Implementation of school nursing in primary schools in Rhineland-Palatinate: A mixed-methods evaluation (SGF-MINZE)

Project period: 2021–2023

Background

Despite the growing need for medical and nursing care in schools and international evidence demonstrating beneficial effects of school nursing on a range of outcomes, including quality of life, symptom severity, and school absenteeism, school nursing has so far been implemented in Germany primarily through pilot projects. Little is currently known about the potential effects of school nursing in German schools or about context-specific barriers to its implementation.

Objectives

We therefore evaluated the expansion of school nursing in primary schools in Rhineland-Palatinate, focusing on the perspectives of parents and school staff regarding:

  • the status quo of school-based healthcare prior to the implementation of school nursing
  • attitudes towards school nursing
  • satisfaction with care provided by school nurses
  • implementation barriers
  • changes associated with the implementation of school nursing

Study design and methods

The stepwise implementation of school nursing in 24 primary schools in Rhineland-Palatinate was evaluated between 2022 and 2023 using a multi-centre mixed-methods design. The evaluation built on a feasibility study conducted by the Institute of Medical Biostatistics, Epidemiology and Informatics at University Medical Centre Mainz between 2018 and 2019, which demonstrated the feasibility and potential benefits of school nursing in primary schools.

In Rhineland-Palatinate, school nurses are based directly in primary schools. In addition to providing acute and emergency care, they place particular emphasis on supporting children with chronic conditions. The study comprised three quantitative survey waves involving parents, including parents of children with chronic conditions, as well as school staff. Survey data were analysed using descriptive and inferential statistical methods. In addition, semi-structured telephone interviews with parents, teachers, school principals, and school nurses from six primary schools explored aspects not captured by the quantitative surveys. The interviews were analysed using qualitative content analysis according to Rädiker and Kuckartz. Finally, routinely collected school nursing records were analysed to assess service utilisation.

Final report

The final report is available here(PDF 1,1 MB) (final report in German).

Funding

Ministry of Education of Rhineland-Palatinate

Collaborating partners

Regional Centre for Health Promotion in Rhineland-Palatinate
Ministry of Education of Rhineland-Palatinate

Contact details

Jana Fischer, M.Sc. (research associate)

Simone Kadel, M.Sc. (research associate)

Dr. med. Michael Eichinger (principal investigator)

Email: sgf@uni-mainz.de