Infrastructure
The American Academy of Pediatrics recognizes the important role school nurses play in promoting the optimal biopsychosocial health and well-being of school-aged children in the school setting. This resource helps pediatricians understand how to collaborate with, support, and promote school nurses in their own communities, thus improving the health, wellness, and safety of children and adolescents.
This AAP policy statement builds on the 2013 AAP Policy Statement on community pediatrics by identifying specific opportunities for collaboration between pediatricians and public health professionals that are likely to improve the health of children in communities. This statement provides recommendations for pediatricians, public health professionals, and the AAP and its chapters.
Economic and racial factors, geographic maldistribution of primary care pediatricians, and limited availability of pediatric medical subspecialists and pediatric surgical specialists all contribute to inequitable access to pediatric care. Robust, comprehensive telehealth coverage is critical to improving pediatric access and quality of care and services, particularly for under-resourced populations.
This guide provides background on school-based Medicaid and outlines various opportunities to advance state policy changes required to access federal funds. It covers best practices for bringing state Medicaid plans into alignment with federal policy, designing the administrative processes, and tackling other obstacles to improving student access to care. It also addresses building a sustainable funding structure and offers concrete lessons for collaboration among agencies.
Learn about the Healthy Schools Campaign model that’s ensuring all students across the country can learn and thrive. This Campaign provides guides for advocating for effective policy changes as well as practical tools for incorporating health and wellness into schools.
Healthy Students, Promising Futures is a website and resource center dedicated to helping states and school districts expand access to Medicaid-funded school health services. The HSPF Learning Collaborative is open to state teams interested in gaining individualized technical assistance and guidance from school Medicaid experts, including federal agencies and national organizations.
It is the position of NASN that the registered professional school nurse should work across sectors, professions, and disciplines to build a culture of health and improve student and community health outcomes by providing leadership, advocacy, care coordination, critical thinking, and mitigation of barriers to health.
NASN believes school nursing services that are reimbursed in other healthcare environments should also be reimbursed in the school setting. The registered professional school nurse provides the health services in the school setting to improve the students’ ability to remain in the classroom and increase their opportunity for academic achievement. Healthcare services provided by the school nurse are reimbursable services in other healthcare settings, including hospitals, clinics, and home care settings.
NASN guideline seeks to create a uniform clinical practice guideline for the administration of medication in schools, and to give the school nurse evidence-based recommendations for the safe care of Pre-K-12 students who receive medications during the day. Specifically, this guideline will improve the structure, processes and outcomes of medication administration in schools.
It is the position of the National Association of School Nurses (NASN) that utilization of telehealth technology may be a valuable tool to assist registered professional school nurses to provide school health services. The health of many students is impacted by lack of access to primary care and specialty services due to health disparities caused by poverty and other social determinants of health. Technology and telehealth can assist the school nurse in addressing these issues.
It is the position of NASN that access to a registered professional nurse all day, every day can improve students’ health, safety, and educational achievement. Student acuity and school community indicators should be assessed to determine appropriate staffing levels. Access to a school nurse may mean that more than one school nurse is necessary to meet the needs of the school population. School nurse workloads should be evaluated on at least an annual basis to meet the health and safety needs of school communities.
It is the position of NASN that all students should have access to school nursing care by a registered, professional school nurse all day, every day. For students who face barriers to accessing healthcare, especially those living in predominantly low-income, rural and minority communities, a school nurse may serve as their only regular healthcare provider. School nurses provide students, staff, and school communities with quality healthcare that is critical for health promotion, disease prevention, health maintenance, and health equity.
Chronic Condition Management
Chronic health conditions affect more than 14 million school-aged youth (almost 20% of the school-aged population), with approximately half of these being moderate or severe. Physicians and other health professionals should use the experience and expertise known about health issues as they relate to schools. This will help ensure the health and development of youth with chronic health conditions, because many of their waking hours are usually spent in school.
