Date of Award

Spring 2021

Project Type

Clinical Doctorate

College or School




Program or Major


Degree Name


First Advisor

Pam DiNapoli

Second Advisor

Quinton Donahue


BACKGROUND: School nursing has a foundation in population health and an essential role within the community, which needs to be structured by the developing field of health informatics in order to compete and communicate with all stakeholders. This quality improvement project specific aim was to improve the electronic medical record (EMR) usability and clinical efficiency.

METHODS: A school district with three elementary, one high and one middle school was chosen, using the school information system (SIS)/EMR currently in place at each school health office. The school health staff participating in this project included 5 registered nurses and 5 clinic assistants. Two pre and post-intervention surveys were administered. The System Usability Scale and a Survey of School Nurse and Clinic Assistant Attitudes Towards Technology were completed by the participants.

INTERVENTION: The intervention included an immunization tool training module followed by 10 weeks of utilizing the immunization tool including the input, extraction and interpretation of compliance and non-compliance data for school administrators.

RESULTS: The results indicate the district immunization non-compliance numbers were reduced by 2.49%, and while the school health staff find the immunization tool useful and relevant to their work, they need access to ongoing training and technical support to improve usability. Participants’ perceptions of usefulness of the system and immunization tool are positive, but their perceived ease of use is negative. Further informatics training may offer opportunities to improve the usability of the system and tool and increase clinical efficiency.