POSTER PRESENTATIONS

Children’s responses to trauma can profoundly influence learning and behavior in school settings. Trauma-informed systems, including schools, support youth exposed to adverse childhood experiences (ACEs) by fostering safe environments that prevent retraumatization and promote recovery. National attention to ACEs has been advanced by Nadine Burke Harris, whose leadership emphasized early identification of childhood adversity through ACEs screening as a public health strategy to mitigate long-term health consequences (2020). This emphasis underscores the importance of assessing school readiness to respond to trauma-related needs.The study purpose was to conduct a baseline organizational assessment of a Texas school district’s readiness to implement a trauma-informed approach. The study followed the Substance Abuse and Mental Health Services Administration’s (2023) guidelines for trauma-informed organizational change and was grounded in Social Cognitive Theory (Bandura, 1977). Using an exploratory cross-sectional design, the Attitudes Related to Trauma-Informed Care instrument was administered electronically to assess staff attitudes, confidence, and perceptions of organizational support for trauma-informed care. Descriptive and inferential analyses, including ANOVA, paired t tests, and Bonferroni post hoc comparisons, were conducted on responses from 211 participants, of whom 44% (n = 92) reported prior TIC training.Findings indicated the On-the-Job Behavior subscale scored highest, reflecting a preference for empathy-driven rather than control-focused approaches. Among participants with prior TIC training, Personal Support scores exceeded System Support scores, suggesting readiness to implement trauma-informed practices despite organizational limitations. Notably, school nurses demonstrated a low response rate (n = 1) compared with school counselors (n = 37), highlighting a gap and the need to explore barriers to school nurse engagement in trauma initiatives.These findings are salient given the National Institute of Nursing Research’s designation of school health as a strategic imperative. Trauma-informed care aligns with the National Association of School Nurses’ School Nursing Practice Framework and supports equity-focused public health goals.

Maintaining up-to-date vaccination status among school-aged children is essential for preventing outbreaks of vaccine-preventable diseases and ensuring safe learning environments. In Prince George’s County Public Schools (PGCPS), a significant number of students have historically been delinquent in meeting required immunizations. Common barriers cited by parents include financial constraints, lack of transportation, and limited availability to access routine vaccinations. To address this critical public health need, PGCPS implemented a mobile vaccine clinic designed to bring immunizations directly to schools, reducing barriers and increasing student compliance.Analysis of immunization records identified 7th grade students as the largest group with non-compliance, particularly lacking the Tetanus, Diphtheria, and Pertussis (TDaP) booster and Meningococcal Conjugate (MCV4) vaccines. The mobile clinic targeted this population, providing on-site administration of required vaccines and coordinating with families to ensure completion. This initiative aligns with Healthy People 2030 objectives to increase adolescent vaccination coverage and reflects the NASN Framework for 21st Century School Nursing Practice, emphasizing care coordination, community/public health, and equitable access to preventive services.Preliminary observations indicate that the mobile vaccine clinic effectively reduces logistical and financial barriers for families, increases compliance with state-mandated immunizations, and supports safer school environments. By bringing vaccines directly to students, the program demonstrates how school-based initiatives can address gaps in preventive care, promote public health equity, and strengthen connections between healthcare and education systems.

