The role of
the school nurse has evolved and become increasingly important since first
introduced in the United States more than a century ago, yet school district
policies regarding school nurses lack uniformity and should be updated,
according to a policy statement issued by the American Academy of Pediatrics.
The policy statement
, published in the June 2016 issue of Pediatrics (published online May 23), calls for a minimum of one
full-time registered nurse in every school. The policy replaces a prior version
published in 2008.
the AAP had supported ratios of 1 school nurse to 750 students in the healthy
student population, and a 1:225 ratio for student populations who need daily
professional nursing assistance. According to the updated policy statement, the
use of a ratio for workload determination in school nursing is inadequate to
fill the increasingly complex health needs of students.
nursing is one of the most effective ways to keep children healthy and in
school and to prevent chronic absenteeism,” said Breena Welch Holmes, MD, FAAP,
a lead author of the policy statement and chair of the AAP Council on School
Health. “Pediatricians who work closely with school nurses will serve all of
their patients better.”
nurse’s job comprises much more than just health services. School nurses
provide surveillance, chronic disease management, emergency preparedness,
behavioral assessment, ongoing health education and extensive case management,
among other duties. The policy statement notes that school nurses today monitor
more children with special needs, and help with medical management in areas
such as attention-deficit/hyperactivity disorder, diabetes, life-threatening
allergies, asthma and seizures.
participate in public health arenas such as immunization, obesity prevention
and substance abuse assessment. The policy statement notes that collaboration
among pediatricians, families and the school medical team is increasingly
critical to optimal health care in both office and community settings. Yet,
school nurse staffing patterns vary widely across the United States.
advocating for a full-time nurse in every school, the American Academy of
Pediatrics recommends that pediatricians ask their patients school-related
questions, such as whether health problems contribute to chronic absenteeism.
Pediatricians are encouraged to include school contact information within the
student’s electronic health record and share relevant information with the
health needs became more complex, the school nursing role has expanded to
include additional responsibilities,” said co-author Anne Sheetz, MPH, RN,
NEA-BC. “By establishing working relationships with the pediatrician, school
nurses can help manage chronic conditions and develop individualized health
care plans for each student.”
The American Academy of Pediatrics is an organization of 64,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org