Reported Impact of COVID-19 Workload and Stressors on School Nurses' Provision of Care During the 2021-2022 School Year: A Secondary Analysis of U.S. School Nurse Survey Data.

Many school nurses experienced increased work burden and stress during the COVID-19 pandemic. This analysis examined data from a Centers for Disease Control and Prevention cross-sectional, nationwide survey of school nurses in March 2022 to examine associations between school nurses' ability to conduct their core responsibilities and selected nurse and school factors among school nurses during the 2021-2022 school year and COVID-19 pandemic. Perceived adequate staffing and financial compensation reduced the odds of reported difficulties across all core school nursing tasks. Nurses without a registered nurse license and with higher caseloads were more likely to report difficulty in implementing specific tasks. The impact of these factors varied, with inadequate financial compensation having the largest association with school nurses' difficulty implementing all the core responsibilities. The study results improve our understanding of school nurses' challenges in implementing core school nursing responsibilities during the COVID-19 pandemic in the 2021-2022 school year.

Symptoms of Depression, Anxiety, and Post-Traumatic Stress Disorder, and Suicidal Ideation Among School Nurses in Prekindergarten through Grade 12 Schools - United States, March 2022.

School nurses are integral to creating safe environments in U.S. schools. Many experienced increased work burden and stress during the COVID-19 pandemic. CDC collaborated with the National Association of School Nurses and the National Association of State School Nurse Consultants to distribute a 121-item online, anonymous survey to school nurses nationwide during March 7-30, 2022. Among the 7,971 respondents, symptoms of depression, anxiety and PTSD, and suicidal ideation were measured, and prevalence ratios were used to identify associations with demographics, workplace characteristics, and support. Results found high levels of work-related stressors and indicated that employment characteristics, COVID-19-related job duties, and other workplace stressors and supports affected school nurse mental health. The survey findings underscore the mental health challenges many school nurses experienced during the 2021/2022 school year. The findings can inform supportive policies and practices to reduce workplace stressors and increase workplace supports for school nurses.

Nurse-Led Mobility Program: Driving a Culture of Early Mobilization in Medical-Surgical Nursing.

BACKGROUND: Hospitalized medical-surgical patients are at risk for adverse health outcomes due to immobility. Despite well-documented consequences, low mobility is prevalent. LOCAL PROBLEM: In a 547-bed hospital, medical-surgical patients were mobilized less frequently than expected. Physical therapists were inappropriately consulted 22% of the time for routine mobility of patients. A preimplementation survey of registered nurses indicated a lack of knowledge and confidence to safely mobilize patients. METHODS: This quality improvement project implemented a nurse-led mobility program in an effort to increase early mobilization, reduce physical therapy referrals for routine mobility, and reduce the sequelae of immobility. INTERVENTIONS: The Bedside Mobility Assessment Tool and standardized interventions were implemented on 5 medical-surgical units. RESULTS: Postimplementation, nurse-led patient mobilizations increased by 40%, inappropriate physical therapy orders decreased 14%, and no significant change in patient falls or pressure injuries was noted. CONCLUSION: A nurse-led mobility program was effective in increasing safe, early mobilization of patients and improving the culture of mobility.

Cannabis Use and Bleomycin: An Overview and Case Study of Pulmonary Toxicity.

BACKGROUND: Legalization efforts in many states have heightened awareness of the medicinal uses of cannabis, and oncology nurses are more frequently caring for patients who have used or are using cannabis. Significant epidemiologic data on the prevalence of cannabis use in patients with cancer are not yet available, and not much is known about the effects of cannabis on cancer treatment. OBJECTIVES: This article describes the effects cannabis may have on the lungs, reviews indications for cannabis use in patients with cancer, and explores an atypical case of progressive pulmonary toxicity in a young patient with a history of Hodgkin lymphoma and cannabis use. METHODS: A review of the literature on cannabis-associated lung injury was conducted, with 32 articles selected for full review. FINDINGS: As cannabis use in cancer care continues to gain support, further research evaluating cannabis use in patients treated with bleomycin is warranted. In addition, the pros and cons of cannabis use must be fully evaluated and discussed with the patient with cancer prior to recommending its use.

