Every Second Counts: The School Nurse as a Health Educator - A Cross Sectional Observational Study

Area of Science:

• Pediatric emergency medicine
• Educational health policy
• Public health preparedness

Background:

• Schools are critical environments for managing pediatric emergencies like syncope, seizures, and trauma.
• In Italy, the absence of school nurses and mandatory teacher training necessitates improved first aid readiness among educational staff.
• Variable teacher preparedness highlights the need for enhanced first aid culture and skills in schools.

Purpose of the Study:

• To evaluate the first aid training level and preparedness of teachers (nursery to lower secondary) in managing pediatric urgent and emergency situations.
• To identify specific knowledge and procedural gaps in school-based pediatric emergency management.
• To assess the impact of training on teacher confidence and competence in handling emergencies.

Main Methods:

• A multicenter, descriptive, cross-sectional observational study was conducted in the Marche region, Italy (April-October 2025).
• A structured questionnaire, integrating two validated instruments, was administered to nursery, kindergarten, primary, and lower secondary school teachers.
• Data analysis included proportions with 95% CIs, chi-square tests for associations, and estimation of correct cardiopulmonary resuscitation (CPR) sequence knowledge.

Main Results:

• While 91% reported first aid knowledge and 88% had attended a course, only 7.5% felt genuinely prepared, with 64.2% feeling insecure.
• Significant procedural gaps were observed, including prioritizing consciousness assessment (55.2%) and correct CPR sequencing (~33%).
• Training correlated with perceived preparedness but not with correct CPR sequencing; age and seniority were linked to lower confidence.

Conclusions:

• Teachers demonstrate theoretical awareness but practical uncertainties, particularly in CPR and initial student assessment.
• Current training is insufficient, necessitating hands-on practice, realistic simulations, and regular refreshers for improved competence.
• Structured, skills-based programs with competency verification and integration of school nurses are recommended for sustainable emergency readiness.