Private, independent, and parochial school nurses represent an important yet largely understudied subpopulation of the broader U.S. school nursing workforce. Limited data exist describing their demographic, educational, and workplace characteristics, leaving a gap in understanding how school context and resources influence nursing practice. Without examining these factors, we risk overlooking disparities in access to school health services and other social drivers of health among students attending private schools.To address this gap, we analyzed private school nurse data from the 2021 National School Nurse Workforce Study 2.0, a representative survey of private schools across the U.S. Our objectives were to describe private school nurse demographics, education and licensure, and to examine group differences using descriptive statistics and Chi-square tests.The analytic sample included 385 school nurses, most of whom were aged 41 years or older (78%), held a bachelor’s degree (53%), and were registered nurses (92%). Regional distribution included 25% from the Northeast, 25% the South, 29% the Midwest, and 21% the West. Slightly more than half of responding schools (53%) reported employing a school nurse, while 47% did not—citing budget limitations and small school size as key reasons. The presence of a school nurse varied significantly by region (p < 0.05), with 84% of schools in the Northeast reporting a school nurse compared to only 19% in the West.When examining roles/activities consistent with the NASN School Nursing Practice Framework, nurses reported dividing their time among care coordination (48%), public health initiatives (24%), leadership (11%), quality improvement (10%), and other activities (7%). Common challenges included addressing students’ social and emotional needs and managing family interactions. Discussions will include how these statistics compare to those of public school nurses and how students—regardless of school type—benefit from equitable access to school nursing services.

Background: A history of inconsistent onboarding for school nurses (SNs) in a Minnesota school district resulted in variations of special education (SPED) practices. Evidence supports offering education in multiple learning modalities to meet the unique needs of SNs. This project aimed to increase newly hired SNs' knowledge level and skill confidence in SPED practices and provide a helpful resource for all SNs in the district.Methods: The Focus, Analyze, Develop, and Execute (FADE) Quality Improvement model and Self-Directed Learning Theory guided this project. Pre- and post-intervention surveys assessed nurses' self-ratings of knowledge level and skill confidence for SPED processes. The post-survey also assessed nurse ratings of the intervention's helpfulness and ease of use, and included open-ended questions to gather qualitative feedback.Intervention: The primary intervention for this project was the creation of a resource toolkit. Educational components included two in-person sessions and asynchronous videos that provided information on SPED processes and introduced the use of the toolkit.Results: Mean score improvement of knowledge level and skill confidence increased by 2.27 points for all nurses, with the highest increase in first-year SNs at 4.17 points. Post-survey ratings of toolkit components for helpfulness and ease of use averaged eight or higher on a 10-point Likert scale. Qualitative feedback included appreciative comments regarding the toolkit components and improvement suggestions.Conclusions: Utilizing a process toolkit for SPED practices, along with in-person and online educational content, improved SN ratings of knowledge level and skill confidence in this practice area. The intervention was well received, with high scores for helpfulness and ease of use, and strong qualitative themes on its positive impact on SN practice. Additionally, it improved educational access for students and team collaboration. This quality improvement project had several limitations, and further improvements are needed to strengthen it for future use and broader dissemination.

The Regional Consultants (RC) of the Massachusetts School Nurse Regional Consultation Program, under the direction of the Massachusetts Department of Public Health, School Health Services, responded to the urgent need for stronger professional development tools and resources to retain and recruit school nurses and to enable students with medical complexity to safely attend school. To address nursing staff turnover, workforce shortages, reliance on per diem nurses for health office coverage and field trips, and the increasing medical complexity of students, Massachusetts School Health Services aligned with broader public health workforce development initiatives. The RCs joined this statewide effort to strengthen and support the school health workforce, promote quality nursing care that enables the inclusion of students with chronic health conditions, and create pathways for simulation training at the school or district level. Simulation based education (simulation) — already proven effective in clinical and emergency settings — offers a powerful way for school nurses to build confidence and competence in managing low-frequency, high-risk events that directly impact student safety and wellbeing. Aligning with the Leadership Standard of championing health and academic equity, along with the Quality Improvement Standard from the School Nursing Practice Framework (NASN, 2024), the Regional Consultant team undertook several key initiatives to expand access to simulation for school nurses. The team secured simulation equipment, compiled relevant educational materials, and partnered with content experts and academic partners within the University of Massachusetts System. The team facilitated meetings across all six regions of Massachusetts in May, 2026. The primary goals of these meetings were to introduce school nurses to the Healthcare Simulation Standards of Best Practice (INACSL, 2021), provide hands-on simulation experiences, share available resources, and collect data. A dedicated website now hosts a catalog of simulation equipment available for loan, along with a range of supporting educational tools.

