Trends and Issues Facing School Nursing
School nurse service delivery is changing as technology and school health needs continue to evolve. The school nurse is a member of a unique professional nursing specialty and is often the sole healthcare expert in an academic setting. The Framework for 21st Century School Nursing Practice TM is student-centered, occurring within the context of the student’s family and school community . School nurses also work in complex environments that span multiple sectors including health and education. They focus on population health and individual care.
In addition to the complexity of their role and settings for school nurses, the oversight for quality benchmarks is most often the purview of local education agencies (LEA) whose quality metrics are focused on educational outcomes, and whose administrators have varying levels of experience with the metrics of quality healthcare services. In most healthcare systems, analysis of quality is driven by Donabedian’s Structure / Process / Outcomes. Traditional healthcare systems have these quality measures reinforced through evaluation by national bodies such as the Joint Commission or designation of Magnet status. The absence of similar quality oversight in school health services has resulted in wide variations in standards that assure quality systems (e.g., access to a nurse administrator, data management systems such as electronic documentation systems, nurse governance, new nurse induction programs, and data metrics for quality performance). These variations can also influence the current status of school health services.
