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Elementary School Nurse Interventions: Attendance and Health Outcomes

Penny C. Weismuller, RN, DrPH, is an assistant professor with California State University, Fullerton, Fullerton, CA

Merry A. Grasska, RN, MPH, NP-C

Merry A. Grasska, RN, MPH, NP-C, 2005 School Nurse of the Year, is a school nurse and nurse practitioner with Newport-Mesa Unified School District, Costa Mesa, CA, and assistant clinical professor at University of California, Irvine, CA

Marilyn Alexander, RN, MSN

Marilyn Alexander, RN, MSN, is a school nurse with the Orange County Department of Education, ACCESS Program, Costa Mesa, CA

Catherine G. White, RN, Med

Catherine G. White, RN, MEd, is a school nurse with Garden Grove Unified School District, Health Services, Garden Grove, CA

Pat Kramer, RN, BS

Pat Kramer, RN, BS, is a school nurse with Garden Grove Unified School District, Health Services, Garden Grove, CA

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.

Key Words: attendance • absenteeism • school nursing outcomes • standardized nursing language • student academic performance

The Journal of School Nursing, Vol. 23, No. 2, 111-118 (2007)
DOI: 10.1177/10598405070230020901


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