Original Research: Concussions at School: The Experiences and Knowledge of School Nurses

Factors associated with continuing education needs in medication administration among school nurses

AIM

To investigate the continuing education requirements and factors influencing school nurses' needs in relation to medication administration on school campuses.

DESIGN

A total of 391 school nurses working in K-12 schools in Taiwan were invited to participate in an online questionnaire survey.

METHODS

This cross-sectional study employed a probability proportionate to size technique along with a random sampling method. Data were collected from February to April 2023.

RESULTS

School nurses reported a significant demand for continuing education and perceived moderate levels of stress and government support related to medication administration. Among the various dimensions, the highest demand was observed for 'definition of campus medication errors' and 'regulations for campus medical orders.' Moreover, the 'identifying drug interactions' and 'adverse drug effects and referrals' dimensions were identified as the most stressful aspects. Notably, perceived stress emerged as the sole predictive factor for continuing education demand, accounting for 16.1% of the variance.

CONCLUSIONS

The study found that there was a significant demand for and moderate stress related to continuing education among school nurses. Therefore, it is crucial for the government and school nursing organizations to develop targeted programs focusing on medication administration. These initiatives should be designed to enhance nurses' capabilities and reduce their stress, thereby ensuring safe medication administration on campuses.

IMPACT

Continuing education enables school nurses to acquire up-to-date knowledge and improve the workflow in their practice. This study highlights a strong need for education in medication administration with a focus on 'campus medication error definitions' and 'campus medical order regulations.' The government and relevant school nursing organizations should prioritize the development and implementation of continuing education programs to decrease the school nurses' stress related to medication administration.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

REPORTING METHOD

This study adhered to the relevant cross-sectional EQUATOR STROBE guidelines.

Update on Pediatric Mild Traumatic Brain Injury in Rural and Underserved Regions: A Global Perspective

BACKGROUND

Mild traumatic brain injury (MTBI) causes morbidity and disability worldwide. Pediatric patients are uniquely vulnerable due to developmental and psychosocial factors. Reduced healthcare access in rural/underserved communities impair management and outcome. A knowledge update relevant to current gaps in care is critically needed to develop targeted solutions.

METHODS

The National Library of Medicine PubMed database was queried using comprehensive search terms (("mild traumatic brain injury" or "concussion") and ("rural" or "low-income" or "underserved") and ("pediatric" or "child/children")) in the title, abstract, and Medical Subject Headings through December 2022. Fifteen articles on rural/underserved pediatric MTBI/concussion not covered in prior reviews were examined and organized into four topical categories: epidemiology, care practices, socioeconomic factors, and telehealth.

RESULTS

Incidences are higher for Individuals in rural regions, minorities, and those aged 0-4 years compared to their counterparts, and are increasing over time. Rural healthcare utilization rates generally exceed urban rates, and favor emergency departments (vs. primary care) for initial injury assessment. Management guidelines require customization to resource-constrained settings for implementation and adoption. Decreased community recognition of the seriousness of injury is a consensus challenge to care provision by clinicians. Low parental education and income were correlated with decreased MTBI knowledge and worse outcome. Telehealth protocols for triage/consultation and rehabilitation were feasible in improving care delivery to rural and remote settings.

CONCLUSIONS

Pediatric MTBI/concussion patients in rural/underserved regions experience increased risks of injury, geographic and financial healthcare barriers, and poorer outcomes. Globally, under-reporting of injury has hindered epidemiological understanding. Ongoing MTBI education should be implemented for rural caregivers, schools, and low-income populations to improve community awareness. Telehealth can improve care delivery across acuity settings, and warrants judicious inclusion in triage and treatment protocols.

Understanding Baseline Concussion Testing: A Resource for School Nurses as Members of Concussion Management Teams

Sports-related concussions (SRCs) are not uncommon among teen athletes. School nurses are in an ideal position to care for athletes affected with SRCs. However, evidence suggests there is a lack of knowledge regarding concussion management, use of baseline concussion testing, and active involvement on concussion management teams among school nurses. This article briefly examines the use of baseline concussion testing as a tool for assessing and managing the student athlete suffering from an SRC. The role of the school nurse on concussion management teams will also be explored. As active members of concussion management teams, working closely with athletic trainers, coaches, school administration, and local medical providers, school nurses have the opportunity to evaluate for return to learn and play, ultimately improving outcomes of student athletes suffering from SRCs.