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NASN School Nurse

NASN School Nurse

Published in Association with National Association of School Nurses

eISSN: 19426038 | ISSN: 1942602X | Current volume: 39 | Current issue: 3 Frequency: Bi-monthly

The NASN School Nurse is a peer-reviewed clinical resource journal of the National Association of School Nurses and is published in January, March, May, July, September, and November.

The mission of the NASN School Nurse is to advance the practice of school nursing through the publishing of evidence-based, clinical resource articles and providing information on emerging issues, innovation in school health, and organizational resources of interest to our members.

This journal is a member of the Committee on Publication Ethics (COPE).

All content in National Association of School Nurses (NASN) publications is for informational purposes only. NASN does not offer clinical, nursing, legal, or other professional services. Mention of any product or inclusion of an advertisement for a product does not represent an endorsement of that product by the NASN. Views, opinions, and claims stated in any article published in the journal do not necessarily reflect the views or positions of NASN. While NASN has taken great care to ensure that all information is accurate, it is recommended that readers seek independent advice on legal issues, drugs, treatments, interventions, product usage, and clinical processes. NASN does not assume any responsibility for any injury and/or damage to persons or property as a matter of products liability, negligence, or otherwise, or from any use of operation of any methods, products, treatments, instruction or ideas contained in this publication.

Photographs used in this publication are for illustration purposes only; they do not reflect any attitudes, opinions, behaviors, or actions on the part of any person/organization who appear in the photographs. Attribution to organizations or individuals within photographs or captions does not imply any affiliation with NASN.

The NASN School Nurse is a peer-reviewed clinical resource journal of the National Association of School Nurses and is published in January, March, May, July, September, and November. The mission of the NASN School Nurse is to advance the practice of school nursing through the publishing of evidence-based, clinical resource articles and providing information on emerging issues, innovation in school health, and organizational resources of interest to our members.

