competency in skills and knowledge through assessment tests,
but are not required to complete a specific number of hours.
School Nurses (ASN to BSN)
Anonymous
Work Process Content
On the Job Training
Standard 1. Assessment
14
The school nurse collects pertinent data and information relative to the student’s health or the situation.
- Recognizes the impact of one’s own personal attitudes, values, and beliefs on the assessment process.
- Creates the safest environmental possible for conducting assessments.
- Integrates evidence-based knowledge from global and environmental factors into the assessment process to foster an inclusive and collaborative climate.
- Conducts a whole child assessment related to health, education, and quality of in an interprofessional, systemic, and ongoing manner.
- Recognizes the student and their parent/guardian as the decision makers regarding their own health.
- Identifies barriers to effective written, verbal, and nonverbal communication based on biological, ethnic, cultural, psychosocial, literacy, environmental, and financial considerations.
- Integrates evidence-based knowledge from current local, national, and global health initiatives and environmental factors into the assessment process.
- Prioritizes data collection based on the student’s immediate condition or the or the anticipated needs of the student or situation
- Adheres to ethical, federal, state, and district laws, guidelines, and policies in the collection, maintenance, use, and dissemination of data.
- Validates the analysis with the student/parent/guardian and interprofessional team.
- Documents relevant data accurately and, in accordance with federal, state, and district privacy regulations, in a manner accessible to the interprofessional team
- Uses national and regional standardized data sets and systems whenever possible.
- Attains knowledge regarding emerging technologies that may impact assessment process. (e.g., telehealth, AI)
- Participates in school community assessment using principals of population health, community engagement, nursing, social, ecology, and a systems perspective.
Standard 2. Diagnosis
8
The school nurse analyzes the assessment data to determine actual or potential diagnosis, problems, and issues.
- Identifies the student, family, and school community strengths and abilities, including support systems, health literacy and engagement of self-care.
- Identifies actual or potential risks to health and safety of the student, family of school community and/or barriers to their health, which may include but are not limited to interpersonal, systematic, cultural, or environmental circumstances.
- Uses assessment data, standardized classification systems, and technology to articulate actual or potential diagnosis.
- Verifies the diagnoses, problems, and issues with the individual, family group, community, population
- Prioritizes diagnoses, problems, and issues with the individual, family, group, community, population, and interprofessional colleagues.
- Documents diagnoses, problems, and issues in a manner that facilitates the determination of the expected outcomes and plan.
- Interprets the diagnoses or issues to the student, family, and appropriate school staff.
- Synthesizes population data to interpret findings and formulate conclusions about the health status, health outcomes, disparities, and health conditions of the students and the school community.
Standard 3. Outcomes identification
6
The school nurse identifies expected outcomes for a plan individualized for the student or the situation.
- Engages the student, family, and interprofessional team, and others in partnership to identify expected outcomes and goals that are specific, measurable, attainable, realistic, time limited, inclusive, and equitable (S.M.A.R.T.I.E)
- Formulates holistic, expected outcomes derived from assessments and diagnoses that reflect the student and family’s culture, values, and ethical concerns.
- Uses clinical expertise and current evidence-based practice to identify health risks, benefits, costs, with expected trajectory of the condition.
- Modifies expected outcomes based on changes in health/wellness
- Develops expected S.M.A.R.T.I.E. goals and outcomes for population interventions in partnership with stakeholders.
- Documents expected outcomes.
Standard 4. Planning
14
The school nurse develops a plan that prescribes strategies to attain expected, measurable outcomes that address the student, family, group, school community, or population.
- Develops an individualized, holistic, evidence-based plan in partnership with the student who has complex conditions and his/her interprofessional team.
- Integrates primary preventive care into planning including collaborations with the medical, dental home and community partners.
- Develops a plan to address the needs of the school community and student populations with community partners.
- Prioritizes elements of the plan based on the assessment of the student’s level of risk, safety needs, assets (or strengths), and the social determinants of health.
- Design the plan to include responsible and appropriate use of health and medical interventions to maximize student health and independence in the least restrictive environment.
- Includes innovative practices from nursing and other disciplines in the plan.
- Seeks new scientific evidence and best or promising practices to achieve expected plan outcomes.
- Designs the plan to address each of the identified diagnosis.
