Diabetes management at school demands close collaboration of multiple stakeholders, including students with diabetes and parents, school nurses, teachers/staff, and local health care providers. This scoping review identified and synthesized evidence concerning factors that contributed to the quality and effectiveness of diabetes care implementation in U.S. K-12 schools. Forty-six studies met the eligibility criteria and were included. Five common factors emerged surrounding training and experiences, communications, parent engagement, resource allocations, and school environment. Complex interactions between multiple stakeholders jointly determined the quality of school diabetes care. A conceptual model was established to elucidate the complex interactions between multiple stakeholders and the relevant facilitators and barriers. Future research should improve sample representativeness, contrast school diabetes care practices to the national guidelines, and assess the impact of the social, economic, and political environment at federal, state, local/district levels on school diabetes care implementation.

School nurses collect data to report to their school district and state agencies. However, there is no national requirement or standard to collect specific data, and each state determines its own set of questions. This study resulted from a joint resolution between the National Association of State School Nurse Consultants and the National Association of School Nurses. The study sought to determine whether similar data points were collected so that comparisons could be made among states and to develop a framework to incorporate the data. Thirty-two states provided their questionnaires or reports. There were 855 data points that could be divided into data related to staff and to students. No categories were measured by all states. The most common data points were the number of students, health screenings, and the number of students with particular conditions for whom the district provided services. A framework for data collection is proposed.

School nurses collect voluminous amounts of data in a variety of ways and use the data to describe trends in students' health and patterns of illness in the student population or to identify ways to improve care. NASN identified years ago that a national school nurse data set was needed to enable data-driven decision making for the millions of children who attend school each day across the United States. Informal work has been done in the past 5 years in preparation for the current joint NASN/ National Association of State School Nurse Consultants workgroup. This article is the first of a two-part series related to the importance of data and national efforts to develop a uniform data set that all school nurses can collect. Collecting data, and collecting it in the same way as other providers, will demonstrate what school nurses do as well as provide the data necessary for robust research on the impact of school nurses on students' health.

There are many stakeholders for school health data. Each one has a stake in the quality and accuracy of the health data collected and reported in schools. The joint NASN and NASSNC national school nurse data set initiative, Step Up & Be Counted!, heightens the need to assure accurate and precise data. The use of a standardized terminology allows the data on school health care delivered in local schools to be aggregated for use at the local, state, and national levels. The use of uniform terminology demands that data elements be defined and that accurate and reliable data are entered into the database. Barriers to accurate data are misunderstanding of accurate data needs, student caseloads that exceed the national recommendations, lack of electronic student health records, and electronic student health records that do not collect the indicators using the standardized terminology or definitions. The quality of the data that school nurses report and share has an impact at the personal, district, state, and national levels and influences the confidence and quality of the decisions made using that data.

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