Due to the COVID-19 pandemic school districts are reimagining how they will operate in the coming years. The core tenets outlined in this statement can serve as a framework for leveraging new partnerships and funding to develop an educational model that fully embeds and supports the health and well-being of all children, including those with chronic conditions.
This policy statement discusses how the overall goal of team-based care is to enhance communication and cooperation among the varied medical, social, and educational partners in a child’s life to better meet the global needs of children and their families, helping them to achieve their best potential. In support of the team-based approach, the AAP urges stakeholders to invest in infrastructure, education, and privacy-secured technology to meet the needs of children.
This policy statement discusses the importance and role of pediatricians in the larger health care and policy arena and how with state legislators, agency administrators, and other advocacy groups—pediatricians can enhance their patients’ health as well as the soundness of public policy regarding children.
The American Academy of Pediatrics recognizes the important role school nurses play in promoting the optimal biopsychosocial health and well-being of school-aged children in the school setting. Although the concept of a school nurse has existed for more than a century, uniformity among states and school districts regarding the role of a registered professional nurse in schools and the laws governing it are lacking. By understanding the benefits, roles, and responsibilities of school nurses working as a team with the school physician, as well as their contributions to school-aged children, pediatricians can collaborate with, support, and promote school nurses in their own communities, thus improving the health, wellness, and safety of children and adolescents.
This policy statement provides an overview of SBHCs, including the scope of services as well as some of the documented benefits and challenges. This policy statement also reviews the role of SBHCs in working with the pediatric medical home and provides recommendations that support the coordination of SBHCs with pediatric primary care providers and the pediatric medical home.
This resource helps teachers and caregivers address the challenges of caring for children with chronic health conditions and special health care needs in child care and school settings. The health issues covered include chronic illnesses, acute situations, and selected developmental and behavioral problems, with a special emphasis on children with special health care needs.
It is the position of NASN that all students should have access to school nursing care by a registered, professional school nurse all day, every day. For students who face barriers to accessing healthcare, especially those living in predominantly low-income, rural and minority communities, a school nurse may serve as their only regular healthcare provider. School nurses provide students, staff, and school communities with quality healthcare that is critical for health promotion, disease prevention, health maintenance, and health equity.
This NASN guideline seeks to create a uniform clinical practice guideline for the administration of medication in schools, and to give the school nurse evidence-based recommendations for the safe care of Pre-K-12 students who receive medications during the day. Specifically, this guideline will improve the structure, processes and outcomes of medication administration in schools.
It is the position of NASN that the registered professional school nurse initiates and develops an Individualized Healthcare Plan (IHP) for students whose healthcare needs require more complex school nursing services. An IHP is a plan of care written by the registered nurse for students with or at risk for physical or mental health needs. It is the responsibility of the school nurse to annually evaluate the IHP, as well as to update the plan if deemed appropriate, to reflect changes in the student’s healthcare needs and address nursing interventions and/or student healthcare outcomes.
Skills-based Approach to Managing Chronic Health Conditions in Schools is an interactive program geared towards helping school nurses apply the NASN Framework for 21st Century School Nursing PracticeTM to the management of chronic health conditions in schools.
SN Chat: School Nurse Chronic Health Assessment Tool
This handbook provides school nurses with the tools and resources needed to prioritize and plan for the care of students with chronic conditions in the school setting.
Emergency & Disaster Preparedness
This is a joint policy statement from the American Academy of Pediatrics, American College of Emergency Physicians, Emergency Nurses Association, National Association of Emergency Medical Services Physicians, and National Association of Emergency Medical Technicians on pediatric readiness in emergency medical services systems.
This policy statement discusses how pediatricians, in their role as advocates to improve the health of all children, are uniquely positioned to strongly encourage the training of children, parents, caregivers, school personnel, and the lay public in the provision of basic life support, including pediatric basic life support, as well as the appropriate use of automated external defibrillators.
The American Academy of Pediatrics recognizes the important role school nurses play in promoting the optimal biopsychosocial health and well-being of school-aged children in the school setting. This resource helps pediatricians understand how to can collaborate with, support, and promote school nurses in their own communities, thus improving the health, wellness, and safety of children and adolescents.
