(811) The Role of School Nurses in the Care of Children After Critical Illness

Introduction: About 125,000 school age children are admitted to pediatric intensive care units (PICUs) in the United States annually. School nurses provide frontline care, yet little is known about their knowledge, comfort, or role in caring for those recovering from critical illness.

Methods: An online survey was distributed to US-based school nurses between April and June 2024. The survey included demographic information (e.g., location, education), experience caring for children after PICU discharge, and knowledge of Post-Intensive Care Syndrome in Pediatrics (PICS-p). Surveys were distributed via the National Association of School Nurses and social media. The study was approved by the University of Michigan Institutional Review Board. Many survey questions permitted respondents to select more than one response.

Results: Nurses (n=80) were primarily located in the Midwest (35%) and Mid-Atlantic (20%) with a median of 9 years (IQR 3-16) experience as a school nurse. In the year prior, 54% cared for children after critical illness. Children were hospitalized for exacerbations of asthma (44%) and diabetes (37%), or trauma (37%). For nurses who provided care following critical illness, 58% felt prepared and 71% agreed they felt comfortable caring for the child following their return to school. Information regarding the child's hospitalization was provided via discharge summary (63%). Less than half of nurses (47%) understood changes in the child’s medical condition. Nurse’s roles included providing direct care (87%), educating classmates/families (71%), care plan development (87%), and school work help/support for absenteeism (44%). Nurses reported that other school staff, including paraprofessionals, aides, and social workers are also involved in caring for children returning to school. Only 4% of nurses were familiar with PICS-p, but 94% expressed interest in receiving PICS-p education.

Conclusions: School nurses commonly care for children after critical illness. While most nurses felt prepared and comfortable to care for a recovering child, there is a knowledge gap in understanding the child’s change in condition. Additionally, less than 5% are aware of PICS-p; however, most nurses expressed interest in receiving more education.