Doctor of Nursing Practice

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Interactive Evaluation of the Mississippi School Nurse Procedures and Standards of Care Manual Use

H. Estelle Watts
University of Mississippi Medical Center
Degree track: DNP
Degree awarded: August 2015
DNP Project Chair: Karen Winters, PhD, RN
DNP Project Team Member: Fazlay Faruque, PhD


Introduction/Background and Significance: School nurses uphold a safety net and improve healthcare in schools and communities. Through a 2007 state legislative mandate, the Mississippi School Nurse Procedures and Standards of Care (SNPS) manual was provided to school nurses, but its use by and value to school nurses have not been assessed.

Methods: Using Owens' interactive model, a total of 30 school nurses in focus groups and 117 school nurse participants in an anonymous REDCap survey responded to questions on their use and value of the 2013 MS SNPS manual. Participant characteristics (age, race, educational level, nursing experience, student ratio and number of campuses assigned) related to manual use or nonuse, as well as determined frequency of use for individual manual sections, were assessed.

Data Analysis: SPSS was used to analyze all survey responses. Manual sections accessed and access frequency were identified. A workload variable was created by combining ratio and campus data. Comparisons between manual use and workload were examined. Focus group responses at study outset, as well as text-box survey comments were evaluated by nurse leaders for themes.

Results: The small size of the reported non-user sample (6%) made statistically significant user/nonuser comparisons impossible. Rather, the survey documented that almost half (48%) of the school nurse participants reported an extreme workload (48%), education among manual users was evenly distributed (ADN 51%, BSN 41.8%), and users (92%) and nonusers (80%) reported valuing the manual.

Discussion: Mississippi school nurse survey participants documented valuing the manual. Their documentation of extreme workloads, even without including the impact of chronic disease, strongly suggests additional resources are needed support the health care of Mississippi schoolchildren.