- Creates an implantation pathway that describes timeline, steps, and expected outcomes.
- Develops the plan that reflects compliance with current statutes, rules and regulations, and standards.
- Modifies the plan according to the ongoing assessment of the student’s response, and other outcome indicators such as health behavior change theory, and new knowledge.
- Documents the plan using the standardized language or recognized terminology.
- Partners with community members, health professionals, and stakeholders, to prioritize assessment findings, diagnosis, and expected outcomes to support the development of population-based plans.
- Participates in development of the emergency operation/disaster plans and after-action reporting.
Standard 5. Implementation
13
The school nurse executes an agreed upon plan/intervention for student, family, school community, or population
- Translates evidence and clinical practice guidelines into the practice with fidelity for safe, quality health care, and student, family, and school community satisfaction.
- Partners with the student, family, and community to implement the plan in a safe, effective, effective, and timely, patient-centered, and equitable manner.
- Integrates interprofessional collaboration and communication in the implementation of the plan.
- Provides culturally congruent, holistic care that focuses on the student and school community and addresses and advocates for the needs of diverse populations.
- Provides culturally sensitive inclusive, holistic care that focuses on the student and school community and addresses and advocates for the needs of diverse populations.
- Uses evidence-based interventions and strategies to achieve the mutually identified goals and outcomes specific to the problem or needs.
- Integrates critical thinking and technology solutions to implement the plan.
- Delegates according to the health, safety, and welfare of the student and considering the circumstance, person, task, direction or communication, supervision, evaluation, as well as the state nursing practice act regulation, institution, and regulatory entities while maintaining accountability for the care.
- Documents implementation and any modifications, including changes or omissions, of the identified plan in the appropriate health and education records.
- Integrates traditional, alternative, and complementary healthcare practices as appropriate.
- Provides prescribed interventions, including medication administration, treatments, counseling, and crisis intervention.
- Facilitates utilization of systems, organizations, and community resources to lead effective change and implement the plan.
- Coordinates implementation of the emergency operation/ disaster plan.
Standard 5A. Coordination of Care
8
The school nurse coordinates care delivery for student, family, group, school community or population.
- Coordinates creation and implementation plan(s).
- Provides care coordination among all members of the student’s interprofessional education and health care team including parents/guardians.
- Manages a student’s care in order to reach mutually agreed upon outcomes.
- Facilitates student’s access to care.
- Communicates with the student, family, interprofessional team, and community-based resources to effect safe transitions in continuity of care, including the use of proper authorizations in accordance with regulations and policies.
- Establishes the expectation of dignified, culturally congruent, developmentally appropriate, student centered, and holistic care by the interprofessional team.
- Documents the coordination of care.
- Incorporates the Individualized Healthcare Plan into the student’s educational day and school-sponsored activities.
Standard 5b. Health Teaching and Health Promotion
12
The school nurse employs strategies to promote health and a safe environment
- Provides opportunities for the student and school community to identify needed healthcare promotion, disease prevention, and self-management topics.
- Engages health promotion/health teaching in collaboration with the student’s values, beliefs, health practices, developmental level, learning needs, readiness and ability to learn, language preference, spirituality, culture, and socioeconomic status.
- Uses evidence- based learning principles to communicate health promotion and disease prevention information to the student and school community.
- Engages consumer alliance and advocacy groups in health teaching. And health promotion activities for students and the school community.
- Provides anticipatory guidance to students and families to promote health and prevent or reduce the risk of negative health outcomes.
- Collaborates with other school health professionals to provide appropriate and timely health promotion and health education to the student, family, and school community.
- Promotes health principles through the Framework for 21st Century School Nursing Practice and the Whole School, Whole Community, Whole Child model for students and the school community.
- Evaluates health information resources within the area of practice for accuracy, readability, and comprehensibly to help the school community access quality health information.
- Serves as a primary resource to the school community regarding health information and wellness.
- Utilizes evidence-based learning principles to conduct health teaching and counseling at the individual, aggregate, and population levels.
- Participates in the evaluation of health curricula and other heath instructional materials and activities.
- Works in partnership with faculty, librarians, and community partners to integrate health literacy, health promotion, and illness and injury prevention into cross-curricular content.
Standard 6. Evaluation
8
The school nurse evaluates progress toward attainment of goals and outcomes.
