title: Certified School Nurse Perspectives on State-Mandated Hearing Screens.
abstract: Approximately 15% of children in the United States 6-19 years of age have hearing loss. Even mild, unilateral hearing loss may adversely affect educational success. In 2014, the Pennsylvania Department of Health (PA DOH) began updating the 2001 regulations on state-mandated school hearing screens. To inform the updates, a needs assessment was conducted with PA-certified school nurses (CSNs) regarding current screening practice and potential barriers to making changes.
  
  
  
  A 42-item electronic survey of CSNs developed with pediatricians, audiologists, nurses, and the PA DOH was administered in October 2014.
  
  
  
  There were 536 completed surveys. Most CSNs (50.8%) screened 251-500 students annually. Only 35.8% strictly followed PA DOH protocol, while 51.6% followed protocol and added nonguideline frequencies. Over half of screens (60.2%) were conducted in places where other people were present. Most CSNs (82.5%) reported annual audiometer calibration, but 92.4% were unsure whether the calibration was exhaustive or limited. Reported barriers to change included time, cost, and staffing.
  
  
  
  As most CSNs added frequencies to the PA DOH hearing screen, an update with added frequencies should be well accepted. Clarification regarding test environment and exhaustive audiometer calibration is needed. Adherence to best practice may be optimized by addressing CSN reported barriers to change.
authors.affiliation: Department of Pediatrics, Penn State College of Medicine, 500 University Drive HS83, Hershey, PA 17033. dsekhar@hmc.psu.edu.
authors.forename: Deepa L
authors.initials: DL
authors.lastname: Sekhar
authors.affiliation: Pediatric Clinical Research Office, Penn State Milton S. Hershey Medical Center, 500 University Drive SB35, Hershey, PA 17033. jbeiler@hmc.psu.edu.
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Beiler
authors.affiliation: Public Health Sciences, Penn State College of Medicine, 90 Hope Drive A210, Hershey, PA 17033. ESCHAEFE@phs.psu.edu.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Schaefer
authors.affiliation: Lebanon School District, 1000 S. 8th Street, Lebanon, PA 17042. ahenning@lebanon.k12.pa.us.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Henning
authors.affiliation: Department of Nursing, Penn State Milton S. Hershey Medical Center, 500 University Drive H068, Hershey, PA 17033. jdillon@hmc.psu.edu.
authors.forename: Judith F
authors.initials: JF
authors.lastname: Dillon
authors.affiliation: Division of Otolaryngology - Head and Neck Surgery, Penn State Milton S. Hershey Medical Center, 500 University Drive HU10, Hershey, PA 17033. bczarnecki@hmc.psu.edu.
authors.forename: Beth
authors.initials: B
authors.lastname: Czarnecki
authors.affiliation: Department of Audiology and Speech Pathology, Bloomsburg University, 338 Centennial Hall, Bloomsburg, PA 17815. tzalewski@bloomu.edu.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Zalewski
mesh_terms: D001291:Attitude of Health Personnel; D019983:Guideline Adherence; D006320:Hearing Tests / Q000592:standards*; D006801:Humans; D007318:Inservice Training; D008403:Mass Screening / Q000458:organization & administration* / Q000592:standards; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D012572:School Health Services / Q000458:organization & administration* / Q000592:standards; D012573:School Nursing / Q000706:statistics & numerical data*; D014481:United States
keywords: audiometric testing; hearing screening; school health services; school nursing practice