Elementary School Nurse Interventions: Attendance and Health Outcomes

Abstract

Regular school attendance is a necessary part of the learning process; student absenteeism has a direct association with poor academic performance. School nurses can influence student attendance. This study describes the impact of school nurse interventions on student absenteeism and student health. A retrospective review of 240 randomly selected elementary student health folders and attendance records was conducted. School nurses were involved with 75% of high-absence students as compared to 66% of low-absence students; they were also more involved with students who had previously identified health conditions. There were no referrals to the school nurse for absenteeism and school nurse interventions were not targeted to attendance, despite 17% of students missing 11 or more school days. Nursing documentation was sparse and primarily task related. Few records contained entries of nursing diagnoses, interventions, or outcomes. Of the 134 interventions provided, only 56 (41.2%) had some information about the condition outcome, but it was insufficient to determine the effectiveness of nursing interventions. Furthermore, the record system did not support the collection of standard information for interventions or outcomes from which effectiveness could be determined. Recommendations include establishment of an attendance referral policy and improved documentation systems, including the use of standardized nursing language to demonstrate student outcomes.

Cost-Benefit Study of School Nursing Services

“…A growing body of research has examined the effect of school nursing services on students and teachers. On-site school nursing services were effective in improving student health 11 and student attendance, 12,13 reducing early dismissals [14][15][16] and reducing teacher time spent on dealing with student illness or injury. 17,18 However, to our knowledge, no study has assessed the economic impact of school nursing services.…”

The Relationship Between School-Based Health Centers, Rates of Early Dismissal From School, and Loss of Seat Time

“…More studies should be performed using loss of seat time as a measure of attendance. Past studies that used conventional attendance data have been unsuccessful because of inconsistency in the collection of this data, high mobility of high‐risk students, and the inability to separate data on nonattendance for health reasons from nonattendance for such other reasons as suspensions and appointments 2,10,22–24 …”

Exploring relationships between school-based health clinics and academic performance in elementary school-aged children

“…Weismuller et al [9] described the effect of school nurse interventions on decreasing the rate of student absenteeism because of their increased interaction with students who are absent from school and by giving health guidance to the students. In similar vein [16] found that there is a strong correlation between student attendance (including absenteeism and tardiness) and SBHCs.…”

“…Attendance is the number one determinant of the connectedness between students and their school community, whether this is high or low [9]. Since attending school regularly is a necessary part of the learning process, being absent most of the time has a direct negative effect on academic performance [9,10].…”

“…According to [9,15] the presence of school nurses can be effective in addressing the issue of school absences. Weismuller et al [9] described the effect of school nurse interventions on decreasing the rate of student absenteeism because of their increased interaction with students who are absent from school and by giving health guidance to the students.…”