Catherine F. Yonkaitis,DNP, RN, NCSN, PHNA-BC, FNASN Clinical Assistant Professor, University of Illinois at Chicago, USA
Editorial Advisory Board
Susan Chaides, MEd, BSN, RN, CPNP Project Director, Los Angeles County Office of Education, NASN Board of Directors, California, USA
Nina Fekaris, MS, BSN, RN, NCSN-E, FNASN Past President, NASN, Oregon, USA
Joshua Landry, MSN, RN, NCSN Professional School Nurse, Alamogordo Public Schools, Legislative Chair, New Mexico School Nurses Association, Past NASN Board of Directors, New Mexico, USA
Sharon Morris, MSN, RN Past NASN Board of Director, Kansas, USA
MaryAnn T. Strawhacker MPH, BSN, RN, SEN Special Education and Section 504 Consultant, Heartland Area Education Agency, Iowa, USA
Shanyn A. Toulouse, DNP, MEd, RN, NCSN NASN Board of Directors, Massachusetts, USA
Editorial Panel
Christine Amidon, MSN, APRN, FNP-C, NCSN Nurse Practitioner, Wabash College, Indiana, USA
Cheryl Blake, MSN, RN, NCSN School Nurse, Trinity School of Durham and Chapel Hill, NASN Private, Independent, Parochial School Nurses Past Chair, North Carolina, USA
Margaret Bultas, PhD, RN, CNE, CNL, CPNP-PC Associate Professor, Trudy Busch Valentine School of Nursing, Missouri, USA
Elizabeth Clark, MSN, RN, NCSN, FNASN Nursing Education and Practice Specialist, National Association of School Nurses, Colorado, USA
Ann M. Connelly, MSN, RN, LSN, NCSN Ohio Department of Health, Public Health Nurse Supervisor, School Nursing and Early Childhood Health programs, Ohio, USA
Megan S. Fioravanti, BSN, RN, NCSN University of Delaware – School Health Services, Past NASN Board Director, Delaware, USA
Linda J. Gibbons, MSN, RN, IL PEL-CSN, NCSN School Nurse Educator and Consultant, Retired Director School Nurse Program, Lewis University College of Nursing and Health Sciences, Illinois, USA
Karen Graf, MSN, RN-BC, APHN Nursing Education and Practice Specialist, National Association of School Nurses, Montana, USA
Constance F. Griffin, BS, RN, AE-C, NCSN District School Nurse Coordinator, High School Nurse, Valley Central School District, New York, USA
Beth E. Jameson, PhD, RN, CNL, FNASN Assistant Professor, Seton Hall University, College of Nursing, New Jersey, USA
Kathleen Johnson, DNP, RN, NCSN-E, APHN-BC, FNASN, FAAN Affiliate Faculty, Child, Family and Population Health Nursing, at the University of Washington, Washington, USA
Denine Kohl, MSN, RN, NCSN, CSN School Nurse, Director of Nursing, The Stepping Stones Group, California, USA
Rodney La Point, MSN, RN Nursing Education and Practice Specialist, National Association of School Nurses, Texas, USA
Cynthia Less, MSN, RN, NCSN School Nurse, Crossroads Elementary School, Quantico, Virgina, USA
Saria Lofton, PhD, RN, PEL-CSN Assistant Professor, University of Illinois - Chicago, College of Nursing, Illinois, USA
Rachel McClanahan, DNP, RN, NCSN, CNE Assistant Professor, Lead Faculty School Nurse Credential & MSN Concentration, California State University, Fullerton, California, USA
Maureen C. McCoy, MSN, RN, FNP-C, NCSN Family Nurse Practitioner, iFM Community Medicine, St. Louis area, Missouri, USA
Constance E. McIntosh, EdD, MBA, RN Associate Professor, Ball State University, Indiana, USA
Lynne P. Meadows, MSN, BSN, RN Director, District Health Services, Fulton County Schools, Georgia, USA
Lindsey Minchella, MSN, RN, NCSN, FNASN School Nurse Consultant, Retired Special Needs School Nurse Coordinator, NASN Special Needs School Nurses Past Chair, Indiana, USA
Wendy Rau, MSN, BA, RN Director of Health Services, Lincoln Public Schools, Past NASN Board of Directors, Nebraska, USA
Debra Robarge, BSN, RN, NCSN Executive Director, Indiana Association of School Nurses, Indiana, USA
Kimberly Stanislo DNP, APRN-CNP, LSN, CPNP-PC Research Education Practice Director, National Association of School Nurses, Ohio, USA
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  • Manuscripts should be submitted electronically at, where authors will be required to set up an online account in the SageTrack system powered by ScholarOne. Follow the step-by-step instructions on the site for the uploading of all manuscript files. Average time from submission to first decision: 14 days.

    Statements and opinions expressed in the articles and communications appearing in the journal are those of the author(s) and not necessarily those of the editors and publisher. The editors and publisher disclaim any responsibility or liability for such material. Neither the editors nor the publisher guarantee, warrant, or endorse any product or service advertised in this publication, nor do they guarantee any claim made by the manufacturer of such product or service.

    There are no fees payable to submit or publish in this Journal. Open Access options are available - see section below.

    NASN School Nurse offers optional open access publishing via the Sage Choice programme and Open Access agreements, where authors can publish open access either discounted or free of charge depending on the agreement with Sage. Find out if your institution is participating by visiting Open Access Agreements at Sage. For more information on Open Access publishing options at Sage please visit Sage Open Access. For information on funding body compliance, and depositing your article in repositories, please visit Sage’s Author Archiving and Re-Use Guidelines and Publishing Policies.

    Questions regarding manuscripts can be directed to the editor:
    Catherine F. Yonkaitis, Editor, NASN School Nurse
    phone: (815) 341-9294

    Peer Review Policy

    Sage does not permit the use of author-suggested (recommended) reviewers at any stage of the submission process, be that through the web-based submission system or other communication. Reviewers should be experts in their fields and should be able to provide an objective assessment of the manuscript. Our policy is that reviewers should not be assigned to a paper if:

    •  The reviewer is based at the same institution as any of the co-authors

    •  The reviewer is based at the funding body of the paper

    •  The author has recommended the reviewer

    •  The reviewer has provided a personal (e.g. Gmail/Yahoo/Hotmail) email account and an institutional email account cannot be found after performing a basic Google search (name, department and institution). 

