Process and Outcomes of School Nurse Case Management for Students With Asthma

Abstract

There have been many studies that have examined the impact of school-based asthma programs on students with asthma. However, most studies do not provide adequate elaboration on the components of the program. Therefore, replication of these programs is difficult. This study examines the process of school nurse case management, which includes the development of individualized goals and the provision of specific interventions. The process is then linked to several outcomes (parent perception, quality of life, and academic success). The study demonstrates the complexity of case management provided by school nurses and how goal attainment is related to the outcomes. The study supports policy recommendations that advocate for the importance of professional school nurses in improving the health and well-being of students with asthma.

Flying by the seat of their pants: A grounded theory of school nurse case management

“…School nurses described guiding others and training as ways they practiced case management (Figure ) and this is consistent with what has been described by other researchers (Cheung et al, ; Engelke et al, ). However, nurse participants described conducting these actions in the practice context of inadequate resources and lack of knowledge of state‐wide tools that would support case management.…”

“…However, participants did not discuss other case management roles such as prioritizing, monitoring, collaboration, supervising others, and evaluating outcomes (Bonaiuto, ; Engelke et al, ; Lee, Mackenzie, Dudley‐Brown, & Chin, ). Participants also did not discuss the health promotion roles of environmental management or advocacy that have been described by other researchers who have examined school nurse work in the US (Bednarz, ; Engelke et al, ; Wainwright, Thomas, & Jones, ). This finding indicates that an emphasis on case management may be limiting or adding constraints to nurses work inside schools.…”

“…Although not required for grounded theory research, a conceptual framework can help justify a methodology or used as a guide as the researcher develops a theory (Strauss & Corbin, ). The framework developed for the anticipated roles of the SNCM centres around the student with a variety of nurse actions and roles (Figure ; Engelke et al, ; National Association of School Nurses, ). These actions and roles include assessment, education, care coordination, delegation, team participation, communication, goal‐centred care plans, and direct care.…”

The Role of School Health Services in Addressing the Needs of Students With Chronic Health Conditions

“…Engelke and colleagues showed a non-significant reduction in grade point average (GPA) among students who received CM. The largest average gain in GPA was when the goal of improving psychosocial support of the family was met; the largest decrease was when children did not meet the goal of disruptive classroom behavior (Engelke, Swanson, & Guttu, 2014). …”

Building Trust

“…We must be visible, recognized as a member of both the health and education teams, and we must be reimbursed by health care funding streams for the care we provide. School nursing care is cost effective; it improves health and educational outcomes for students while decreasing absenteeism and increasing student time in the classroom (Engelke, Swanson, & Guttu, 2014;Lineberry & Ickes, 2014;Wang et al, 2014). School nurses recognize the care and positive outcomes for students as a result of our interventions and yet the public and others often do not realize the benefit to our students as well as the complexity of our role.…”