Page 82 - MMP-N-NJ CCN 21st Century School Nurse Leadership Book

Social determinants of health and health disparities (health
inequity) are closely related. For example, children of racial
minorities are more likely to have untreated asthma and
be obese (U.S. Department of Health and Human Services,
HEALTH EQUITY 2012; Wang, 2011). School nurses are in the critical position
to address health disparities of students and families and
provide equitable health services (health equity) because of
their intimate knowledge of the environments where students
and families live, play, and access care.

The environment—including air, water, food, pollution,
chemicals, biological agents, and psychological influences—
is a fundamental determinant of individual and community
health. Children are vulnerable to environmental threats
ENVIRONMENTAL HEALTH that may exist in schools due to their daily exposure. School
nurses assess for factors that negatively affect health in the
school environment and promote policy and practices that
reduce environmental health risks and promote emotionally
and physically healthy school communities (ANA & NASN,
2017; MacNeil, Prater, & Busch, 2009).

Surveillance, closely aligned with nursing assessment, is a
key school nursing and community/public health practice
component. Surveillance is the ongoing, systematic collection,
analysis, and interpretation of health-related data essential
to the planning, implementing, and evaluating practice. It
SURVEILLANCE is usually proactive and includes disseminating the data to
those who need it to prevent or control health conditions
(Centers of Disease Control and Prevention, 2017). School
nurses practice surveillance when they monitor and describe
an increase in strep throat cases or influenza-like illness.
Surveillance and use of the data overlap with the principle
of QI.

Outreach, like surveillance, is proactive and involves identifying
individuals or populations at risk, providing education about
the health risk, strategizing ways to reduce the risk, and
OUTREACH finding services to assist (Minnesota Department of Health,
2001). For example, school nurses outreach to students
with undiagnosed asthma who exhibit signs or symptoms,
educating them and their families, and connecting them with
appropriate health care services.

*Definitions of the framework principles and components were taken from the original articles that developed the Framework for 21st
Century School Nursing Practice™ (NASN, 2016a; Maughan, Duff, et al., 2016). Where applicable the original source is cited. Permission
to use granted by the National Association of School Nurses. Re-printed with permission by the National Association of School Nurses.

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