Significant strides have been made over the past 10 to 15 years to develop medical countermeasures (MCMs) to address potential disaster hazards, including chemical, biological, radiologic, and nuclear threats. This policy statement provides recommendations to close the remaining gaps for the development and use of MCMs in children during public health emergencies or disasters.
Infants, children, adolescents, and young adults have unique physical, mental, behavioral, developmental, communication, therapeutic, and social needs that must be addressed and met in all aspects of disaster preparedness, response, and recovery. Pediatricians, including primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists, have key roles to play in preparing and treating families in cases of disasters. Pediatricians should attend to the continuity of practice operations to provide services in time of need and stay abreast of disaster and public health developments to be active participants in community planning efforts.
NASN guideline seeks to create a uniform clinical practice guideline for the administration of medication in schools, and to give the school nurse evidence-based recommendations for the safe care of Pre-K-12 students who receive medications during the day. Specifically, this guideline will improve the structure, processes and outcomes of medication administration in schools.
It is the position of NASN that the safe and effective management of opioid-related overdoses in schools must be incorporated into the school emergency preparedness and response plans. The registered professional school nurse provides leadership in all phases of emergency preparedness and response. When emergencies happen, including drug-related emergencies, proper management of these incidents at school is vital to positive outcomes. The school nurse is essential to the school team responsible for developing and implementing emergency response procedures. School nurses in this role should facilitate access to naloxone for quick response in the management of opioid-related overdoses in the school setting.
It is the position of NASN that the registered professional school nurse provides expertise in school health and is a vital member of the school team who collaborates with community agencies to develop comprehensive emergency response procedures. The school nurse is knowledgeable about the pathophysiology of physical and psychological trauma and is a valuable resource for the provision of health care and support in emergencies.
Emergency Action Plan Templates
Includes action plan templates for the following conditions: asthma, anaphylaxis/ allergies, diabetes, sickle cell disease, seizures, and general health condition.
Mental Health & Social Services
The AAP’s webpage outlining additional information and resources on mental health in schools.
In this policy statement the American Academy of Pediatrics (AAP) advocates for increasing resources to improve access to medication-assisted treatment of opioid-addicted adolescents and young adults. The AAP recommends that pediatricians consider offering medication-assisted treatment to their adolescent and young adult patients with severe opioid use disorders or discuss referrals to other providers for this service. The AAP supports further research focus on developmentally appropriate treatment of substance use disorders in adolescents and young adults, including primary and secondary prevention, behavioral interventions, and medication treatment.
This revised policy statement on childhood toxic stress acknowledges a spectrum of potential adversities and reaffirms the benefits of an ecobiodevelopmental model for understanding the childhood origins of adult-manifested disease and wellness. It also endorses a paradigm shift toward relational health because SSNRs not only buffer childhood adversity when it occurs but also promote the capacities needed to be resilient in the future.
The American Academy of Pediatrics published its policy statement “Substance Use Screening, Brief Intervention, and Referral to Treatment for Pediatricians” in 2011 to introduce the concepts and terminology of screening, brief intervention, and referral to treatment (SBIRT) and to offer clinical guidance about available substance use screening tools and intervention procedures. This policy statement is a revision of the 2011 SBIRT statement. An accompanying clinical report updates clinical guidance for adolescent SBIRT.
The recommendations in this statement and the clinical report build on other American Academy of Pediatrics policies that address the needs of special populations (such as children and adolescents in foster or kinship care, in immigrant and refugee families, or in poor or homeless families) and are congruent with American Academy of Pediatrics policies and technical reports concerning the role of pediatric clinicians in the promotion of lifelong health.
This report from the American Academy of Pediatrics, in collaboration with the National Center for School Mental Health, indicates the findings from Supporting Mental Health in Schools Project, funded by the Centers for Disease Control and Prevention Division of Adolescent and School Health. The Supporting Mental Health in Schools Project began with a goal to gather formative, in-depth information from a small number of school districts with recognized high-functioning comprehensive school mental health system.