    Manuscript Preparation
    As part of the submission process you will be required to warrant that you are submitting your original work, that you have the rights in the work, and that you have obtained and can supply all necessary permissions for the reproduction of any copyright works not owned by you, that you are submitting the work for first publication in the journal and that it is not being considered for publication elsewhere and has not already been published elsewhere. Please see Sage’s guidelines on prior publication and note that the journal may accept submissions of papers that have been posted on pre-print servers; please alert the Editorial Office when submitting (contact details are at the top of these guidelines) and include the DOI for the preprint in the designated field in the manuscript submission system. Authors should not post an updated version of their paper on the preprint server while it is being peer reviewed for possible publication in the journal. If the article is accepted for publication, the author may re-use their work according to the journal's author archiving policy. If your paper is accepted, you must include a link on your preprint to the final version of your paper.

    Manuscripts submitted to NASN must be prepared as described in the guidelines of the Publication Manual of the American Psychological Association, 7th edition (APA style; APA, August 2020). For an online tutorial of APA style basics, go to the tutorial at: For a short summary of APA points with examples, download the NASN Style Guide for Authors and/or Sage’s Reference Guide.

    All manuscripts must be submitted electronically in Microsoft Word file format (*.doc files). Please do not attempt to mimic the format of the typeset newsletter. Manuscript text should be in 12-point Times New Roman font, double spaced, with 1-inch margins on all sides and the beginning line of each paragraph indented. Each image should be numbered (Figure 1, Figure 2, etc.) in order as it appears in text, with instructions in the body of the manuscript on where it should be placed using brackets (e.g., [Insert Figure 1 about here.])

    Whenever possible, please include hyperlinks as supplementary material, which can be referenced in-text within the article. In cases where including a hyperlink is critical to the article's content, including within tables and figures, please ensure that the full URL is included, so it can be hyperlinked properly in the online version of the article. Additionally, by including the full URL, readers of the print version will be able to type in the URL to their computer to access.

    Length. For a Featured Article, approximately 1,500 to 3,000 words (~4 pages) in the aforementioned format. Articles that are over the 3,000-word limit must be discussed with the editor before submission. Regular Article submissions should be approximately 750 to 1,500 words (~2 pages) in the aforementioned format.

    Order. Submissions should be arranged into the following sections: (1) title page, including author information and keywords; (2) main document, consisting of all text-based material, including abstract (if needed), article text, and any references, figure captions (submit any figures themselves separately; see the Graphics and Tables section below), tables, and sidebar text; and (3) artwork, images, and photographs.

    Title Page. On the title page include: (1) the full title of the article; (2) authors’ full names, arranged in the order they should appear in print; (3) academic degrees and institutional affiliation of all authors; (4) Include a one- to two-sentence biographical statement for each author and list any acknowledgments and funding information related to the article. (5) Provide any acknowledgements as they should appear at the end of your article. All contributors who do not meet the criteria for authorship should be listed in an ‘Acknowledgements’ section. See the Title Page Template.

    Main document layout. The main document file should consist of text-based elements only: the body of your article as well as any references. Tables and table captions, and figure captions/descriptions should be submitted as separate documents. Be sure you refer to each table and figure you submit in the body of your manuscript (ex: "for more information ..., see Table 2"), and indicate placement with brackets as follows: [Insert Table 1 about here.] The bracketed text will not appear in the article, but will serve as a placeholder for formatting. When preparing your paper, the fewer layout specifications (such as multiple columns, font changes, type size, page parameters, etc.) the better. You should not mimic the pages of publication in which your paper will be published.

    References. All references should be formatted in APA style (APA, 2020). Refer to examples in the NASN Style Guide.

    Graphics and Tables
    Artwork includes charts and graphs, maps, photographs, figures, and line art. Images should be easily readable, clear, and neat; color images are preferred. Number artwork files consecutively in the order the images should appear within the article (Figure 1, Figure 2, etc.) and submit each image as a separate file.