Follow-up of an elementary school intervention for asthma management: do gains last into middle school?

OBJECTIVE: Albuquerque Public Schools (APS), in collaboration with the Centers for Disease Control and Prevention, conducted an evaluation to examine whether students who were exposed to the APS asthma program in elementary school retained benefits into middle school. METHODS: APS middle school students who participated in the APS asthma program in elementary school, including the Open Airways for Schools (OAS) education curriculum, responded to a follow-up questionnaire (N = 121) and participated in student focus groups (N = 40). Asthma management self-efficacy scores from the follow-up questionnaire were compared to scores obtained before and after the OAS education component. Additional items assessed students' asthma symptoms, management skills, avoidance of asthma triggers, and school impact. RESULTS: Although asthma management self-efficacy scores declined in middle school among students exposed to the asthma program in elementary school, they remained significantly higher than scores obtained during elementary school prior to the OAS intervention. CONCLUSION: The results indicate that although students benefited from the asthma program delivered in elementary school, they need booster sessions and continued school support in middle school.

Relationship between asthma, overweight, and physical activity among U.S. high school students.

Asthma is a leading chronic illness among children and adolescents in the United States. This study examined the relationship between asthma and both overweight and physical activity levels. Results are based on data from the Centers for Disease Control and Prevention's 2003 national Youth Risk Behavior Survey, a cross-sectional survey of health risk behaviors among a representative sample of high school students in the United States. The overall survey response rate was 67% and the results are based on weighted data. SUDAAN was used for all data analysis (prevalence estimates and logistic regression) because it accounts for the complex sampling design of the survey. Significantly more students with current asthma than without were overweight (odds ratio [OR] = 1.4; 95% confidence interval [CI] = 1.1, 1.6) and described themselves as overweight (OR = 1.2; 95% CI = 1.0, 1.4). Significantly more students with current asthma than without used a computer for non-schoolwork 3 or more hours/day (OR = 1.3; 95% CI = 1.1, 1.5). No significant differences were found for participation in sufficient vigorous or moderate physical activity or strengthening exercises among students with and without current asthma. Unlike some other risk factors for developing or exacerbating asthma, overweight and physical activity are generally modifiable. School and community policies and programs can play an important role in asthma management, including promoting the maintenance of an appropriate weight and encouraging continued physical activity.

Tobacco and other drug use among high school students with asthma.

The 2003 national Youth Risk Behavior Survey data were analyzed to compare drug use among high school students with and without asthma. High school students with current asthma used cigarettes, cigars, marijuana, and inhalants (huffing) at rates equal to or greater than high school students without current asthma.

School climate and implementation of the Pathways study.

BACKGROUND: Pathways was a multisite school-based study to prevent obesity in American Indian school children by encouraging healthy eating and physical activity. METHODS: Over the 3-year study, a total of 290 in-depth interviews were conducted with school administrators, food service managers, classroom teachers, and physical education instructors in all 21 intervention schools to examine support and barriers for Pathways. Analysis included qualitative assessment of key themes using NUD*IST and quantitative modeling of the impact of a school climate score on implementation of intervention components. RESULTS: Overall, teachers, food service managers, and physical education instructors were supportive of the Pathways interventions. School administration and lack of family participation were perceived barriers at some schools. Attitudes toward the program ranged from neutral to positive during the first year, with about two-thirds giving positive ratings, with greater variation in successive years. Overall, the mean score was 3.5 on a 5-point scale (1=very negative, 5=very positive). School climate score was positively associated with classroom curriculum and student exposure indices, but not with family attendance, food service, or physical activity implementation indices. The latter two indices were associated with site. CONCLUSIONS: An assessment of school climate through interviews is useful in understanding successes and failures in a school-based health intervention and can predict implementation success for some programs.