Implementation of School Diabetes Care in the United States: A Scoping Review.
Ruopeng An, Danyi Li, Marjorie Cole and 3 others
PMID 34184953WHAT IT FOUND
Facilitators to school diabetes care included competent nurses, engaged parents, responsible teachers, adequate resources, and communication.
Barriers included inadequate training, heavy nurse workload, unclear roles, and rules against glucose checks, snacks, or insulin.
Key findings
01Facilitators to forming a responsible and efficient school diabetes management team included competent school nurses, engaged parents, responsible teachers, well-informed school leaders, adequate resources, and frequent communication.
02Barriers included inadequate training, heavy school nurse workload, unclear responsibility division, and policies that prevented glucose checks, smartphone use, or possession of syringes.
03The review included 46 articles, and the evidence base was a mix of experimental, cross-sectional, and qualitative studies.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review could not combine studies statistically because designs, outcome measures, stakeholders, and school characteristics varied widely. Few studies compared school diabetes care practices to the NIDDK guideline. Most studies focused on stakeholder and school-level factors, not national, state, or school-district policies. Most studies were small in sample size and geographical scale, often covering one or two schools, limiting generalizability. Only ten studies applied an experimental design and measured outcomes over time.
The easy way to misread this
Do not read the facilitators as tested treatments. The review did not test interventions or combine studies statistically, and many included studies were qualitative or cross-sectional. Do not attribute better care to any single component, such as nurse training alone.