Professional Practice, Collaboration, and Evidence-Based Practice
Standards and process
NASN's standards of professional school nursing practice frame the role: assessment, diagnosis, outcomes identification, planning, implementation, and evaluation - plus ethics, education, evidence-based practice, quality, communication, leadership, and collaboration. The nursing process is the backbone of every clinical scenario question.
Evidence-based practice
Know the steps: form a focused question (PICO - population, intervention, comparison, outcome), search, appraise, integrate with clinical expertise and family preference, implement, evaluate. Levels of evidence rank systematic reviews and randomized trials above cohort studies, expert opinion, and anecdote. Distinguish EBP (using the best evidence for a practice decision), quality improvement (iterative local improvement), and research (generating generalizable knowledge that requires IRB review and consent).
Collaboration and professionalism
- Interprofessional teams: teachers, counselors, administrators, food service, facilities, outside providers, and families, with clear communication and structured handoffs.
- Cultural humility and health equity: language access, interpreters, awareness of bias, and social determinants of health.
- Delegation and supervision: the RN retains accountability and evaluates the delegated care.
- Professional development: certification (NCSN), continuing education, and reflective practice.
- Advocacy: for students, families, and the school nursing role itself.
Traps
Calling a practice "evidence-based" because it is traditional. Confusing QI with research. Delegating assessment or judgment. Omitting family-centered, shared decision-making language. Overlooking the duty to report unsafe practice or unsafe staffing.
Rule of thumb
When asked what the nurse should do first in a practice-improvement scenario, the answer is usually to assess current practice or gather data before changing it. When asked for the best evidence, look for the systematic review or clinical guideline.