School nurses are expected to implement their roles in providing care for individual health needs; supplying education for school staff and students; and acting as bridges for communities, schools, families, and healthcare professionals (Council on School Health, 2016; NASN, 2016). The importance of age- and developmentally-appropriate diabetes education has been emphasized in the literature, there is very little information about reasons that school nurses initiate diabetes education in school settings
Methods: A content analysis methods was employed (Duncan, 1989; Elo & Kyngäs, 2008; Hsieh & Shannon, 2005). Twenty semi-structured interviews were conducted with a subsample of 114 school nurses who have taken care of students with type 1 diabetes in public schools in the State of Washington, U.S. and participated in a larger study including surveys and interviews. The interviews were digitally recorded, transcribed verbatim, and analyzed. Peer debriefing and member-checking were used to maintain the trustworthiness (Lincoln & Guba, 1985; Polit & Beck, 2012).
Results: Interview participants were highly homogeneous: female (95% ), non-Hispanic (90%), White (85%), and RNs (80%). The primary reason for initiating diabetes education in schools was ‘responding to a diabetes-relevant situation immediately’. The major themes identified in this reason included: 1) Immediate situation-driven diabetes education; 2) new information relevant to diabetes care for a student; 3) s diabetic student’s expression for need for support; 4) students’ incorrect performance of diabetes management; 5) expected visits based on school schedule, and 6) a diabetic student’s developmental status.
Conclusion: School nurses seemed to provide diabetes education as an immediate response to students’ diabetic needs in both management and their diabetic situations, such as hypoglycemic events in schools. School nurses’ education while responding to an immediate situation could assist students manage their conditions more independently, although it was not planned as long-term education. The findings were consistent with school nurses’ roles suggested by National Association of School Nurses (2017), American Academy of Pediatrics (Council on School Health, 2008), and American Diabetes Association (2014), in terms of supporting diabetic students’ learning in schools. Developing a standardized diabetes education plan and materials for situation-specific diabetes education in schools is recommended for providing proper diabetes education to diabetic students in a timely manner.
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