Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Galloway, Lynette

Committee Member

Robertson, Sara

Author's Keywords

school nursing; social determinants of health; school nurse workload; school nurse caseload; school nurse ratios; student outcomes


Background: School nurses play a vital role in the success of students. Having a school nurse is associated with improved attendance, management of chronic student conditions, and graduation rates. Public schools in Kentucky, and across the nation, face huge budget issues, and often, school nurse jobs are cut. With limited staff, school districts must find efficient ways to staff school nurses to meet student needs. The National Association of School Nurses (NASN) argue for staffing school nurses based on social determinants of health, along with medical complexity of students. In 2021, only one staffing model had been published with measurable outcomes demonstrating school nurse's relationship to student outcomes.

Purpose: The purpose of this policy change proposal was to introduce a published staffing model based on social determinants of health along with medical complexity of students, to school nurses in Kentucky.

Methods: A descriptive and qualitative design was used for this policy change proposal. A recommendation of using a staffing model focused on SDOH was presented to school nursing staff via a pre-recorded online PowerPoint presentation. An online survey consisting of four two-part questions was given at the end of the presentation.

Results: A SWOT analysis was completed using an online survey. Six out of ten participants completed the survey. Key findings related to opportunities for change, barriers to implementation, and threats for uptake of model were placed in a 2x2 grid.

Discussion: Themes that emerged for strengths, weakness, opportunities and threats aligned with current literature. Issues with data collection, need for models generalizable, budgets, and the

Covid-19 Pandemic were the key issues. Use of this SWOT analysis will be used to revise policy change proposal.

Included in

Nursing Commons