- Utilizes applicable standards and defines criteria in the evaluation process.
- Determines, in partnership with the student, family, and other stakeholders, the safety, timeliness, effectiveness, efficacy, equitability, and patient-centeredness (STEEP) of the strategies in relation to the responses to the plan and attainment of outcomes.
- Collects data to conduct holistic, systemic
- Conducts process evaluation of evidence-based interventions to determine fidelity and application within the school setting (e.g., Open airways for schools, seizure guidelines, peak flow meters).
- Documents the results of the evaluation including recommendations for improvement of the plan as identified by the school nurse. student, family, education, and community partners.
- Shares evaluation data and conclusions with the student, family, and other stakeholders in accordance with federal and state regulations.
- Analyzes feedback and evaluations from the students, parents, staff, and school community members to determine the effectiveness of employed strategies.
- Uses Results of the evaluation to recommend process, policy, procedure, or protocol revisions.
Standard 7: Ethics
10
The school nurse integrates ethics in all aspects of practice
- Integrates the Code of Ethics for Nurses with Interpretive Statements (ANA, 2015a) and Code of Ethics for School Nurses (NASN, 2016b) to guide nursing practice and articulate the moral foundation of school nursing.
- Demonstrates commitment to self-reflection, self-care, and ethical competence through continued personal and professional development.
- Integrates caring, kindness, social justice, and respect for the inherent autonomy, dignity, worth, and unique attributes of all people into nursing practice and policy.
- Promotes student and family engagement in the informed and shared decision-making and self-determination.
- Utilizes ethics guidance or resources in situations where the rights of the student and parent conflict with evidence-based practice.
- Demonstrates their primary commitment is to the student regardless of setting, situation, or institutional policy.
- Maintains therapeutic relationships and professional boundaries.
- Safeguards the privacy and confidentiality of students, their data, and information within ethical legal, and regulatory parameters, that is FERPA and HIPPA.
- Contributes to the establishment and maintenance of an ethical environment that is conducive to safe, quality health care in the educational setting.
- Collaborates with other health professionals and the public to protect human rights, promote health diplomacy, enhance cultural sensitivity and congruence, and reduce health disparities.
Standard 8. Advocacy
16
The school nurse demonstrates advocacy in all roles and settings.
- Advocates for the rights, health, and safety of the students and school community.
- Promotes removal of individual barriers and pervasive systemic inequities to optimize well-being, health, and educational achievement.
- Advocates for adequate school nurse staffing models to improve student, school. And community health.
- Promotes safe and evidence-based care of students, positive school environments, and sufficient allocation of culturally appropriate resources presented at an acceptable level of literacy to optimize health and educational outcomes.
- Empowers all members of the school team to include the student and family in care decisions.
- Promotes self-advocacy by students, families, communities, and populations.
- Participates in healthcare initiatives on behalf of the student, family, school, and community.
- Informs the political arena (which includes editorials, voting and other acts of advocacy) about the complex and holistic needs of the student, the role of the school nurse, and the vital components of optimal healthcare delivery in schools.
- Embraces diversity, equity, inclusivity, health promotion, and healthcare for students and families of varied geographic, educational, cultural, ethnic, racial, gender, and spiritual backgrounds.
- Leverages the ANA and the NASN Code of Ethics to develop policies, programs, and services to improve educational and health care delivery and access for underserves and vulnerable populations.
- Promotes evidence-based policies, regulations, and legislation at the school, local, state, and national level to improve healthcare access, equity, and delivery of health care.
- Advances evidence-based policies, programs, and practices in the school and community that maintains, sustains, and restores the environment and natural world.
- Incorporates societal, political, economic, and cultural factors to address societal determinates of health.
- Highlights the urgent need for a diverse and inclusive workforce as a strategy to improve outcomes related to the social determinates of health and inequities in the healthcare system.
- Models’ personal commitment to advocacy for students, the school nursing profession, the school community, and the public at large.
- Contributes to professional organizations to collectively advance advocacy efforts.
Standard 9. Respectful and Equitable Practice
15
The school nurse practices with cultural humility and inclusiveness
- Inventories one’s own values, beliefs, cultural heritage, and implicit biases via critical self-reflection to improve culturally congruent practice.
