title: School nurses and children with diabetes: a descriptive study.
abstract: BACKGROUND
  Managing diabetes in children is complex. The aims of this descriptive study were to describe the care provided to children with diabetes by school nurses using case management, to identify differences in care on the basis of the workload of the nurse and the age of the child, to explore the role of the nurse in responding to emergencies, and to describe the relationship between case management and quality of life.
  
  
  METHODS
  School nurses completed an expanded health assessment. Individualized goals were established and interventions were provided on the basis of a protocol. Quantitative and qualitative data for children enrolled during the 2009-2010 academic year were analyzed.
  
  
  RESULTS
  Eighty-six children were enrolled. The most common goals were related to establishing a safe school environment. Interventions varied depending on the workload of the nurse and the age of the child. Nurses assigned to 1-2 schools provided more intervention days (mean, 40.3 days) than did nurses assigned to 3-4 schools (mean, 24.4 days) (P < .05), particularly in the area of direct care. A total of 25 students experienced an emergency at school that initiated a cascade of events involving the parent (in 100% of cases), the teacher (in 96%), management of hyperglycemia (in 100%), and/or management of hypoglycemia (in 96%). For teens, case management improved quality of life, particularly the ability to communicate with health professionals.
  
  
  CONCLUSIONS
  The sample was small, and there was no comparison group.
  
  
  CONCLUSIONS
  School nurses are effective in using case management to enhance the health and well-being of children with diabetes. This study should be replicated with a larger sample, a comparison group, and the inclusion of clinical outcomes.
authors.affiliation: East Carolina University College of Nursing, 4210C Health Sciences Bldg, Greenville, NC 27858-4353, USA. engelkem@ecu.edu
authors.forename: Martha Keehner
authors.initials: MK
authors.lastname: Engelke
authors.forename: Melvin
authors.initials: M
authors.lastname: Swanson
authors.forename: Martha
authors.initials: M
authors.lastname: Guttu
authors.forename: Michelle B
authors.initials: MB
authors.lastname: Warren
authors.forename: Sarah
authors.initials: S
authors.lastname: Lovern
mesh_terms: D000293:Adolescent; D019090:Case Management / Q000458:organization & administration*; D002648:Child; D002675:Child, Preschool; D048909:Diabetes Complications / Q000453:epidemiology / Q000628:therapy; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006266:Health Education / Q000458:organization & administration; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000628:therapy; D007003:Hypoglycemia / Q000209:etiology / Q000628:therapy; D008297:Male; D010347:Patient Care Planning; D011788:Quality of Life; D012573:School Nursing / Q000379:methods / Q000458:organization & administration*; D012648:Self Care; D013315:Stress, Psychological; D016526:Workload