Background: School connectedness is a vital concept that integrates protective factors favorable to academic performance and health outcomes for students. While its impact is documented in healthcare and educational contexts, a clearer understanding of how it relates specifically to school nursing services is essential. Methods: Utilizing the Walker and Avant (2005) concept analysis method, this investigation seeks to define school connectedness and outline its attributes and characteristics as they pertain to school nursing services. We employed a search strategy that included keywords such as “school connectedness”, “sense of belonging”, “student engagement”, or “social inclusion” and searched databases including PsycINFO, CINAHL, Education Research Complete, and ERIC in January 2025. Results: After removing duplicates, title and abstract screening of 4,596 articles led to the exclusion of 4,338. A full-text review of 258 articles resulted in 204 being included for review. Key attributes of school connectedness include: (a) feeling respected and valued, (b) having supportive relationships with school adults and peers, and (c) an interest in and participation within the school community. This concept is crucial for school nursing, emphasizing a student’s perception of a meaningful relationship with a school nurse in a supportive environment that promotes well-being, regardless of health challenges. The goal is to ensure each child feels supported, fostering engagement in school despite health challenges. Conclusions and Implications for School Nurse Practice: Gaining a greater appreciation for school connectedness is vital for school nursing practice, as it allows nurses to positively impact a significant part of the school-age population. School nurses should recognize how connectedness connects with academic achievement and health. This understanding can inform their assessments and interventions guided by the NASN School Nursing Practice FrameworkTM which highlights student-centered activities school nurses perform to support student health, safety, and readiness to learn.

A substantial decline in meningococcal vaccination rates, specifically a 90% decrease among 16- to 18-year-olds at the Southern Family Medicine Clinic and a 55% decrease at Eunice High School, necessitated a quality improvement (QI) project that leveraged the National Association of School Nurses' Framework for its strategies and solutions. The decreased adolescent vaccination rates at the two sites indicated the need for practice change to improve outcomes, given the risks of a potential meningococcal disease outbreak. This quality improvement project aimed to create an educational presentation and a brochure to provide evidence-based resources for adolescents and parents to increase vaccination knowledge and rates by 30 %. A PowerPoint presentation was designed and presented to parents on evidence-based facts about meningococcal disease and vaccines. The Parent Attitudes About Childhood Vaccines Survey Item Response (PACV) was utilized for 12 weeks (Opel et al., 2019; Cunningham et al., 2019; Opel et al., 2013; Opel et al., 2011a; Opel et al., 2011b). Participants took pre- and post-surveys to evaluate the parents’ attitudes about childhood vaccines to aid in demonstrating attitude changes to vaccination hesitancy. The PACV pre- and post-survey data were analyzed using JMP Pro v 16.2.0, calculating the mean score and standard deviation. A paired t-test was utilized to compare the pre- and post-survey raw scores. The analysis indicated no significant change in the mean score (p = 0.1941). Notably, the vaccination rate at Eunice High School showed a significant increase of 12.2% after the implementation of the project from August 2023 to December 2023. KeywordsMeningococcal disease, vaccines, adolescent, vaccination rates, hesitancy.

Within NASN's School Nursing Practice Framework school nurses utilize the principles of Care Coordination and Community Public Health to work with Delaware Public Health to improve our student's oral health. Oral health plays a vital role in the overall health and well-being of school-aged children, influencing not only their physical development but also their academic and social success. Dental problems such as tooth decay, gum disease, and infections are among the most common chronic conditions in childhood. When untreated, these conditions can lead to pain, difficulty eating, sleep disruption, and infection—all of which can impair growth and nutrition. According to the CDC (May 24), from 2016 to 2021, there has been about a 10% decrease in the percentage of low-income children and adolescents (aged 1–17) who had a past-year dental visit to get preventive dental care. The Delaware Smile Check Program (DSCP) is administered by the Bureau of Oral Health and Dental Services (BOHDS), Delaware Division of Public Health, and is an important initiative aimed at providing essential dental care and preventive services to underserved populations. The program plays a critical role in improving oral health outcomes, particularly for children and low-income families, by offering screenings, fluoride treatments, and referrals for further care as needed.

