School nurses' competency in supporting students with type 1 diabetes: A mixed methods systematic review

Aim To evaluate school nurse and family-reported perceptions of school nurse competencies in supporting students with Type 1 diabetes. Design: Mixed methods systematic review of the Joanna Briggs Institute methodology. Data sources: Five academic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Embase, and Research Information Sharing Service) were used as data sources. Review methods: Qualitative, quantitative, and mixed-method studies published between 2014 and 2023 were included. Two authors independently assessed the eligibility and quality of the included studies. The quality of the included studies was evaluated using a mixed methods assessment tool. Results: Thirteen qualitative studies, 11 quantitative studies, seven non-randomized studies, and four mixed studies met the inclusion criteria. Consequently, five competencies and 11 sub-competencies were derived under two themes. The two themes were "demand for training in school diabetes care" and "demand for more active cooperation." In particular, the literature confirmed challenges in school nurses' utilization of diabetes devices despite moderate to high confidence in basic diabetes care tasks. Conclusions: This systematic review offered useful information from the perspective of stakeholders (school nurses, parents, and students) regarding school nurses' competencies in caring for students with T1D. This can help us understand the various tasks and requirements faced by school nurses, and future capacity development interventions for school nurses that consider these are needed.