Factors impacting school nurse care coordination for children with special healthcare needs.

Abstract

Background: Children with special healthcare needs (CSHCN) compose a significant potion of pediatric clients. Approximately 14.2 million U.S. children have special healthcare needs. CSHCN are integrated into the school system to the level their disability allows. School nurses are responsible for the healthcare needs of these children while in school. Purpose: The purpose of the study was to explore the factors which impact school nursing care coordination of CSHCN. Six specific study aims were identified to support the research purpose. Methods: The design of this research was a qualitative descriptive study. Data were gathered during semi-structured interview with 27 school nurses from one Midwestern state. Participants described their experience with care coordination for CSHCN in their schools. Results: A total of 19 separate themes across the six study aims were identified. From the 19 themes identified there were four overarching factors which could encapsulate all 19 themes. Factors which impact school nurses' provision of care coordination for CSHCN are: school nurses need to establish relationships with a team; information needs to be collected and shared; each child has individualized plans to meet overarching educational goals; and sufficient time is needed. Conclusions: The school nurse participants in this study provided insights into the care coordination efforts they make on behalf of the CSHCN in their schools. Little research has been conducted about factors contributing to care coordination for CSHCN by school nurses. This study fills a gap in knowledge about school nursing and raises questions for future research about the understanding, contributing factors and barriers to effective care coordination by school nurses for CSHCN.