Explaining the Variability in School Nurse Workload and Educational Outcomes

This secondary analysis examined the variability in the effects of school nurse workload on individual student outcomes of 9th grade attendance, being on track to graduate, and high school graduation. A principal axis factor analysis of the variables underlying school nurse workload and a structural equation model of the latent construct school nurse workload in 5th grade and the three outcome variables was tested using data from student records (N = 3,782). Two factors explained 82% of the variability in school nurse workload: acuity and volume factor and social determinants of health factor. The model had acceptable fit indices and school nurse workload explained between 35% and 52% of the variability in the outcomes with a moderate effect size (.6-.72). Creating school nurse workload assignments that maximize student educational outcomes may improve graduation from high school, which in turn increases the resources available for lifelong health.