- Identifies the cultural-specific meaning of interactions, terms, and content.
- Engages community partners to identify cultural norms and values.
- Uses language translation resources to ensure effective communication.
- Seeks to understand the effects and impact of discrimination and oppression within and among vulnerable cultural groups.
- Respects student and family decisions based on age, tradition, belief and family influence, and stage of acculturation.
- Communicates with appropriate language and behaviors including the use of professional and competent adult interpreters and translators in accordance with the student’s and family’s healthcare preferences and state and local regulations.
- Utilizes terminology and salutations, communication characteristics, and written material vetted for the culture, literacy, and language of the population served.
- Engages students, families, key stakeholders, and others in designing and establishing internal and external cross-cultural partnerships.
- Advocates for policies, procedures, programs, services, and practices that promote health, prevent harm, and improve equitable access to care for culturally diverse students and families.
- Advances equitable access to school health services, interventions, health promotion programs, enrollment in research, health and academic education, and other opportunities.
- Promotes equity for students and families by education nurse colleagues, other professionals, and community stakeholders about cultural similarities and differences of students and families in the school community.
- Models safe, respectful, inclusive, accepting, just, and culturally congruent school nurse practice.
- Collaborates to establish a culture of safety for vulnerable students or groups.
- Documents student and family’s cultural practices, preferences, beliefs, language(s), as well as interventions and outcomes.
Standard 10. Communication
12
The school nurse effectively conveys information in all areas of practice.
- Assesses the effectiveness of their own communication skills.
- Engages in continuous improvement of communication skills based on identified learning needs.
- Applies laws and regulations pertaining to privacy and confidentiality in all communications.
- Uses communication styles and methods that demonstrate professionalism, caring, respect, empathy, cultural humility, sensitivity, active listening, authenticity, and trust.
- Utilizes evidence-based health counseling techniques as effective communication strategies.
- Incorporates appropriate alternative strategies to communicate effectively with those who have disabilities including visual, hearing, speech, language, or communication difficulties.
- Conveys accurate information in appropriate formats that takes into account the communication ability, health literacy, resources, and preferences of students, families, stakeholders, and members of the interprofessional team.
- Confirms that the recipient of the communication heard and understands the message.
- Contributes the nursing perspective in interactions and discussion with students, families, stakeholders, and members of the interprofessional team.
- Maintains communication with the interprofessional team and others to facilitate safe transitions and continuity in care delivery.
- Communicates to the appropriate authority, concerns about care processes and decisions, potential or actual hazards, deviations from the standard of care, errors in care, or the practice environment.
- Communicates student and school community outcomes and the school health program to the community, administrators, and the school board and key stakeholders.
Standard 11. Collaboration
12
The school nurse collaborates with students, families, and key stakeholders.
- Explores the areas of expertise and contribution of self, other professionals, and key stakeholders.
- Articulates the school nurse’s education, scope of practice, role and responsibilities within the team and community.
- Adheres to standards and applicable codes of conduct that govern behavior among peers and colleagues to create a work environment that promotes cooperation, dignity, respect, inclusion, and trust.
- Leverages the unique and complementary abilities of all members of the team to optimize attainment of desired outcomes.
- Translates knowledge of community health systems and populations, as well as the synergy between families, schools, and communities to enhance and effective collaboration on population health issues.
- Leads efforts to establish, improve, and sustain collaborative relationships to achieve safe, quality care for the school community that reflects values for justice, equity, diversity, and inclusion.
- Partners with students, families, stakeholders, and members of the interprofessional team to create, implement, and evaluate a comprehensive plan for change that leads to positive outcomes and quality care.
- Facilitates partnerships between families, schools, and communities, and other agencies to support student health and education goals.
- Promotes engagement through consensus building and conflict management.
- Uses effective group strategies to enhance team performance.
- Develops health policies, procedures, and programs in collaboration with school administrators and other stakeholders.
- Documents the outcomes and decisions of collaborative planning.
Standard 12. Leadership
12
The school nurse leads within their professional practice setting and the profession.
- Establishes a culture of respect, trust, dignity, and integrity.
- Embraces evaluation in practice and role performance to attain professional goals.
- Uses evidence-based leadership strategies to promote effective relationships, influence others, and manage change to achieve quality outcomes and a culture of safety.
