Expanded models of public health nursing in the schools

As public health and health care budgets tighten, new and innovative approaches to provide individual and population-based care to the most vulnerable are emerging. This is evidenced in school health delivery. Traditionally, funding for school nurses has been from school district budgets. New sources of revenue have expanded the reach and impact of school nurses, making them literally extenders of public health. After IRB approval, a national exploratory study was conducted to learn about new models for school health services (SHS). Snowball sampling was used to identify non-traditional SHS across the U.S.A. Phone interviews were conducted to learn about these nontraditional models including funding sources, services provided, and perceived strengths and weaknesses. The qualitative data was analyzed for common themes. Results indicate non-traditional funders involve public health agencies, hospitals, and other community health organizations. Strengths identified include an increase in the number of nurses and expanded school nurses’ role, which includes surveillance, identification of social determinants of health, as well as those at risk for hospital readmissions. There were also improved communication efforts between SHS, public health agencies, and health providers. Both student academic and health outcomes remained a priority. As health care reform continues and the emphasis on community based coordinated care grows, traditional roles like school nurses can be expanded with nontraditional funding sources. This can provide the support needed to ensure that every youth has contact with a nurse who serves as the bridge between community, health care providers, and public health.