The Need to Develop Evidence-based Practice Guidelines for School Nurses in Iran

DEAR EDITOR

The importance of evidence-based practice (EBP) was first suggested in 1972 when Dr. Archibald Cochrane suggested that physicians needed to synthesize and use evidence to inform and improve their practice. Later, in 1989, Dr. Cochrane suggested that all health professions should consider similar approaches to review. ¹ EBP is a decision-making method that has become essential to healthcare in recent decades. It is recognized as a way to improve healthcare standards and excellence in nursing care. As a problem-solving method, EBP integrates the best available scientific evidence with situational conditions, available resources, and patient preferences. Therefore, knowledge of EBP principles and skills in applying the steps of the EBP implementation process are essential competencies for all healthcare professionals. ²

School nursing is a specialized practice responsible for intervening in students’ social, physical, and emotional needs and developing comprehensive care that benefits academic success, lifelong development, and student health. The goal of school nursing is to optimize the health of students so that they can learn and live productive lives. School nurses can only do this if they use the best practices and available information. ³ Currently, EBP implementation focuses on nurses providing care in hospitals and outpatient clinics. However, incorporating EBP wherever nurses provide care, including schools, is no less critical. A change in school nursing culture is needed so that every school nurse works according to the EBP model of care. ¹

From this standpoint, it’s evident that school nurses in Iran lack evidence-based clinical practice guidelines to provide systematic and quality care to students. There is a dearth of school nursing guidelines, including protocols and treatment guidelines to guide the performance of nurses in the care of students by prioritizing needs and in specific clinical situations. ⁴ Therefore, to the best of our knowledge, there is still no school nursing guide in Iran that focuses on adolescent health promotion and is also based on a nursing theory.

The process of developing EBP guidelines is a collaborative effort that involves several steps. First, the health problem is identified according to EBP guidelines. Then, a systematic review of the literature, including identification of the level of available evidence, is conducted. After evaluating the evidence, practical recommendations are made, preferably directly related to individual recommendations. These guidelines are peer-reviewed and then published through sponsored publications and websites. ⁵ According to the above evidence, there is a need for a group of experts in the fields of school nurses in Iran, which include the fields of public health, environmental health, nursing, midwifery and nutrition, who have the necessary and sufficient expertise and experience to translate and develop EBP guidelines. These guidelines should be updated and made available to school nurses in the most appropriate way possible. Developing EBP guidelines is a time-consuming process that requires cooperation across the country. For instance, one successful collaboration model started at the University of Iowa in the US, where professors and students from other universities partnered to develop instruction as a major project in their master’s program. Another successful model is interdisciplinary collaboration. ⁶ Given the educational environment and the impact of health on learning, developing school health EBP guidelines can be an interdisciplinary collaboration. For example, a school nurse can work with a physical education teacher to develop physical activity guidelines.

In conclusion, it is high time for Education Health Unit in Iran to establish EBP centers, organize national EBP seminars and workshops, and create web pages to develop evidence-based information, as well as advocacy groups. These initiatives provide an opportunity to learn about available resources and may encourage school nurses to begin the process of identifying information that needs to be developed to meet their specific practice needs.

ACKNOWLEDGEMENT

We appreciate and thank all the authors whose articles we have used in writing the text.

Authors’ Contribution

M.S: Conceptualization and design, editing, and revision. Z.S: Drafted the manuscript. All authors reviewed the final manuscript.

Funding Source

There is no financial support for this article.

Conflict of Interest:

None declared.

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