Scholarly mission. Fostering scholarship in research, theory, and practice

After the publication of Ernest Boyer's book on Scholarship Reconsidered in 1990, campuses across the nation began debating how scholarship is recognized and rewarded. The current system mainly recognizes and rewards faculty for their scholarly achievements in research. However, Boyer's book has called attention to the need for a paradigm for evaluating scholarship that better articulates with the world of an academician. According to Boyer (1990), it is time to recognize the full range of faculty talent that includes research as well as three other equally important areas of scholarship: teaching, integration, and application (practice). The emergence of nursing science as an independent academic discipline valued by society and health consumers parallels the professional and social demands to assume full responsibility for nursing decisions, actions, and outcomes. The scholarly mission of VUSN is based on the values shared by the faculty that excellence and innovation in preserving and advancing the science, art, philosophy, and history of nursing is accomplished through the components of theory, research, and practice. The faculty believe the interrelatedness of the three components forms the basis for the development of scholarliness in both its students and faculty.

Teach us body sense (TUBS): a health education program for primary students

Health education is an important component of the elementary school curriculum. It is at this young age that children form the foundations for a healthy lifestyle that can carry them through their lifetime. It is imperative that the young are reached through education so they can incorporate healthy living choices into their decision making skills.

Guidelines for adolescent preventive services: a role for the school nurse

Morbidity and mortality for today's adolescent are linked most often to complex behavioral and psychosocial risk factors than in the past. The American Medical Association has developed Guidelines for Adolescent Preventive Services (GAPS) to assist the primary health practitioner in deterring adolescents from participating in health-debilitating behaviors and to promote health-enhancing behaviors. Studies have affirmed usefulness of the GAPS protocol in the private practitioner's office and in the school-based clinic. This paper explores the possibility of using the traditional school nurse to deliver the GAPS in collaboration with school and community professionals. Issues explored include identifying students for he screening, administering the survey, triage of students, interdisciplinary and interagency collaboration, confidentiality, barriers, and time constraints.

Nursing in project Head Start: improving health

The purpose of this study was to evaluate the effectiveness of a nurse-directed health promotion program in decreasing upper respiratory illness symptoms and injury rates in preschool children attending a Head Start (HS) program. The health promotion program presented to the Head Start staff consisted of signs and symptoms of childhood illnesses, infection control, injury prevention and first aid. The 47 children had their health evaluated by a registered nurse once per week for 4 weeks before the program and once per week for 4 weeks after the program. The children's health was evaluated using the Child Health Assessment Inventory. Symptoms of upper respiratory illness were significantly decreased after the intervention of the program. Injury rates increased, but further data analysis determined that 88% of the injuries had occurred at home.

Audit of school entry health assessments: to maximise efficient use of health personnel at school entry assessments at 5 years

During the last 3 years in which doctors saw all school entrants, the decisions made about each child on examination were recorded and a protocol about decision-making to support children with health needs was drawn up. In September 1994, school entry health care assessments by the school nurses were introduced. Having previously recorded the numbers in each school who required medical interest and support, it was possible to rationalise which schools should be the primary responsibility of the nurses, which should retain medical contact for all children and in which schools assessments should be shared. The outcomes in decision making after introducing nurse assessments were recorded in the same format as used by the doctors, so that the effect of passing responsibility to nurse colleagues could be assessed. The findings suggested that an equivalent number of children were referred to other services or selected for continuing review. However, the proportion of children whose needs were discussed with the headteacher without the children being selected for review was reduced. Issues to take forward were identified.

A nursing intervention to ensure a safe playground environment

Unintentional injuries sustained on school playgrounds are a continual problem not only for children but also for the school nurses who are concerned with their safety. A group of school nurses organized by the local health department's pediatric nurse practitioner responded proactively to this problem by enlisting both school officials and students to accept joint responsibility for a safe play environment. The school nurses assisted the staff in providing a safe play environment and encouraged the students to behave in a safe and acceptable manner on the playground. The nurses developed (a) a Playground Safety Assessment Guide for the school staff to establish and maintain a safe play environment, (b) an in-service session for playground monitors to learn how to supervise children at recess, and (c) a student-oriented program for the children to improve behavior on the playground based on a program conceived by Utah State University (Daug & Fukui, 1988). School nurses and pediatric nurse practitioners can use this program as a model for other schools to improve the physical play environment and behavior of the children at recess.

Proportion of Swedish school nurses' time devoted to different health care activities

School nurses play an important role in the preventive health care of children and adolescents. This study aimed to describe and investigate the school nurses' different activities and time spent on these activities. By completion of a time study record form all 26 school nurses, in a medium-sized town in Sweden, documented their activities during 10 working-days. Altogether 635 record forms were received. It was found that almost half of the school nurses' time was used for individual pupil activities, 17% for groups of pupils and 34% for administrative activities. School nurses spent 17% of all their working time at the school clinic, which in some way may reflect the pupils need of the nurse in the school. These results highlighted the importance of school nurses and resulted in internal structural changes of school nurses' working time.

