School health nursing: screening, chronic conditions at school and the school setting
- Safe practice
At school the nurse screens, prepares care plans for children with chronic illness, handles emergencies and helps the school become a healthy place.
What it is
WHO describes a health-promoting school as one that keeps strengthening its capacity as a healthy place to live, learn and work, with students, staff, families, health providers and community leaders. School health services include preventive care such as vaccination and vision and hearing screening, first aid and emergency care, and management of chronic conditions such as asthma, diabetes and epilepsy through an individual care plan shared by the school, the family and health providers (CDC). In Colombia, Res. 3280 de 2018 describes collective interventions in the school setting: characterising the school community and its environment, health education, screening and community networks. The nurse coordinates, teaches and links the school with the health service.
What it requires
- CDC reports that more than 40% of school-aged children and adolescents in the USA have at least one chronic condition.
- Res. 3280 de 2018 includes in the school setting the identification of students with disability, mental disorders or psychosocial problems, and of the school climate (bullying, stigma).
- The whole school community can learn seizure first aid to support students with epilepsy (CDC).
- A student with head lice can finish the school day and return after starting treatment; nits rarely spread and checks by non-health staff often get them wrong (CDC).
Components
- Prevention: vaccination, vision and hearing screening, oral health, nutrition, physical activity.
- Chronic conditions: asthma, diabetes, epilepsy, allergies and obesity with an individual plan.
- Emergencies: first aid, a crisis plan and trained staff.
- Mental health and climate: bullying, stigma, listening spaces and referral.
- Environment: water, food, sanitation and safe surroundings.
How it is applied (and why)
- Review the school's characterisation and health needs with the school — the plan starts from the school's reality.
- Check vaccination cards and organise catch-up with the health service — school is a good place to close gaps.
- Organise vision and hearing screening and refer positives — undetected problems harm learning.
- Write an individual care plan for each student with a chronic condition with the family and doctor — everyone knows what to do.
- Train teachers in the plan: warning signs, first aid and when to call — the nurse is not always present.
- Agree how medicines and supplies for the school day are stored and given, under the plan — safety and access together.
- Teach health topics agreed with the school (hygiene, nutrition, sexuality, substance use) — education changes habits.
- Detect bullying, distress or signs of abuse and activate the route — the school sees what the clinic does not.
- Keep communication with families and the health service and record every action — continuity protects the student.
In nursing practice
- Asthma: the school adopts asthma-friendly policies and the student's care plan says what staff do in an attack.
- Diabetes: plan glucose checks, snacks and physical activity during the school day with the family.
- Head lice: share information with staff and families to limit spread, and avoid exclusion from class (CDC).
- Obesity: the school can help young people reach and keep a healthy weight through food and physical activity (CDC).
Common mistakes
- Keeping the care plan only in the nurse's office where teachers cannot use it.
- Excluding a child for nits.
- Screening without a route to refer and follow up positives.
- Giving talks without agreeing topics with the school and students.
Test yourself
Think of the answer, then tap the question to see it.
What is a health-promoting school according to WHO?
A school that keeps strengthening its capacity as a healthy place to live, learn and work, with the participation of students, staff, families and community.
Who shares responsibility for a student's chronic condition care plan?
The school, the family and the health providers, coordinated by the school nurse (CDC).
Should a child with head lice be sent home immediately?
No. CDC says the student can finish the day, start treatment and return; «no-nit» policies are not recommended.
Elsewhere in DurgiPedia
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Health-promoting schools (health topic) (World Health Organization, 2024); School health services (Centers for Disease Control and Prevention, 2024); Providing care for individuals with head lice (Centers for Disease Control and Prevention, 2024); Resolución 3280 de 2018 (Ruta de Promoción y Mantenimiento de la Salud), 3.2.1.2 Intervenciones colectivas en el entorno educativo (Ministerio de Salud y Protección Social, Colombia, 2018).
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Representative model, for educational purposes only.