Strategies

Delay school start times for middle and high schools to better align with adolescent sleep-wake cycles; often until 8:30 a.m. or later

Increase wages and benefits for personal or home care workers, nurse aides, and others who provide direct care to patients in long-term care (LTC) settings

Pair new nurses with more experienced nurses who act as a resource and provide support as the new nurse establishes her or himself professionally

Focus heavily on reading and math achievement, enforce high behavioral expectations through a formal discipline system, lengthen instructional time, and increase feedback on teacher performance

Improve work environments for nurses via establishment of strong nursing leadership, organizational support, etc.

Teach positively stated behavior expectations to all students, often reinforced with prizes or privileges and supported with coaching and data

Create a school culture of high behavioral and academic expectations, with intense tutoring, increased teacher performance feedback, lengthened instruction time, and health care services

Require school officials to apply predetermined consequences for certain infractions, regardless of situational context or circumstances; consequences are usually severe (e.g., suspension or expulsion)

Support programs to provide students with a nutritious breakfast in the cafeteria, from grab and go carts in hallways, or in classrooms

Provide health care services on school premises to attending elementary, middle, and high school students; physical and mental health services provided by teams of nurses, nurse practitioners, and physicians