    • Photos and illustrations. Acceptable file formats include TIFF, EPS, JPEG, and press-ready PDF. Submit images in roughly the same size they should appear in print, at high resolution (at least 300 dots per inch [dpi]).
    • Line art (charts, graphs, maps, and line graphics). Submit original line art in the same program it was created (such as MS Word or Excel for graphs). Scanned line-based artwork should be submitted at 900 dpi, in roughly the size they will appear in print.
    • Tables. Statistics, facts, and resource lists should be submitted in table format for easier reading. Submit tables in an editable format such as Microsoft Word or Excel-based tables. Tables should be submitted as separate document files; multiple tables should be numbered in order as they appear within the article. Include brief descriptive captions for each. All tables will be reformatted and typeset in the journal’s table style.

    Letters to the Editor:
    Letters to the Editor provide a forum for commenting on articles published in the NASN School Nurse. The length should not exceed 600 words of text and may include a minimal number of references. Any comments regarding a specific article must include the title, author(s), and date of publication. Letters that contain questions or critique of a previously published paper will be forwarded to the author(s) of that article for a reply. The sharing of ideas, experiences, opinions, and alternative views is encouraged. The Editor of The Journal reserves the right to accept or reject  letters to the editor based on clarity and appropriateness of content, and to accommodate space requirements. Email letters to following criteria guide the review of Letters to the Editor.
    1. The purpose of the letter is clearly stated.
    2. The narrative regarding the current issue or previous published manuscript in the NASN School Nurse is clear and not personal.
    3. The supporting literature is adequate and current (most within the last five to ten years).
    4. The letter narrative does not exceed 600 words including references.
    Papers should only be submitted for consideration once consent is given by all contributing authors. Those submitting papers should carefully check that all those whose work contributed to the paper are acknowledged as contributing authors.

    The list of authors should include all those who can legitimately claim authorship. This is all those who:

    (i) made a substantial contribution to the concept and design, acquisition of data or analysis and interpretation of data,
    (ii) drafted the article or revised it critically for important intellectual content,
    (iii) approved the version to be published.
    (iv) have participated sufficiently in the work to take public responsibility for appropriate portions of the content

    Please refer to the ICMJE Authorship guidelines at

    Please note that AI chatbots, for example ChatGPT, should not be listed as authors. For more information see the policy on Use of ChatGPT and generative AI tools.

    As part of our commitment to ensuring an ethical, transparent and fair peer review process Sage is a supporting member of ORCID, the Open Researcher and Contributor ID. ORCID provides a unique and persistent digital identifier that distinguishes researchers from every other researcher, even those who share the same name, and, through integration in key research workflows such as manuscript and grant submission, supports automated linkages between researchers and their professional activities, ensuring that their work is recognized.

    The collection of ORCID IDs from corresponding authors is now part of the submission process of this journal. If you already have an ORCID ID you will be asked to associate that to your submission during the online submission process. We also strongly encourage all co-authors to link their ORCID ID to their accounts in our online peer review platforms. It takes seconds to do: click the link when prompted, sign into your ORCID account and our systems are automatically updated. Your ORCID ID will become part of your accepted publication’s metadata, making your work attributable to you and only you. Your ORCID ID is published with your article so that fellow researchers reading your work can link to your ORCID profile and from there link to your other publications.

    If you do not already have an ORCID ID please follow this link to create one or visit our ORCID homepage to learn more.

    NASN School Nurse Manuscript Review Criteria:

    1. Article is relevant to the practice of school nursing; reflects NASN's core values of child well-being, diversity, excellence, innovation, integrity, leadership, and scholarship; and considers NASN Professional Practice Documents as related to the topic of the article.