This new quick reference guide provides child care directors, teachers, and caregivers with essential information on managing emotional and behavioral issues in group care settings.
This document provides model policies and best practices for schools to follow to protect the health and safety of all students. It is important for schools to have in place policies and procedures in place to prevent, assess the risk of and intervene and respond to youth suicidal behavior.
It is the position of the National Association of School Nurses (NASN) that student behavioral health and wellness must be prioritized for students to successfully access and engage in educational opportunities. It is imperative that school systems respond to, and address, student behavioral health and wellness to ameliorate disparities related to the social determinants of health. School nurses are often the initial access point to identify concerns, determine interventions, and link families to school and/or community resources.
It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse is an essential member of multidisciplinary educational teams participating in the identification, evaluation, and monitoring of students who may be eligible for services through the Individuals with Disabilities Education Improvement Act (IDEIA) (2004) and Section 504 of the Rehabilitation Act of 1973, as amended through the Americans with Disabilities Amendment Act (ADAA) in 2008. Evaluations must be comprehensive, multifactorial, and nondiscriminatory; and they must be conducted by qualified professionals . In the school setting, the school nurse is the professional qualified to conduct a comprehensive health evaluation. The school nurse identifies needed health accommodations, outlines plans of care, provides nursing services, and evaluates the effectiveness of the health services provided to students. School nurses should be consulted regarding any information needed in the areas of health.
It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse) initiates and develops an Individualized Healthcare Plan (IHP) for students whose healthcare needs require more complex school nursing services. An IHP is a plan of care written by the registered nurse for students with or at risk for physical or mental health needs. It is the responsibility of the school nurse to annually evaluate the IHP, as well as to update the plan if deemed appropriate, to reflect changes in the student’s healthcare needs and address nursing interventions and/or student healthcare outcomes.
The mission of the National Center for School Mental Health (NCSMH) is to strengthen policies and programs in school mental health to improve learning and promote success for America's youth.
A public-access, web-based platform that offers schools, districts, and states a workspace and targeted resources to support school mental health quality improvement.
School-Based Screenings & Preventive Services
The 2022 recommended childhood and adolescent immunization schedules have been approved by the Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American College of Nurse-Midwives, American Academy of Physician Assistants, and National Association of Pediatric Nurse Practitioners. The schedules are revised annually to re?ect current recommendations for the use of vaccines licensed by the US Food and Drug Administration.
The 2022 childhood and adolescent immunization schedule has been updated to ensure consistency between the formats of the childhood and adolescent and the adult immunization schedules.
The American Academy of Pediatrics recognizes the important role school nurses play in promoting the optimal biopsychosocial health and well-being of school-aged children in the school setting. This resource helps pediatricians understand how to can collaborate with, support, and promote school nurses in their own communities, thus improving the health, wellness, and safety of children and adolescents.
It is the position of NASN that immunizations are essential to primary prevention of disease from infancy through adulthood and that childhood vaccinations are an effective way of preventing serious childhood illnesses. NASN supports elimination of all exemptions except those necessary for valid medical contraindications. School nurses are leaders who use evidence-based immunization strategies, such as School Located Vaccine clinics, parent/guardian reminders about vaccine schedules, state immunization information systems.
It is the position of NASN that the registered professional school nurse has the knowledge, expertise, and skills to promote the prevention and reduction of overweight and obesity among children and adolescents in schools. Grounded by standards of practice within the Framework for 21st Century School Nursing Practice™, school nurses can identify, assess, refer, and follow-up with children and adolescents who are at risk for health problems associated with overweight or obesity. School nurses can provide cost-effective, sustainable school-based overweight and obesity interventions that address the complex physical, social, and health education needs of children and adolescents who are overweight or obese. School nurses also lead in the development of local school health policies and district/community policies that support wellness, healthy nutrition, increased physical activity, and healthy lifestyle behaviors for all students.