Background:School nurses are essential to student health and academic success, yet many face daily challenges with inefficient or outdated documentation systems. These issues contribute to increased workload, reduced time for direct care, and limited access to actionable health data—especially in under-resourced schools impacted by Social Drivers of Health (SDoH).Purpose:This project aimed to design a school nurse–centered health informatics documentation solution that improves efficiency, supports ethical data use, and aligns with the NASN School Nursing Practice Framework™ domains of Standards of Practice, Leadership, and Quality Improvement.Methods:As part of a PhD nursing research trajectory, this project involved:A needs assessment with school nurses in Texas public schoolsA review of current documentation tools and gapsThe design of a prototype system incorporating customizable templates, SDoH prompts, and simplified reporting featuresPilot testing with practicing school nurses to evaluate usability and impact on workflowResults:Early pilot feedback indicates reduced documentation time, improved data accuracy, and increased nurse confidence in utilizing data for student care and advocacy. Nurses valued built-in SDoH indicators, which helped prioritize health equity during daily encounters.Conclusion/Implications:This project demonstrates how a school nurse–informed informatics tool can streamline documentation while advancing equity, data integrity, and nurse well-being. Attendees will identify practical strategies to implement similar tools in their settings and explore how informatics supports both student outcomes and ethical nursing practice.

Background: Health disparities in childhood immunization persist across the United States, with children from low-socioeconomic status (SES) households often experiencing lower vaccination coverage compared to their higher-income peers. While the federally funded Vaccines for Children (VFC) program provides no-cost vaccines to eligible children, obtaining access to a health care provider utilizing the VFC program can limit its impact (Valier et al., 2024). Utilizing the NASN School Nursing Practice Framework, the role of the school nurse is to monitor immunization compliance and to collaborate and connect students and families with available resources. Additionally, a school nurse needs to advocate for programs and services that promote health and provide equitable access to health care. (NASN, 2024) The Reading School District, in Pennsylvania, operates a school-based VFC vaccination program, fully managed and staffed by school district nurses, to overcome barriers to childhood vaccination. Methods: Analyzed the correlation between the accessibility to receive vaccines at the school-based clinics, and the rate of student exclusion due to non-compliance with Pennsylvania state-mandated immunization requirements in each school year from 2017-2018 thru 2024-2025.Results: The results demonstrated that the school-based VFC program resulted in an eighty-seven percent decrease in the number of students who were excluded from school due to incomplete/ missing immunizations as required by PA School Code.Conclusion: Immunization inequity, due to low-SES and other health disparity issues, is a serious concern for the students, families and communities. The School-nurse operated clinic dramatically reduced the number of students excluded from school.Implications for practice: A school-based VFC vaccination program is an equitable strategy for delivering immunizations to underserved low-SES populations as this model can overcome many access barriers and promote public health equity by ensuring students receive routine vaccinations, regardless of their family's income, lack of insurance, ethnicity, or other health disparities.

