Working closely with parents, school staff, and community pediatricians, school nurses are well positioned to help contain costs. The school nurse functions as a leader and the coordinator of the school health services team. The school nurse may also coordinate with school counselors in developing suicide prevention plans. These policies include health promotion and protection, chronic disease management, coordinated school health programs, school wellness policies, crisis/disaster management, emergency medical condition management, mental health protection and intervention, acute illness management, and infectious disease prevention and management.16. Some schools may have a school-based health center in or adjacent to the school, which may provide primary care and psychosocial services. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication. Cost-benefit study of school nursing services. A specialized practice of professional nursing that advances the well-being, academic success, and lifelong achievement of students. This policy statement describes the crucial aspects of the school nurse’s role, its relationship to pediatric practice, and recommendations to facilitate productive working relationships benefiting all school-aged children and adolescents. 104-191) and Family Educational Rights and Privacy Act (Pub L No. They help children and families gain additional help and support when required, and provide and coordinate additional services for vulnerable children. disaster teams, school health advisory councils Advocates for programs and policies that positively affect Reference: National Association of School Nurses (2002). The school nurse promotes a healthy school environment.13 The school nurse provides for the physical and emotional safety of the school community by monitoring immunizations, ensuring appropriate exclusion for infectious illnesses, and reporting communicable diseases as required by law. Increasing numbers of students enter schools with chronic health conditions that require management during the school day. In addition, with increased awareness recently about such issues as head injuries, the school nurse is poised to offer on-site assessment of the student’s postconcussion progress and adaptations required in the educational plan.13, School nurses are also participants in public health arenas, such as immunization, obesity prevention, substance abuse assessment, tobacco control, and asthma education. Although the concept of a school nurse has existed for more than a century, uniformity among states and school districts regarding the role of a registered professional nurse in schools and the laws governing it are lacking. School health nurses provide the service in partnership with schools. The school nurse provides leadership for the provision of health services13 As the health care expert within the school, the school nurse assesses the overall system of care and develops a plan for ensuring that health needs are met. The school nurse has a crucial role in the seamless provision of comprehensive health services to children and youth. Position Statement: The Role of the School Nurse Regarding Drug Testing in Schools. Feedback mechanisms regarding student response to the treatment plan in school are critical to timely medical management in areas such as attention-deficit/hyperactivity disorder, diabetes, life-threatening allergies, asthma, and seizures as well as for the growing population of children with behavioral health concerns. However, the reality is that school nurse staffing patterns vary widely across the United States.14 When a school nurse is not available at all times, the American Academy of Pediatrics, the National Association of School Nurses, and the American Nurses Association recommend that delegated, unlicensed assistive personnel be trained and supervised in the knowledge, skills, and composure to deliver specific school health services under the guidance of a registered nurse. The school nurse has a crucial role in the seamless provision of comprehensive health services to children and youth. School nurses, working with pediatric patient-centered medical homes, school physicians, and families, are in a critical position to identify unmet health needs of large populations of children and adolescents in the school setting. This role includes providing preventive and screening services, health education and assistance with decision-making about health, and immunization against preventable diseases. As a leader of the school health team, the school nurse must assess the student's health status, identify health problems that may create a barrier to educational progress, and develop a health care plan for management of the problems in the school setting. School attendance is essential for academic success. The Privacy, Security, and Breach Notification Rules of the Health Insurance Portability and Accountability Act of 1996 (Pub L No. The school health service is free and confidential. This policy statement has been endorsed by the National Association of School Nurses. Exemptions to school immunization requirements: the role of school-level requirements, policies, and procedures. Promoting the presence of a qualified school nurse in every school and a school physician in every district fosters the close interdependent relationship between health and education. The school nurse assists on health education curriculum development teams and may also provide programs for staff, families, and the community. Interim steps toward achieving this ideal can be made by achieving the Healthy People 2010 goal, which states that districts should employ at least 1 nurse per 750 students, with variation, depending on the community and student population.25 Schools with high percentages of students with special health needs would require more intensive ratios of nurse to students; for example, 1 nurse per 225 students when students require daily professional nursing services or interventions, and 1 nurse per 125 when students have complex health needs.26 The presence of the school nurse in every school allows the school physician to work most efficiently in providing the coordinated care that each student requires. This statement has been endorsed by the National Association of School Nurses. With a nurse in the school, other school staff, including teachers, divert less time from their primary job responsibilities to deal with student health issues.40. 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