- Adopts evidence-based conflict management strategies to facilitate critical conversations and diffuse tense situations among team members, students, parents, school, staff, and community partners.
- Directs the health services program within the school and community.
- Accepts authority, ownership, accountability, and responsibility for the quality of school health services.
- Contributes to the evolution of the profession through participation in professional organizations.
- Influence policy to promote health for students and school communication at the local, state, national, and global level.
- Serves in key roles in the school and work settings by participating in professional organizations.
- Respects and promotes structures and processes that reflect that people are the most valuable asset in an organization.
- Promotes recognition of school nursing accomplishments and the achievements of school nurse colleagues.
- Demonstrates inclusiveness and recruits diverse school nurses.
Standard 13. Education
9
The school nurse seeks knowledge and competence that reflects current nursing practice and promotes innovative, anticipatory thinking.
- Commits to lifelong learning through critical thinking, self-reflection, and inquiry for personal growth and learning.
- Identifies their own learning needs based on continual self-assessment and analysis of gaps based on nursing knowledge and the changing needs of the school population and the broader community.
- Acquire learning experiences to maintain and advance knowledge, skills, and abilities relative to the school nurse roles, the population of students, their families, the school community, and the status of local or global health.
- Participates in continuing professional development activities related to school nursing, interprofessional knowledge bases, and professional topics.
- Demonstrates application of education and knowledge via formal consultation and informal discussion to address issues in school nursing practice.
- Shares new knowledge from educational findings, experiences, ideas, and pertinent information relative to optimal healthcare and delivery in an educational setting with peers and health and education colleagues.
- Translates school culture for novice school nurses by role modeling, coaching, and sharing pertinent information relative to optimal care delivery.
- Facilities an environment supportive of ongoing education of school nurses, nursing students, healthcare, and interprofessional colleagues.
- Achieves professional certification including national school nurse certification and requires state credentials.
Standard 14. Scholarly Inquiry
9
The school nurse integrates scholarship, evidence, and research findings.
- Articulates the value of research and its application relative to the practice of school nursing.
- Identifies questions in school nurse practice that may be resolved through research.
- Participates in data collection such as surveys, pilot projects, and formal studies, including the school nursing national dataset.
- Engages with the scientific literature that is foundational to school nursing practice,
- Advocates for the ethical conduct of research and translational scholarship with particular attention to the protection of the student as vulnerable research participate.
- Investigates processes for team members to have continuous access to evidence-based practices and guidelines.
- Shares peer-reviewed research findings with colleagues to integrate knowledge into the school nursing practice.
- Collaborates with research from outside the educational system when they seek to study student health, school nursing practices, and school communities.
- Complies with institutional, district, state, and federal policies regarding the safe conduct of research.
Standard 15. Quality of Practice
14
The school nurse contributes to quality nursing practice.
- Engages in nursing practice that is safe, effective, efficient, equitable, timely, and student-centered (STEEP).
- Identifies barriers to and opportunities for improvement of healthcare safety, effectiveness, efficiency, equity, timeliness, and student centeredness.
- Document’s school nursing practice in a manner that supports quality and performance improvement initiatives across the interprofessional team.
- Uses a systemic, ongoing process (i.e., quality improvement process) to monitor the quality of care, implement corrective actions, and evaluate the outcomes of corrective actions.
- Collects structure, process, and outcomes data on school nursing practice and the practice of non-licensed school health staff.
- Analyzes data to monitor the structure, processes and outcomes of school nursing practice and the practice of non-licensed school health staff.
- Prioritizes quality initiatives based on importance, severity, timeliness, trends, and readiness.
- Develops specific measurable achievable, realistic, timely, inclusive, and equitable (S.M.A.R.T.I.E.) objectives.
- Collaborates with interprofessional and stakeholders team members (administrators, teachers, staff, parents, or community members) in all stages of the quality improvement process.
- Uses creativity and innovation to enhance school nursing care, school environment, and access to learning.
- Provides regular and critical review and evaluation of policies, procedures, and guidelines to improve the quality of healthcare and delivery of school health services.
- Engages in formal and informal peer review processes.
- Contributes to annual performance evaluation by conducting self-assessment of competencies and setting goals for improvement.
- Adopts available technology to the work setting.