Postural Orthostatic Tachycardia Syndrome (POTS) presents unique challenges for students, requiring a multifaceted approach to care. This session will explore evidence-based strategies for managing POTS in the school environment, with an emphasis on empowerment, collaboration, and individualized care plans. Effective classroom management begins with understanding the symptoms of POTS and tailoring strategies to minimize symptom triggers. This includes providing flexible seating, ensuring access to hydration, and allowing for frequent breaks. Teachers and staff play a crucial role in fostering an environment that supports both physical and academic success.
Collaboration with families is essential for maintaining a consistent care approach. Regular communication with parents/guardians ensures that the school nurse is informed of any changes in treatment or symptomatology. Equipping the nurse’s office with appropriate supplies is vital for managing both acute and chronic symptoms. Essential items include electrolyte drinks, salty snacks or salt tablets, mobility aids, and tools for measuring vital signs. Frequent position changes (such as sitting or lying down when feeling lightheaded) should be incorporated into the student’s daily routine to alleviate symptoms and promote circulation. Acute symptoms may require immediate interventions and having supplies readily available is critical.
Minimizing lost instructional time is crucial to the success of students with POTS. Modifying physical education (PE) programs or other school activities to accommodate the student’s specific limitations ensures they can participate in a safe and supportive manner without sacrificing their education.
This session will also provide practical tips and tricks for maintaining clear and timely communication with the healthcare team, ensuring that students’ treatment plans are consistently followed. By providing comprehensive care, school nurses can significantly improve the quality of life for students with POTS, supporting their physical, emotional, and educational well-being. Ultimately, empowering students with POTS involves a holistic, collaborative approach that fosters understanding, engagement, and success.

Background: School nurses play a critical role in helping elementary students monitor their diabetes throughout the school day (Wilt et al, 2021). Due to a lack of standardized diabetes training and minimal time for continuing education, school nurses lack knowledge in diabetes management (Wilt et al., 2021). Additionally, social drivers of health play a significant role on health outcomes due to the significant burden diabetes care places on families (Hersey et al., 2021). This quality improvement project seeks to increase knowledge by implementing an asynchronous, evidence-based Diabetes toolkit that meets the needs and time constraints of school nurses. The project aligns with the care coordination concept of The School Nursing Practice Framework in that when nurses practice within clinical practice guidelines, students with complex diseases will be healthy and ready to learn (National Association of School Nurses, 2024). Methods: Five school nurses participated in this project at five public elementary schools in an inner-city of a large metropolitan area of the mid-Atlantic United States. A Diabetes toolkit was developed utilizing diabetes management standards from the American Diabetes Association and the National Association of School Nurses clinical practice guidelines. A pre- and post-test will evaluate participant knowledge of diabetes.Results: The test and survey instruments will be analyzed to determine if the asynchronous education was helpful in increasing school nurse knowledge of diabetes and whether this was an effective method for training. Conclusion & Implications: Diabetes care management is complex. School nurses with adequate knowledge of diabetes management will indirectly improve health for their students. This project aims to increase school nurse knowledge of diabetes care management through a low-cost and easily accessible resource that could be replicated by other institutions and school nurses. Final outcomes and recommendations will be available in time for the final poster submission.

Background: Recognizing the unique challenges language barriers can create, school nurses may need to address communication gaps in care provided, particularly for individuals who have recently immigrated to the United States or have limited English proficiency (LEP). Language barriers create systematic effects that can compromise the quality and safety of health services delivered in school settings. These barriers can lead to significant academic disruptions and contribute to gaps in educational outcomes. This study examined how language barriers influence the school nurse's role and capacity to deliver effective healthcare and explored the school nurse’s perception of how language barriers affect student health. Methods: A qualitative descriptive study involved semi-structured interviews with 15 school nurses. Data analysis followed Graneheim & Lundman's (2004) qualitative content analysis method. Interviews were transcribed verbatim using Zoom. Meaning units identified from the transcripts were translated into codes and subcategories, enabling a deeper understanding of the data. Results: One overarching theme was revealed: Communication Inconsistencies Require Adapting in the Moment. The theme is defined as encompassing the communication-barrier generated practice inconsistencies affecting school nurse roles and student health, and processes to mitigate the issue. Three sub-themes illustrate the challenges associated with the adaptation process: Accessing, implementing, and trusting interpretation and translation; Navigating role strain; and Missing or delayed care as a result of miscommunication.Conclusion and Implications for School Nursing Practice: When a language barrier is present, working with students and families adds layers of complexity to care delivery requiring more time and different resources for school nurses to be effective in their roles. Following NASN School Nursing Practice Framework ™ principles of care coordination, community/public health, leadership, and quality improvement, school nurses can address inconsistencies in the use of translation and interpretation, thereby ensuring more accessible and inclusive healthcare delivery for students.

