PolicyLab

School nurses play an important role in the well-being of children and are uniquely positioned to support whole child health.  

PolicyLab researchers recently partnered with leaders from the Wallingford-Swarthmore School District Nursing Department to design and implement a review of the school nursing program within their own district and benchmark metrics of interest with surrounding districts.

Rooted in data and a long-standing partnership with local schools, this project aligned with PolicyLab’s evidence to action model. In this approach to project design, a community identifies their needs and goals, PolicyLab provides research expertise to guide the methodologic process, and both parties contribute their unique knowledge and skills throughout the work to produce relevant, actionable findings. PolicyLab faculty and staff are committed to conducting respectful and rigorous community-engaged research and working with collaborators outside the hospital setting to address current, complex, real world questions and needs.

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In this post, I talk with Megan McCullough (right) about our partnership and how the school district is putting recommendations from our shared effort into practice. Megan is the director of student services at the school district.

Editor’s Note: This conversation has been edited for length and clarity. 

Question: Why did you reach out to PolicyLab?  

Our district was in the midst of developing a strategic plan and there was a pathway for wellness, within which nursing services were identified as an important component to include.

We felt like our nursing program was probably on the slimmer side in terms of our staffing numbers. But I didn't have an actionable way to address or to evaluate how we were doing with our staffing.

And then I saw the evaluation that was done with the School District of Philadelphia and that inspired me. We had an audit through CCIU (Chester County Intermediate Unit) for our counseling department—there was a lot of baseline data and measurement tools that were used to evaluate and to build our counseling services, but it felt like we didn't necessarily have that with our nursing department.  

PolicyLab was very connected to us during COVID in a lot of different ways, and I think they really have some credibility in our community. So that was kind of a natural fit for me. 

Question: How did the partnership build on the School District’s work to develop the school nursing program?  

There were three main factors that this partnership was able to build upon. First, our nursing team was starting to build their role as it relates to student mental health needs and supports. Our nurses were beginning trainings on this topic and we had a lot of research, an audit, and baseline data to inform the social emotional work.

Second, our department chair was newly in their role before the strategic plan was due to be developed.

Third, we structured the partnership to be an exchange of information along the way. Districts become very siloed, and within that silo, our nurses become even more siloed. So we're all just sort of turning in on ourselves and not really getting best practices from other places.

It was also a real back and forth and a learning experience where PolicyLab was bringing some of their expertise, but we were translating based on what it looks like in a school setting. And I think that was helpful for both sides.

Question: How are you using the assessment and the process? 

This work continues to evolve in a few ways. It started with sharing the evaluation both internally and externally, kicking off with the nursing department. It wasn't anything they didn't already know necessarily, but it was helpful to have the learnings in one place, have a better understanding of what similar districts are doing, and to have a better idea of how current practices connect to evidence-based practices.

We shared the evaluation in two board committees, the Educational Affairs Committee and the Wellness Advisory Committee, and shared it with our principles.

In sharing, we’ve also bridged partnerships with other groups. For example, I did a session with Pennsylvania’s American Academy of Pediatrics’ school health committee in which I met members from local counties, and we talked about some of the common issues. Our nursing department chair also maintains communication with the Delaware County Health Department and has worked closely with CHOP’s Youth Heart Watch, leading to all schools in the district earning the Heart Safe School Award in 2026.

There was also clear evidence in the evaluation that we needed to build capacity within the nursing department. We were able to hire two staff nurses, which was a change we could make pretty quickly within our budget.

With the additional staff nurses, we're able to get our certified school nurses involved in more of the broad initiatives of the district. So, for example, nurses are able to participate in our PBIS teams and support drug and alcohol prevention work. And our school nurse over at the high school did a hands-on CPR refresher for the entire faculty. So we built some things early on just by having those additional hands helping us.

Finally, we agreed that we would do an end of the year nursing program appraisal, giving us a baseline, helping us to set goals, and figuring out where we need to grow.

All of these efforts support continued growth for the department and a longer-term vision. We identified five broad topics that we should be always thinking about with school nurses, and starting off this most recent school year in that way was helpful.

Question: The school district’s vision for the school nursing program is inspiring. Tell us more about what will help your district and others realize that vision for students and school nurses.  

I hope to continue to build on my own learning and also others in our school community. For example, helping school leadership and staff better understand the role of school nurses as it relates to annual screenings, communicable disease control and mental health. School nursing is hard—for the most part, there’s one nurse in a building. Building a better understanding of school nursing will help support an overall community of care.

In service to this vision, we are taking steps to strengthen the supports offered to nurses. First, we’ve adjusted our induction training (which is required during the first two years of employment in a new school district) based on the evaluation and feedback we’ve previously heard to separate teachers and non-teaching professionals, such as nurses, counselors, speech therapists, and school psychologists. In lieu of some of the teaching strategies offered in training, we were able to offer more relevant supports such as those focused on whole child health.

Second, like other school professionals, it is important to provide our nurses with meaningful feedback and collaboration around goal setting, monitoring our progress and celebrating successes.

Finally, as it relates to our strategic plan, we’re focused on ensuring preventive and responsive evidence-based supports that promote physical, social, and emotional wellness are available to all students based on their unique needs.