The Journal of School Nursing

A high prevalence of epilepsy diagnoses and seizure events among students was identified at a large Midwestern school district. In partnership with the Epilepsy Foundation of Minnesota (EFMN), a quality improvement project was conducted to provide education and resources to staff caring for school children with seizures. School nurses (N = 26) were trained as seizure management educators and instructed staff in 21 schools on seizure awareness and response. School nurses utilized new seizure management resources, a procedural guideline, and care plan updates. The majority of school nurses rated the resources and training interventions as “very helpful.” School nurse confidence in managing students with seizures increased, seizure action plan use increased, and 88% of children’s records with new seizure diagnoses had completed documentation. School nurses played vital roles in increasing seizure awareness as educators and care managers. EFMN is using this project as an exemplar for expanding its Seizure Smart Schools program.

“Transition Planning for Youth with Special Health Care Needs (YSHCN)” chronicles the research and work completed by agencies in Illinois to provide examples of best practice in transition planning. Increasing numbers of YSHCN survive into adulthood creating a need for focus on the transition to adult life for these young people, including meeting health care needs. As a part of the Transitions project, the Illinois Chapter of the American Academy of Pediatrics and the University of Illinois at Chicago Division of Specialized Care for Children surveyed Illinois public high schools to identify transition planning efforts, staff training needs and used those results to develop and implement training. A natural way to organize health services is by integration with school transition services. The credentialed school nurse would be the ideal person to contribute to the development of the health care transition plans based on the student’s heath care provider’s medical management plan.

The landscape of childhood health and disease has changed over the past century, and school nurses are now in a unique position to address the conditions that lead to chronic disease, such as obesity. Measuring body mass index (BMI) during childhood and adolescence is the recommended method for screening and/or monitoring obesity in school communities. Yet changes in the size, proportion, and distribution of fat mass and fat-free mass during growth and development introduce challenges to interpreting BMI measurements. Understanding these challenges and ensuring accurate measurement techniques are the foundation for implementing school-based BMI measurement programs. This article will provide an overview of body composition during childhood and adolescence, introduce strategies to improve the accuracy of BMI measurements, and explore the school nurse’s role in BMI surveillance and/or screening activities.

Female high school athletes are an at-risk population for the Female Athlete Triad—a syndrome including low energy availability (with or without disordered eating), menstrual dysfunction, and low bone mineral density. School nurses can play an important role in reducing the health burden of this syndrome, by educating coaches and athletes, and by referring symptomatic student-athletes to appropriate community resources for evaluation and treatment. This study assessed knowledge, attitudes, communication, and referral behaviors of U.S. high school nurses about the Female Athlete Triad. Participants were a random sample of 370 U.S. high school nurses. The results indicated that only 19% of the nurses were able to identify the three components of the Triad and only 25% reported that they work proactively with coaches to help prevent health issues among their female athletes. Over 95% expressed interest in learning more about the Triad. Implications for educational program design are discussed.

The purpose of this study was to analyze pornography exposure in a sample of 702 Italian adolescents (46% males; mean age = 18.2, SD = 0.8). Among male students, 11% were not exposed, 44.5% were exposed to nonviolent material, and 44.5% were exposed to violent/degrading material. Among female students, 60.8% were not exposed, 20.4% were exposed to nonviolent material, and 18.8% were exposed to violent/degrading material. Among males, adjusted odds ratio (AdjOR) of exposure to violent/degrading pornography were higher if using alcohol, having friends who sell/buy sex, and taking sexual pictures. Females who were victims of family violence, attending technical/vocational schools, and taking sexual pictures had higher AdjOR of watching violent pornography; smoking and having friends who sell/buy sex were associated with both nonviolent and violent/degrading exposure. Exposure to violent/degrading pornography is common among adolescents, associated with at-risk behaviors, and, for females, it correlates with a history of victimization. School nurses have a pivotal role in including discussions about pornography in interventions about relationships, sexuality, or violence.

Health care reform has changed the landscape for the nation’s health safety net, and school-based health centers (SBHCs) remain an important part of this system. However, few large-scale studies have been conducted to assess their impact on access to care. This study investigated differences in access among a nationally representative sample of adolescent SBHC users. An analysis using multivariate logistic regression examined the association between student characteristics and access to care. We found no differences based on race/ethnicity or insurance status among adolescent SBHC users; however, we did observe significant differences with regard to unmet health needs. School nurses serve as invaluable frontline staff who can facilitate equitable access to care, provide high-quality primary care, coordinate care for students with community health services, and advocate for policy and funding support of SBHCs as a critical part of the safety net for underserved adolescents.

This study examined the response of parents of elementary school-aged children to a school-based body mass index (BMI) screening and parent notification program conducted in one Minnesota school district in 2010–2011 and whether parent’s response was moderated by child’s weight status. Randomly selected parents (N = 122) of second- and fourth-grade students completed a mailed self-administered anonymous survey. Child’s weight status was determined using measured height and weight. Most parents read the BMI notification letter and considered it helpful, independent of child’s weight status. Parents of overweight children were significantly more likely than parents of normal weight children to report healthy lifestyle changes. This low-intensity intervention has the potential to support children, especially overweight children, and their parents to make healthy lifestyle changes. Future studies should investigate whether parent’s response contributes to improved short- and long-term health outcomes for children.