Standard 16. Professional Practice Evaluation
12
The school nurse appraises one’s own and others, school nursing practice.
- Engages in self-reflection and self-evaluation of nursing practice on a regular basis, identifying areas of strength as well as areas in which professional growth would be beneficial.
- Adheres to professional practice guidance as specified in the School Nursing: Scope and Standards of Practice, the NASN Code of Ethics for School Nurses and other defined criteria (e.g., Quality and Safety Education for Nurses (2020)).
- Ensures that nursing practice is consistent with regulatory requirements pertaining to license, relevant statues, rules, and regulations.
- Uses organizational policies and procedures to guide professional practice, including use of accepted tools in self-evaluation and peer evaluation.
- Provides evidence for practice decisions and actions as part of the formal and informal evaluation processes.
- Seeks formal and informal feedback regarding one’s own practice from students, families, peers, colleagues, supervisors, and others.
- Provides peers and others with formal and informal constructive feedback regarding their practice or role performance.
- Acts to achieve learning needs and goals identified during the evaluation process.
- Maintains a professional portfolio based on the school nursing standards of practice that provides evidence of individual competence and lifelong learning.
- Prepares self-evaluation based on the school nursing standards of practice for annual performance appraisal.
- Documents the evaluation process, including strategies to enhance one’s own and others. School nursing practice.
- Participates in the formal performance evaluation of school health support personnel.
Standard 17. Resource Stewardship
14
The school nurse utilizes appropriate resources to plan, provide, and sustain evidence-based nursing services that are safe, effective, financially responsible, and used judiciously.
- Assess student care needs and available resources to achieve desired outcomes.
- Designs and articulates persuasive justifications for needed resources.
- Assists in analyzing costs, risks, and benefits in decisions about care and delivery of school health services, including health promotion, health education, and maintaining a healthy and safe environment.
- Partners with the student, family, and community in identifying and securing appropriate services to address needs across the healthcare continuum.
- Delegates in accordance with applicable legal and policy parameter, such as state nurse practice acts, NASN National Principals of Practice for Delegation and the NCSBN National Guidelines for Nursing Delegation.
- Identifies impact of resource allocation on the potential for harm, complexity of the situation, and desired outcomes.
- Advocates for resources that support and enhance school nursing practice and delivery of school health services.
- Integrates appropriate and available telehealth and mobile health technologies into practice.
- Uses organizational and community resources to implement interprofessional plans and programs.
- Addresses discriminatory healthcare practices and community and neighborhood inequities and the impact on resource allocation.
- Synthesizes data on all aspects of resource utilization, including delegation and staff training.
- Reports data on all aspects of resource utilization, including delegation and staff training.
- Contributes data to the budget analysis for basic annual school nursing service needs such as regular and substitute staffing, technology, and software, general supplies, furnishings, health equipment procurement/maintenance/calibration, continuing education, current clinical reference publications, and materials.
- Participates in disaster and after-action planning and reporting, anticipating needed resources and supplies.
Standard 18. Environmental Health
10
The school nurse practices in a manner that advances environmental safety, justice, and health.
- Recognizes the environment as a determinant of health that impacts student educational, health, and social equity.
- Assesses the school and community to identify environmental determinants of health and the impact on holistic student health and education.
- Integrates evidence-based environmental health concepts into school nursing practice including upstream environmental health strategies that promote safe, healthy, and ecologically sound workplace, school, and community.
- Collaborates with school and community partners to develop and implement strategies that promote safe, healthy, and ecologically sound workplace, school, and community environments.
- Communicates information about environmental health risk, mitigation, and adaptation strategies to promote and protect student health and well-being (e.g., lead, radon, pests, climate change, ecological destabilization, and environmental injustice).
- Addresses environmental health risks for students, populations, and communities through mitigation, advocacy, and education.
- Advocates for the safe, judicious, and appropriate use of products and environmentally safe disposal of waste in the workplace, school, and community.
- Uses products or treatments consistent with evidence- based practice to reduce environmental threats and hazards.
- Incorporates equipment and technologies to promote safe practice environments including personal protective equipment (PPE) and ventilation.
- Incorporates identified environmental health learning needs in individual professional development plans.
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Training Provider(s):
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Psychiatric/Mental Health Nurse/Nursing.
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Public Health/Community Nurse/Nursing.
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