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Demonstrating the Relationship Between School Nurse Workload and Student Outcomes

Release Date: 01/08/2018 
Expiration Date: 01/18/2021
Originally presented at the NASN2016 Annual Conference

Upon successful completion of this offering,
participants will receive 1.0 CNE contact hour.

Cost: $20.00
FREE for NASN members!

Program Overview
Traditionally, school nurse workload recommendations have been based on a caseload acuity model. The National Association of School Nurses (NASN) issued a Position Statement advocating for the development and evaluation of new workload models that include social determinants of health. Incorporating these more comprehensive measures should provide a more accurate representation of the needs for school nursing, particularly for students with health needs that are not reported or not effectively addressed by their family or other school personnel.
This educational activity will describe a Workload Acuity Model that includes traditional measures (identified health conditions and procedures) and nontraditional measures (ABC Composite Score, % free and reduced lunch, % with limited language proficiency). The model that was used during the 2014-15 school year gave a higher weight to the nontraditional measures in determining the number of school nurse hours a particular school received. Of the 169 schools in the district, 41 schools received 24 hours/week, 55 schools received 16 hours/week, and 73 schools received 8 hours/week.
Data will be presented that is related to the impact of the model on several student outcomes including the number of students who received case management, the outcomes of case management, and the number of students who were referred to and obtained a medical home.
The data indicate that schools that received additional school nurse hours based on the acuity model had improved students outcomes. The implications of the model for other school districts as well as future plans for revisions to the model will be discussed. 

Learning Outcomes
As a result of participating in this educational activity, learners will be able to
  • Describe a school nurse workload model that incorporates identified healthcare needs as well as social determinants of health.
  • Discuss the relationship between the acuity workload model and student outcomes.
  • Examine the implications of the model for school nurse practice and research.
Intended Audience
This continuing education program is a knowledge-based activity developed to meet the educational needs of registered nurses who are interested in child and adolescent health.


Martha K. Engelke, PhD, RN, CNE, FAAN
East Carolina University College of Nursing
Graduate Nursing Science
Greenville, North Carolina

Donna H. Daughtry, BSN, RN, NCSN
Program Manager
Wake County Human Services, School Health
Raleigh, North Carolina

Faculty and Program Planner Disclosures
NASN must ensure that all educational session content is free of commercial bias and influence. The intent of this disclosure is to provide learners with information on which they can make their own judgments.

The nurse planner, faculty and reviewers disclose the absence of personal financial relationships with commercial interests relevant to this educational activity within the past 12 months.

Accreditation Statement
National Association of School Nurses is accredited with distinction as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Accredited status does not imply endorsement by NASN or ANCC of any commercial products discussed in this learning activity.

Commercial Support or Sponsorship
This program did not receive commercial support or sponsorship.

Instructions to Complete This CNE Activity
To receive a Certificate of Completion for this course, follow the steps below, and complete and view the full content of the program including the course evaluation.

NASN will conduct an outcome assessment of a sample of participants at a later date. Please be advised that, if you complete this course, you may be asked to participate in this outcome assessment.

Step 1: Enroll in the course. Select the Purchase button. Enroll through the e-commerce system. The cost for this course will be waived for NASN members during the checkout process.

Step 2: Complete and view the full content of the program. Content items are indexed at the bottom of this screen. After you enroll, you will return to this screen. The first content item will be “unlocked” so that you can begin completing the course. Subsequent items will “unlock” as you complete previous items.

Step 3: Print the certificate.