It is the position of NASN that reaching high vaccination coverage of school-age children, as outlined in Healthy People 2030, is an essential public health objective. The National Strategic Plan for the United States 2021-2025 highlights the importance of increasing the availability of vaccines and removing barriers to access in non-traditional healthcare settings. School-located vaccination can enhance other emerging non-traditional vaccination sites. The registered professional school nurse is in a critical position to create awareness, influence action, and provide leadership in the development of SLV programs.
Sexual & Reproductive Health
This update of the 2013 policy statement is intended to assist pediatricians in understanding and supporting the use of barrier methods by their patients to prevent unintended pregnancies and STIs and address obstacles to their use.
The goal of this policy statement is to (1) educate pediatricians and other physicians on available emergency contraceptive methods; (2) provide current data on the safety, efficacy, and use of EC in teenagers; and (3) encourage routine counseling and advance EC prescription as one public health strategy to reduce teenage pregnancy.
In this policy statement, AAP reviews relevant concepts and challenges and provide suggestions for pediatric providers that are focused on promoting the health and positive development of youth that identify as TGD while eliminating discrimination and stigma.
This report aims to provide the pediatric health care provider with resources and tools for clinical practice to address the sexual development of children and youth with disabilities. The report emphasizes strategies to promote competence in achieving a healthy sexuality regardless of physical, cognitive, or socioemotional limitations.
Research shows that students with intellectual/developmental disabilities are five times more likely to be sexually molested or assaulted, are less likely to understand or report the incident, and are less likely to be believed. Although many states are now requiring comprehensive sexual health education for secondary students, schools often fail to deliver comprehensive sexual health education to their special education students in developmentally?appropriate ways, leaving students in jeopardy of molest, assault, bullying, sex trafficking, and pregnancy. This also poses a negligence and liability problem for schools when such incidents occur. The results of interviews and discussions with special education teachers will be presented, including which sex?related topics are to be emphasized as well as which topics are generally beyond the comprehension of low?to?moderate students. Sample individual and small group learning strategies. motivational interviewing, handling self?disclosure of abuse and instructional resources will also be discussed.
It is the position of the National Association of School Nurses (NASN) that, to provide culturally competent care, school staff and communities should institute affirming policies that support lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth. These include bullying, health risk behaviors, and rejection from family and friends. Such challenges can cause adverse mental and physical health effects such as depression and suicidal ideation. Registered professional nurses are uniquely positioned to help LGBTQ youth by creating LGBTQ-affirming spaces, guiding youth towards resources, advocating for school-wide protections, and assuring youth that their identities and feelings are normal and appropriate.
This toolkit is designed for schools and school nurses interested in promoting efforts to reduce HIV, other STDs, and unintended pregnancy, as well as reduce behaviors that contribute to health risks among our Nation’s adolescents.
Infectious Disease Prevention & Management
This policy statement reviews the related to the COVID-19 vaccines for children and adolescents.
The American Academy of Pediatrics (AAP) supports regulations and laws requiring certification of immunization to attend child care and school as a sound means of providing a safe environment for attendees and employees of these settings. The AAP also supports medically indicated exemptions to specific immunizations as determined for each individual child. The AAP views nonmedical exemptions to school-required immunizations as inappropriate for individual, public health, and ethical reasons and advocates for their elimination.
The 2022 childhood and adolescent immunization schedule has been updated to ensure consistency between the formats of the childhood and adolescent and the adult immunization schedules.
This statement updates the recommendations of the American Academy of Pediatrics for the routine use of influenza vaccine and antiviral medications in the prevention and treatment of influenza in children during the 2021 - 2022 influenza season. A detailed review of the evidence supporting these recommendations is published in the accompanying technical report.
This policy statement provides recommendations for the prevention of serogroup B meningococcal disease through the use of 2 newly licensed serogroup B meningococcal vaccines: MenB-FHbp (Trumenba; Wyeth Pharmaceuticals, a subsidiary of Pfizer, Philadelphia, PA) and MenB-4C (Bexsero; Novartis Vaccines, Siena, Italy).
