School Nursing Scope and Standards of Practice

CSNO Wishes to thank Dr. Liz Deitz, CSNO Member and Co-chair of the ANA Committee on Nursing Practice Standards for update notification.

Definition of School Nursing
School nursing is a specialized practice of professional nursing that advances the well‐being, academic success and lifelong achievement and health of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety including a healthy environment; intervene with actual
and potential health problems; provide case management services; and actively
collaborate with others to build student and family capacity for adaptation, self‐management, self-advocacy, and learning (NASN, 2022).

School Nursing: Scope and Standards of Practice
Standards of School Nursing Practice 1- 6

  1. Assessment: The school nurse collects comprehensive data pertinent to the child’s health or situation.
  2. Diagnosis: The school nurse analyzes the assessment data to determine the diagnosis and issues.
  3. Outcomes Identification: The school nurse identifies expected outcomes for a plan individualized to the client or situation.
  4. Planning: The school nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes.
  5. Implementation: The school nurse implements and documents the identified plan using evidence-based interventions and standard language or recognized terminology.
    1. Coordination of Care
    2. Health Teaching and Health Promotion
    3. Consultation
    4. Prescriptive Authority and Treatment
  6. Evaluation: The school nurse evaluates progress towards attainment of outcomes.

Standards of Professional Performance 7: Ethics: The school nurse practices ethically.

  1. Upholds healthcare consumer’s confidentiality within legal, regulatory and ethical parameters of health and education
  2. Advocates for equitable healthcare consumer care
  3. Assists healthcare consumers in self-determination and informed decision-making, as developmentally appropriate
  4. Speaks up when appropriate to question healthcare practice when necessary for safety and quality improvement.

Standards of Professional Performance 8: Education: The school nurse attains knowledge and competency that reflects current nursing practice.

  1. Participates in ongoing educational activities related to professional issues
  2. Contributes to a work environment conducive to the education of professionals
  3. Shares educational findings, experiences and ideas with peers
  4. Maintains state and national certification and/or credentialing

Standards of Professional Performance 9: Evidence-Based Practice and Research: The school nurse integrates evidence and research findings into practice

  1. Uses current evidence, including research findings to guide practice decisions
  2. Incorporates evidence when initiating changes in school nursing practice
  3. Participates in data collection such as surveys, pilot projects, and formal studies

Standards of Professional Performance 10: Quality of Practice: The school nurse contributes to quality of nursing practice.

  1. Demonstrates quality of practice by documenting the application of the nursing process in a responsible, accountable, and ethical manner
  2. Uses creativity and innovation to enhance school nursing care
  3. Participates in quality improvement practices

Standards of Professional Performance 11: Communication: The school nurse communicates effectively in a variety of formats in all areas of nursing practice.

  1. Seeks continuous improvement of own communication and conflict resolution skills.
  2. Conveys information to healthcare consumers in formats that promote understanding.
  3. Uses communication as a strategy to achieve nursing goals.
  4. Contributes own professional perspective with multidisciplinary team and others.

Standards of Professional Performance 12: Leadership: The school nurse demonstrates leadership in the professional practice setting and the profession.

  1. Seeks ways to advance nursing autonomy and accountability of school nurses.
  2. Participates in school nursing, school health and other professional organizations.
  3. Serves in formal and informal leadership roles in professional organizations and committees at local, state and national levels.
  4. Mentors colleagues for the advancement of nursing practice, the profession, and quality healthcare.

Standards of Professional Performance 13: Collaboration: The school nurse collaborates with the healthcare consumer, the family and others in the conduct of nursing practice.

  1. Partners with others to effect change and generate positive outcomes through the sharing of knowledge about the healthcare consumer and/or situation.
  2. Functions as a liaison between the family, school and community.
  3. Acts as an advocate for the healthcare consumer in multidisciplinary collaboration.

Standards of Professional Performance 14: Professional Practice Evaluation: The school nurse evaluates one’s own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules and regulations.

  1. Provides age-appropriate and developmentally appropriate care in a culturally and ethically sensitive manner
  2. Engages in self-evaluation on a regular basis, identifying areas of strength and areas in which professional development would be beneficial.
  3. Enhances one’s own professional nursing practice by networking with peers and colleagues.
  4. Demonstrates achievement of goals identified during the evaluation process.

Standards of Professional Performance 15: Resource Utilization: The school nurse utilizes appropriate resources to plan and provide nursing services that are safe, effective, and financially responsible.

  1. Evaluates factors such as safety, effectiveness, availability of cost and benefits, and impact on practice
  2. Assists the healthcare consumer and family in identifying and securing appropriate and available resources
  3. Develops innovative solutions and applies strategies to obtain appropriate resources for nursing initiatives
  4. Assists healthcare consumer and school community in becoming informed consumers about health promotion, health education, school health services and individualized health interventions.

Standards of Professional Performance 16: Environmental Health: The school nurse practices in an environmentally safe and healthy manner.

  1. Promotes a practice environment that reduces environmental health risks of healthcare consumers, including visitors.
  2. Assures communication regarding environmental risks and exposure reduction strategies to student healthcare consumers, families, colleagues, and communities.
  3. Participates in or initiates strategies that promote an emotionally or physically healthy school culture.

Standards of Professional Performance 17: Program Management: The school nurse manages School Health Services.

  1. Conducts school health needs assessments to identify current health problems and identify the need for new programs.
  2. Develops and implements needed health programs using a program planning process
  3. Evaluates ongoing health programs for outcomes and quality of care.
  4. Interprets the role of the school nurse and school health service needs to the school and the community.

Based on ANA School Nursing: Scope and Standards of Practice (2022)

Last updated 9/25/2022



Previously updated on 8/23/2020