Title : Beyond nurse to student ratios: School nurse caseloads and type 1 diabetes (T1D) care
Abstract:
Background: School nurse caseload and workload are often used interchangeably, but the two terms are different. Caseload focuses on the actual number of students assigned to a school nurse, whereas workload incorporates the number of assigned students and other factors related to performing nursing responsibilities. Students with Type 1 Diabetes (T1D) may need support from school nurses and school staff for diabetes management during the school day. However, little is known about how school nurses assigned caseloads per Full-Time Equivalent (FTE) are related to their nursing practice in providing diabetes care to students.
Purpose: The aims of this study were to (1) report school nurses caseloads per FTE and (2) explore relationships among school nurses caseloads per FTE, their self-efficacy in diabetes care and education, and diabetes care for students with T1D.
Methods: This descriptive study explored relationships between school nurses FTE caseloads and their diabetes management and education practices. A convenience sample of 114 school nurses participated in surveys exploring school nurses roles in diabetes management and education. Participants were school nurses working in public school districts who had provided diabetes management and education to students with T1D. Descriptive statistics, correlation coefficients, t-tests, and multiple regression analyses were used to analyze the data.
Results: School nurses reported caseloads ranging from 100 to more than 1,800 students per FTE, and approximately one-quarter reported more than 1,800 students per FTE. The number of schools covered by a nurse and the number of students with diabetes cared for by a nurse were positively correlated with school nurses caseloads per FTE. School nurses caseloads per FTE were significantly associated with school staff’s knowledge of students Emergency Care Plans and having a care plan for students attaining independent diabetes management after adjusting for full-time status and self-efficacy in diabetes care and education.
Conclusion: School nurses care for students with diabetes as part of their caseloads per FTE. The findings suggest that school nurses caseloads per FTE are related to selected diabetes care practices in school settings. Collaboration among school nurses, school districts, state government agencies, and researchers is needed to better understand school nurse caseloads and their relationship with diabetes care for students in schools.
