association of School Nurses Membership Report) were
rated higher on the state’s child well-being as reported by the 1994 Kids Count Data Book, a publication of the Annie E. Casey
Foundation.
Of the different factors
considered to influence child-well-being, three statistically significant
associations were found that may be influenced by the ratio of school nurses to
students: deaths, births to single teens, and percent of students graduating on
time. The strongest of these
correlations was percentage of students graduating on time.
This may be particularly relevant since students who miss a significant
number of school days in a semester often fail that grade.