A State School Nurse Initiative that Could Transform Healthcare Globally

The long-range purpose of this project is to legislate school nurses in all Kentucky public schools.   The short-range outcomes are to provide data supporting the value of the school nurse, suggest models for funding the school nurse, and provide strategies for garnering support among all stakeholders.  National data suggest that school nurses decrease absenteeism and increase graduation rates, important motivators for mandated legislation.   A state-wide initiative that involved youth advocates, nursing organizations, the state department of education, and county health departments, surveyed the school nurses to determine which counties had school nurses.  A follow-up IRB-approved project involved a telephone survey to determine the numbers of schools that had employed a nurse over the past five years and those that had not. Graduation rates, ACT scores, and absenteeism for schools with full time nurses were compared to those schools with no access to a nurse.  Findings noted that 42.3% of Kentucky schools had a full time nurse.  When compared to schools without access to a full time nurse, those with daily nurses had a significantly lower absence rate (6.3 vs. 6.8, with a p value of 0.05).  Graduation rates were also higher in the schools with access to a daily nurse (83 vs. 78%, with a p value of 0.0002).  There was no significant difference in ACT scores for the two comparison groups. The next phase in supporting the value of school nurses will be to provide data related to chronic condition outcomes, as well as measures for health and wellness outcomes.  Research related to alternative methods for funding school nurses, especially as the Accountable Care Act has emphasized the importance of health promotion and disease prevention, will be presented to the legislators.