This guide provides child care directors, teachers, and caregivers with essential information on the prevention and management of infectious diseases in group care settings. The robust section of more than 55 quick reference fact sheets on common infectious diseases and symptoms has been expanded to include a new sheet on croup.
It is the position of the National Association of School Nurses (NASN) that immunizations are essential to primary prevention of disease from infancy through adulthood and that childhood vaccinations are an effective way of preventing serious childhood illnesses. NASN supports elimination of all exemptions except those necessary for valid medical contraindications.
It is the position of the National Association of School Nurses (NASN) that reaching high vaccination coverage of school-age children, as outlined in Healthy People 2030 , is an essential public health objective. The National Strategic Plan for the United States 2021-2025 highlights the importance of increasing the availability of vaccines and removing barriers to access in non-traditional healthcare settings. School-located vaccination (SLV) can enhance other emerging non-traditional vaccination sites. The registered professional school nurse is in a critical position to create awareness, influence action, and provide leadership in the development of SLV programs.
This educational activity will promote school-located vaccination (SLV) as a measure to improve and maintain a safe and healthy environment for students and the community. With many students behind on routine vaccinations and the COVID-19 vaccines anticipated approval for children under the age of 12 pending, SLV is a means to maintain a safe school environment. A brief overview of the AIM/NASN E-scan and Roundtable documents will be shared, and a state immunization director, school nurse leader, and school leader will provide insight on how their role champions SLV’s and the importance of their role to the success of SLV’s.
This session will explore how school nurses can implement effective communications and advocacy strategies to help support and improve adolescent vaccination in school environments. Strategies shared in this session will integrate parent, student and health provider perspectives, ensuring students and their parents remain central to the decision-making process. A teen vaccination advocate (VaxTeen) will share her experiences working to empower other teens to take an active role in their health in order to improve vaccination rates among adolescents. In addition, two mothers (including a fellow nurse) who each lost their adolescent daughters to a vaccine-preventable disease (Meningitis B) will share best practices for increasing awareness and the uptake of vaccination. In addition, samples of effective communication campaigns and resources will be shared that can be adapted for use by school nurses in their respective schools.
School-Based Health Centers
In support of the team-based approach, the AAP urges stakeholders to invest in infrastructure, education, and privacy-secured technology to meet the needs of children. This statement includes limited specific examples of potential team members, including health care providers and community partners, that are meant to be illustrative and in no way represent a complete or comprehensive listing of all team members who may be of importance for a specific child and family.
This policy statement builds on the 2013 AAP Policy Statement on community pediatrics by identifying specific opportunities for collaboration between pediatricians and public health professionals that are likely to improve the health of children in communities. In the statement, recommendations are provided for pediatricians, public health professionals, and the AAP and its chapters.
This policy statement provides an overview of SBHCs, including the scope of services as well as some of the documented benefits and challenges. This policy statement also reviews the role of SBHCs in working with the pediatric medical home and provides recommendations that support the coordination of SBHCs with pediatric primary care providers and the pediatric medical home.
Launched in 2013 with support from Kaiser Permanente’s Thriving Schools, Hallways to Health (H2H) looks at delivering services and building partnerships beyond the physical walls of a school-based health center to include integrating health into classrooms, teachers’ lounges, and neighborhoods.
Several state Medicaid programs enforce policies that protect and promote reimbursement for services delivered in school-based health centers (SBHCs). The School-Based Health Alliance encourages the school-based health care field to advocate for these or similar policies in their state Medicaid program.
The National School-Based Health Care Census is a triennial survey of school-based health centers (SBHCs). For twenty years, the School-Based Health Alliance has conducted the survey of SBHCs to track and record their growth and evolution across the country. The 2016-17 Census collected information on SBHC locations, staffing, services provided, populations served, use of telehealth, and funding.
This document is a joint statement from SBHA and NASN, School nurses and school-based health centers working together share a critical mission: protecting and advancing the health and well-being of our nation’s school-age children. One does not replace the need for the other. Each has a distinct and complementary function.