Development of a nurse-managed, school-based health center

As the healthcare environment continues to change, nurses are developing models for interdisciplinary care in a variety of community settings. The high school is an ideal treatment setting for the delivery of health services to adolescents. This article describes the development of a nurse-managed, school-based health center. The steps in planning and implementing this interdisciplinary service and training site are outlined to provide a guide for nurses wishing to develop autonomous community practice settings.

Handwashing education can decrease illness absenteeism

A handwashing program for elementary school students was developed and implemented by the school nurse in a suburban elementary school. The program consisted of surveying teachers, inspecting handwashing facilities, and providing classroom presentations and follow-up activities. Absenteeism records indicated a significant decrease in absenteeism for illness during the two months following the presentations.

Quality management in a school-based nursing center: program development and implementation

As community-based health care services continue to grow, quality management programs for new, nontraditional settings are being developed. The article describes a quality management program implemented in a nursing center in an urban, multicultural high school. The three components of the program--formulation of the quality management plan, the development of written structure, process, and outcome standards, and the development of a monitoring and evaluation plan--are summarized. The application of the principles and practices of quality management to a school-based nursing center has provided challenges, opportunities, and rewards for all involved.

A school-based clinic for elementary schools in Phoenix, Arizona

A community hospital, a school district, and a private pediatrician's office collaborated to ensure all children enrolled in five elementary schools had access to health care services. The school nurse at each school identified children needing health care services and obtained parental consent. The school nurse referred children to a nurse practitioner who visited one school each day. School nurses and space in the nurse's office were provided by the school district. The hospital provided a nurse practitioner as well as pharmacy, radiology, laboratory, and emergency department services. The pediatrician as medical director for the program provided vision, training, and community connections, and served as collaborating physician for the nurse practitioner.

The 'Health Promoting Schools' strategy: implications for nursing and allied health professionals

In 1993, the Commonwealth government officially recommended that schools were excellent places in which to promote better health as part of the proposed National Health Strategy. The concept of Health Promoting Schools (HPS) has recently been endorsed by the Department of Education, with the result that teachers are now expected to further expand their role and responsibilities in this area. This paper outlines a survey of infant and primary school teachers in New South Wales (n = 350) which, amongst other factors, ascertained teachers' perceptions of the assistance they needed from school and community nurses in order to effectively implement the HPS strategy. Results demonstrated that teachers have a fundamental lack of understanding of child health issues and the HPS strategy, and that an overwhelming call by teachers for assistance from the nursing profession has implications not only for nurses but also for allied health agencies and the tertiary sector.

The child with HIV in day care and school

HIV-infected children attend day care programs and schools in communities throughout the United States. This article examines the care of these children in the school and child care environment. Legal issues of school access, confidentiality, and school policies are discussed. Specific health, developmental, psychosocial, and educational needs of infected children are presented along with the roles that the nurse can play, as advocate and care provider for the child and family, and as school/community resource and educator.

Functions of school nurses and health assistants in U.S. school health programs

This paper reports results from a nationwide survey of a systematic random sample of school districts. Information obtained from 482 participating districts was used to contrast roles of nurses and health assistants in school health programs throughout the country. Most districts relied heavily on nursing personnel for technically involved clinical services, but often employed health assistants to administer medications and basic first aid. Litigation was somewhat more frequently filed regarding care provided by health assistants than care by nurses or classroom personnel. But in general, health assistants were performing satisfactorily, particularly in districts where registered nurses coordinated the services and activities of health program personnel. While use of health assistants increased the past three years, school nurses were not being displaced. Just 9% of districts had downsized their nursing staff during that period. Despite the modest expansion of nursing resources, nurses reportedly were underused in health education programs of most schools.

Exposure to bloodborne pathogens in the academic setting: prevention, reporting, and management issues

Management of nursing students exposed to bloodborne pathogens in the academic setting continues to challenge nurse educators. Management issues include nonreporting by students, lack of established policies and procedures, and inconsistent application of postexposure policies. The authors confirmed previously identified 50% nonreporting rates by students. Development of a postexposure management plan is discussed, emphasizing the need for psychological and medical interventions.

Defining the future for school nursing

This article examines some of the health needs of school-age children and adolescents within a changing society, and explores how school nurses can respond, and are responding to these needs. The author also considers an educational programme designed for school nurses of the future, which should enable graduate school nursing specialists to take their place alongside other community nursing and teaching colleagues.