    2. The title is descriptive of the article content and includes key words.

    3. The abstract includes key words and themes of the articles.

    4. The purpose of the article is clear and consistent throughout.

    5. Content is evidence-based.

    6. Grammar, sentence structure, punctuation, and sequencing are precise and accurate.

    7. Tables and figures enhance understanding of the content.

    8. Ethics are maintained: includes but not limited to maintain confidentiality and ethical principles, recognizes ethical dilemmas as applicable to topics, and credits other authors (e.g. quotes, tables).

    All projects that are research and involve human subjects should be reviewed by an Institutional Review Board (IRB). In addition, individuals who wish to publish their findings (data) from community assessments, quality improvement projects, chart reviews, and most needs assessment projects should seek IRB review. The Office of Human Research Protections (OHRP) recommends that, “because of the potential for conflict of interest, investigators not be given the authority to make an independent determination that human subjects research is exempt” (DHHS, 2021, para 1). Academic institutions, health care agencies, hospitals, local and state level departments of health or education, and school districts have mechanisms (such as IRBs) to evaluate projects for human subjects' protection. Authors should document that projects have been reviewed by the appropriate IRB(s). U. S. Department of Health & Human Services (DHHS). (2021). Exempt research determination FAQs. Office for Human Research Protections.

    9. References are current (preferably within past five years); from peer-reviewed journals and other professionally acceptable sources; and are multidisciplinary, when appropriate.

    10. In-text citations are included and follow APA, 7th edition.

      Permission to Reprint Copyrighted Material
      It is the author’s responsibility to submit written permission and releases for materials where needed. Because the process of obtaining permission can be time consuming, we highly recommended that authors submit any necessary documentation with their manuscript. No article will be published in NASN without all required permissions.

      • Written permission from the copyright holder to use non-original material (including any photographs, images, figures or tables, or quotations exceeding 100 words) must be submitted with the manuscript, and acknowledgment must be given to the original source of the copyrighted material in the manuscript. You may download and submit the NASN Permission to Reprint Form for this purpose.
      • Identifying information regarding a person featured in an article, including recognizable photos or voice recordings, should be removed from the manuscript or written informed consent from the person obtained. For images and recordings, submit a signed copy of the NASN Audio-Visual Likeness Release Form.

      Conflict of Interest
      It is the author’s responsibility to disclose any potential conflict of interest regarding the manuscript, as specified on the Contributor Publishing Agreement which authors sign upon manuscript acceptance (see below). Additionally, for any photographs of people, identifying features should be removed or informed consent from each recognizable individual will be required.

      To comply with the guidance for Research Funders, Authors and Publishers issued by the Research Information Network (RIN), NASN School Nurse additionally requires all Authors to acknowledge their funding in a consistent fashion under a separate heading. Please visit Funding Acknowledgements on the Sage Journal Author Gateway to confirm the format of the acknowledgment text in the event of funding or state in your acknowledgments that: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

      Copyright Agreement
      Authors of accepted manuscripts are required to sign an electronic Contributor Publishing Agreement. Upon acceptance, authors will be instructed on how to sign and submit an agreement online.

      Page Proofs
      After an article’s layout has been determined and it has been typeset, a set of page proofs in PDF format will be e-mailed to the corresponding author. If there are any outstanding queries found at copyediting, they will be included in a cover sheet at the beginning of the file. Authors should review the proofs and submit minor revisions by the due date given. Note: Major corrections and changes after an article has been typeset are time consuming and difficult, and they may affect the overall layout. To ensure timely publication, keep revisions to a minimum and do not introduce substantial new material at this stage.

      Disclosure Statement
      The editor will do what is necessary to prepare the article for publication—including changes in title, grammar, and format to conform to editorial usage and style. Changes may include such last-minute deletions as are necessary to meet space and format requirements.

      Open Data Sharing
      The journal is committed to facilitating openness, transparency and reproducibility of research, and has the following research data sharing policy. For more information, including FAQs please visit the Sage Research Data policy pages.

      Subject to appropriate ethical and legal considerations and if applicable to your article, authors are encouraged to:

      • share your research data in a relevant public data repository
      • include a data availability statement linking to your data. If it is not possible to share your data, we encourage you to consider using the statement to explain why it cannot be shared.
      • cite this data in your research


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