School Nurses Beyond First Aid: Development and Validation of the School Nursing Framework for Violence Prevention and Response in Philippine Basic Education

Background: School nurses have traditionally been viewed as providers of first aid and managers of school-related illnesses; however, their potential contribution to violence prevention, child protection, and multidisciplinary school health remains underutilized, particularly in Philippine basic education. As school violence continues to threaten students’ safety, mental health, and academic success, there is a need for an evidence-based framework that clearly defines and expands the professional roles of school nurses. This study aimed to develop and validate the School Nursing Framework for Violence Prevention and Response (SNF-VPR) for Philippine basic education.
Methods: A sequential exploratory mixed-methods framework development design was employed. The study comprised four phases: an integrative literature review, qualitative interviews with 30 stakeholders (school nurses, school principals, guidance counselors, teachers, and parents), framework development through evidence synthesis, and expert validation using a three-round modified Delphi technique involving 18 multidisciplinary experts. Qualitative data were analyzed using thematic analysis, while content validity was established using the Item Content Validity Index (I-CVI), Scale Content Validity Index (S-CVI/Ave), and Kendall’s coefficient of concordance.
Results: Five interconnected domains emerged: Violence Prevention and Health Promotion; Early Identification and Risk Assessment; Crisis Intervention and Care Coordination; Recovery, Reintegration, and Family Support; and Leadership, Advocacy, and Policy Development. These domains were synthesized into the SNF-VPR, which positions the school nurse as the central coordinator of multidisciplinary violence prevention and response. Expert validation demonstrated excellent content validity (S-CVI/Ave = 0.98; I-CVI = 0.94–1.00) and strong agreement (Kendall’s W = 0.89, p < .001), indicating that the framework is relevant, comprehensive, applicable, and feasible.

school nursing; school violence; bullying; child protection

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