School nursing services and school health initiatives have been developed because of the needs of children in schools.  Nursing services use various agencies, personnel and programs, both in school and in the community, to bring about an increase in student health and success in school.  This is done by using a standard of policies, procedures and activities designed to promote and protect the general health of both school children and school staff. 

    Education and health are interdependent – an unhealthy child, in mind or body, cannot learn.  Schools are one of the most appropriate places where community and families can come together to work for a holistic approach to health and education.



    • Emergency care, education, prevention, referrals, management of acute and chronic health problems.
      • Nurses ensure access to healthcare and try to identify and manage barriers to student education.
    • Health education is used to improve and maintain student’s health, to reduce risk factors and behavior, and to prevent diseases
    • Encouraging staff and family health promotion by sponsoring disease prevention programs.
      • Blood pressure checks, blood-borne pathogen lectures, and cancer awareness information were just a few ways nurses try to reach this goal.  Individual and group information sessions are used for health maintenance and emergencies
    • Nurses also help maintain a safe physical and psychological environment to support learning
    • Partnerships with families, schools, community groups and individuals that allow them to share and maximize resources to support the health and welfare among children
    • Case finding by screening, observation and direct referrals:  observation, obtaining and updating health information on students allows the nurse to form a nursing assessment of the student.  Referrals from parents, staff, and students are assessed.  New students, pre-k, kindergarten, first-, third-, fifth-, and ninth-graders are routinely screened for height, weight, and vision deficiencies.  Fifth-graders are screened for scoliosis also.
      • Kindergarten and preschoolers now have to have a test called the random-dot E test that is a specialized test for amblyopia.
      • New blood pressure screenings have also been voluntarily added by CMSD nurses in conjunction with Case student nurses for fifth-graders to discover pre-hypertension or hypertension earlier. This includes the new House Bill 210 about BMI (Body Mass Index) and health.
    • Immunizations:  This is an ongoing process to determine if students are in compliance with state regulations.  If students are found to be in compliance, records are computerized and hard copies made.  If not in compliance, parents are referred to either private physicians, Health Department Clinics, or to a school based immunization clinic.
    • Referrals and consultation:  Nurses notify parents, teachers and health professionals of screening results and make referrals as necessary.  From these consultations, an IHP (Individual Healthcare Plan) may be developed.  Assistance is also given to parents and staff to find appropriate health care providers and teach them to access the health care system.
    • Nurses attend SST meetings when there is a health issue involved that can affect the child’s education.  They assist in writing the IEP’s and provide documentation by acting as an intermediary with the health care system.  Parents might also need assistance with barriers with the educational system concerning a medical / emotional issue.
    • Environmental health- This means anything from whether a bathroom has soap, water and paper towels to helping decide if a lunch time snack is considered healthy.  Nursing consults take an active role in all aspects of a child’s educational life.


    • Dental:
      • Case School of Dentistry- Dental Sealants applied to the erupting molars of students in grades 2, 3, 6 and 7 at school (FREE)
      • Ronald McDonald Care Mobile – Semi truck that comes to individual schools to give dental care (x-rays, fillings, extractions, cleanings) to elementary students.  Medicaid / insurance billed if possible (NO OUT OF POCKET EXPENSES TO FAMILY)
      • Mobile Dentists - To individual schools to give dental care (x-rays, exams, cleanings) to all students.  Medicaid / insurance billed if possible (NO OUT OF POCKET EXPENSES TO FAMILY)
    • Vision:
      • VisionFirst- Serves Pre K, K, first graders with free glasses at individual schools.
      • OneSight – 20- 25 rotating schools each year to see 3500-4000 students grades 3-12.  Free Glasses from Lenscrafters Foundation and Mr. Ken Lanci. Taken to central location.
      • ChildSight – (Formerly Helen Keller, Int.)- Exams and free glasses to all students at individual schools.
      • Prevent Blindness, Ohio – For all students and families if no insurance or other programs available.  Please see your school nurse.

    COLLABORATIONS: (Partial List)

    • American Lung Association
    • Case Western Reserve University Dental / Medical School
    • Francis Payne Bolton School of Nursing (Case)
    • Baldwin College School of Nursing
    • Ursuline College
    • Cleveland Health Department
    • Cleveland EMS
    • Cleveland Clinic Foundation
    • University Hospitals
    • MetroHealth Medical Center
    • Cleveland State School of Nursing
    • Ohio Department of Health
    • Epilepsy Foundation
    • Sickle Cell Anemia Foundation
    • Prevent Diabetes Association
    • American Heart Association