ABSTRACT
At the University of North Florida School of Nursing, students, faculty, and community partners engage in a long-term relationship with a home-base to address community issues and student learning objectives. Community home-bases can be geographic or programmatic, but they serve as the central place where all of the partners come together and participate in mutually beneficial service-learning activities. The Home-base model addresses the unique integration of this partnership in the undergraduate curriculum, distinguished by the continuity of the student's clinical practice in one place throughout their nursing program. Findings from formative evaluation indicated that students "see the big picture," "shed underlying prejudices," "value upstream approaches," and "make a difference." This article describes the development and structure of the Home-base model, identifies preliminary outcomes, and discusses implications for nursing education.
Subject(s)
Clinical Competence , Community Health Nursing/education , Continuity of Patient Care/organization & administration , Education, Nursing, Baccalaureate/organization & administration , Patient-Centered Care/organization & administration , Students, Nursing , Attitude of Health Personnel , Community Health Nursing/organization & administration , Community Participation , Curriculum , Florida , Focus Groups , Humans , Models, Educational , Models, Nursing , Nursing Education Research , Nursing Methodology Research , Program Development , Program Evaluation , Students, Nursing/psychologyABSTRACT
Published qualitative studies have not focused on nurses who solely care for children with special health care needs. The purpose of this study was to explore and describe (a) the work of school nurses who care exclusively for these children, (b) nurses' interaction with parents, staff, or providers, and (c) the challenges, benefits, and support for their role. Data from on-site observation and in-depth interviews with experienced, long-term employed nurses (n = 13) were analyzed using qualitative descriptive inquiry. Performing a personally satisfying clinical role, school nurses adapted to a "teachers world" by working alone, feeling responsible; begging, bartering, and subsidizing; and embracing school as family. They bridged home and school by doing for children, building relationships with parents, and knowing the child. Nurses need to be supported through peer supervision and adequate resources to provide family-centered care to students in a setting dominated by education professionals.
Subject(s)
Chronic Disease/nursing , Disabled Children , Education, Special , Health Knowledge, Attitudes, Practice , School Nursing , Child , Female , Humans , Interpersonal Relations , Nurse's Role , Qualitative Research , School Nursing/methods , School Nursing/organization & administration , United StatesABSTRACT
BACKGROUND: Few recent studies have focused on the role of school nurses who predominantly care for children with special health care needs (CSHCN). The primary aim of this study was to explore differences related to (a) child health conditions covered, (b) direct care procedures, (c) care management functions, and (c) consultation sources used among nurses who spent the majority of their time caring for CSHCN compared to a mixed student population and among nurses who covered a single school versus multiple schools. METHODS: A community-based interdisciplinary team developed a 28-item survey which was completed by 50 nurses (48.5% response) employed by health departments and school districts. Descriptive and comparative statistics and thematic coding were used to analyze data. RESULTS: Nurses who covered a single school (n = 23) or who were primarily assigned to CSHCN (n = 13) had a lower number of students, and more frequently (a) encountered complex child conditions, (b) performed direct care procedures, (c) participated in Individualized Education Plan (IEP) development, (d) collaborated with the Title V-CSHCN agency, and e) communicated with physicians, compared to nurses who covered multiple schools or a general child population. Benefits centered on the children, scope of work, school environment, and family relationships. Challenges included high caseloads, school district priorities, and families who did not follow up. CONCLUSION: The number of schools that the nurses covered, percent of time caring for CSHCN, and employer type (school district or health department) affected the scope of school nurse practice. Recommendations are for lower student-to-nurse ratios, improved nursing supervision, and educational support.
Subject(s)
Disabled Children , School Nursing , Schools/supply & distribution , Child , Cross-Sectional Studies , Disabled Children/classification , Education, Continuing , Florida , Humans , Surveys and QuestionnairesABSTRACT
The University of North Florida School of Nursing used a participatory approach to develop a community-based and community-focused curriculum that engaged students, faculty, and community stakeholders. This Home-base Model evolved over 6 years, building inductively using a continuous quality improvement process. We describe the formative evaluation process, the strategies used to engage the key stakeholders, and identify the benefits leading to the sustainability of the Home-base Model. A plan for external evaluation is in progress, building on existing stakeholder involvement and focusing on outcomes. The development of the Home-base Model is offered as an exemplar of how a participatory approach can build community nursing curricula that are consistent with community-driven agendas.
