exploratory trial in phase 3 to put phases 1 and 2 to the test. This will involve a feasibility study that takes the intervention into the school setting and investigates on a relatively small sample of school children the effect of the school nurse as navigator against specified health outcomes such as vaccine uptake, mental health or nutritional health. Finally, a full-scale multi-factorial randomized controlled trial will be designed to trial the model on a much larger scale across a range of school settings. This will enable a full evaluation of the effect of the navigator components on health outcomes based on well developed concepts and interventions. A full-scale well-designed RCT of school nursing has not, to our knowledge, been carried out so far. The application of the MRC framework would enable researchers to plan and envision how future work around school health might develop, including the refinement of the navigation concept.
Conclusion
School nursing has evolved in recent years away from a solely task-focused health protection role to a professional with a wide public health remit. The breadth of responsibilities represented by the new public health agenda is something of a double-edged sword for school nursing. Although allowing for opportunities to employ skills in innovative ways to meet the needs of the school aged children, the vastness of the role can result in policy makers perceiving school nursing as a ‘catch all’ profession. In addition the evidence base for school nursing is currently weak especially in relation to health promotion interventions (Wainwright 2000).