Abstract

Evidence has shown that students with untreated or poorly managed mental health concerns are at higher risk for absenteeism, psychiatric hospitalization, and school dropout. School nurses are often among the first healthcare professionals students encounter when experiencing emotional distress; however, many report limited preparation in mental health screening, grounding techniques, and referral support. The purpose of this quality improvement project was to determine the feasibility of a simulation-based educational intervention for school nurses in managing student anxiety. Guided by the Johns Hopkins Nursing Evidence-Based Practice Model and Neuman Systems Model, this initiative also included the Plan-Do-Study-Act (PDSA) quality improvement model for implementation strategies. A single-group pretest-posttest design was used with registered nurse participants who were practicing school nurses attending a regional continuing education School Nurse Bootcamp. The intervention included brief education and pre-briefing, an adolescent standardized patient anxiety scenario, practice using evidence-based grounding techniques, and guided debriefing focused on recognizing student anxiety, using evidence-based screening concepts, and responding with appropriate support strategies. Confidence was measured using an adapted six-item, 5-point Likert self-assessment tool. Survey items assessed confidence in recognizing a mental health crisis, conducting screening with an evidence-based tool, interpreting screening results, identifying resources, knowing who to contact, and providing directions during a school mental health emergency. Surveys were completed at baseline, immediately following the intervention, and at three-week follow-up. Nineteen (86.4%) matched responses were analyzed. Results indicated a statistically significant improvement in participants’ confidence in conducting a mental health screening using an evidence-based tool (p = .008; Cohen’s d = 0.701). Other confidence domains demonstrated improvement following the intervention, but did not reach statistical significance. Three-week follow-up data were limited and interpreted descriptively. These findings suggest that implementation of a simulation-based educational intervention for school nurses in managing student anxiety is feasible and scalable. In addition, such an intervention is a practical, low-cost method to strengthen school nurses’ confidence when responding to student anxiety. This project supports the use of simulation-based professional development to improve preparedness, promote early identification of student mental health concerns, and strengthen school nurses’ confidence in responding to student anxiety in school settings.

Date of publication

Summer 8-2026

Document Type

DNP Scholarly Project

Language

english

Persistent identifier

http://hdl.handle.net/10950/5124

Committee members

Deanna Adams, DNP (Faculty Mentor) Jodi Bullard, DNP (Project Sponsor) Emily Fox, DNP Program Director Angie (Mary) McInnis, Associate Dean for Academic Affairs Jeni Chilton, Dean, School of Nursing

Degree

Doctor of Nursing Practice

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