School Nurse Adherence to Evidence-Based Best Practice Screening for Functional Constipation in the School-Age Child

Nancy L. Castner, The University of Vermont


Purpose: Pediatric functional constipation (PFC) is a common health issue affecting children's well-being and quality of life. This project aimed to improve the identification and management of PFC-related bowel and bladder dysfunction in the primary school setting. The primary goal was to increase the percentage of children screened by school nurses for PFC, leading to timely referrals to primary care clinicians.

Methods: An evidence-based educational module was developed to educate school nurses of the connection between functional constipation and associated bowel and bladder dysfunction. A comprehensive workflow was implemented, utilizing standardized assessment practices, and validated pediatric-based functional constipation assessment tools.

Results: A retrospective chart review established baseline screening rates, which demonstrated a significant increase in the percentage of children screened for PFC (from 19% to 91%) and referred to primary care (by 25%) after the implementation of the educational module and assessment workflow.

Conclusion: This project demonstrates that increased screening for PFC in primary schools is achievable through education, evidence-based assessment strategies, and the dedication of school nurses. The adoption of comprehensive educational interventions and evidence-based practices enabled the identification, management, and timely referral to primary care clinicians for PFC in the school setting.