For several years, there has been a steady increase of parents who are postponing to vaccinate or are choosing to not vaccinate their children. This trend disrupts herd immunity, escalates the risk of spreading vaccine-preventable illnesses and undermines the public trust in the health care system (Damnjanovic et al., 2018, Kaufman et al., 2021; Obohwemu et al., 2022). In light of the current political healthcare landscape and the measles outbreaks in various areas of the United States, it is imperative to acquire parental cooperation in combating the spread of vaccine-preventable diseases. With the advancement of technology, parental engagement about immunization can be enhanced by providing them with the information that can be accessed by the tips of their fingers. In partnership with the Chicago Department of Public Health, the research manager implemented an intervention campaign about vaccination via a website platform. Parents with school-aged children were invited to navigate through the webpage by scanning the QR code featured on the Don’t Wait…Vaccinate flyers and on the VaxUp themed bulletin boards displayed at the CDPH immunization clinics. Providing support to increase parental engagement about immunization will help combat misinformation and disinformation about vaccines which is rampant in our society today. Keywords: vaccine-preventable diseases, herd immunity, misinformation, disinformation.

Teachers in Japan carry significant responsibilities and often experience physical and mental strain, compounded by the need to navigate diverse socio-economic and cultural contexts. Maintaining teachers’ health is essential for supporting student well-being and enhancing school activities. School nurses play a critical role in this process by providing care coordination and leadership in promoting health and preventing disease across the school community. They must also support school health policy decisions and connect these efforts to public health professionals.This proposal introduces an educational video created by school nurses in 2025 for resident teachers. The video aims to demonstrate practical strategies for motivating teachers to prioritize their own health and adopt health-conscious practices within their work and community engagement. By shifting teachers’ awareness from individual health to a broader perspective encompassing school and community, the initiative seeks to foster sustainable health management practices.In Japan, health management duties are typically considered administrative tasks handled by vice-principals, adding to teachers’ workload alongside educational and personnel responsibilities. Health managers themselves often face stress related to these duties. To address this, the training program will employ case studies to develop mindsets that prevent overwhelming those responsible for health management. It will also emphasize effective communication among colleagues and the careful handling of personal information. School nurses will leverage their expertise to provide leadership during the training. A key concept is to avoid making health management a burden. The goal is to ensure that the “gatekeeper” remains healthy by empowering the person in charge to act effectively in this role. Ethics approval is not required, as only training content will be presented.

Inhaled insulin (tradename Afrezza®) presents unique considerations as an alternative to injectable insulins for children with diabetes due to its pharmacokinetic profile that differs from rapid-acting analogs (RAA). Inhaled insulin acts more quickly and has a shorter duration, which may introduce differences for diabetes management in school settings. Rapid-acting injectable insulins are typically administered 5-15 minutes before eating and reach peak action at 1–3 hours, whereas inhaled insulin is given at the start of the meal and reaches peak effect within 45-60 minutes. This difference in onset and duration may require adjustments to school insulin dosing routines, particularly around lunch and other meals.

This poster will present practical considerations for school nurses supporting students with diabetes who may use inhaled insulin. Brief background on the differences between inhaled and injectable insulin will be provided, followed by discussion of real-world scenarios encountered during the INHALE-1 pediatric diabetes study. Case examples from INHALE-1 investigators will illustrate how school nurses collaborated with study teams to address dosing, timing, and safety in the school environment.

Attendees will learn about strategies for integrating inhaled insulin into daily routines, including communication with families and healthcare providers, and adapting care plans to meet individual student needs. The poster also considers how social drivers of health, including variability in school health resources and family–school communication, may affect the practical implementation of inhaled insulin use during the school day. The session will highlight challenges and solutions identified during the study, with emphasis on supporting safe and effective diabetes care in schools.