Homelessness has reached crisis levels in Seattle and King County. Poor health outcomes and limited access to culturally competent, quality medical services are significant challenges for people experiencing homelessness. Despite the need for skill-building in this area, nursing students traditionally receive limited training in caring for homeless patients, and stigma toward this population is common among clinicians. Literature indicates that service learning experiences can help prepare nursing students to offer better care to the homeless. The purpose of this study is to evaluate the impact of a quarter-long service learning course on the attitudes and behavioral intentions of nursing students toward homeless populations. This study examines data collected from 1st year Doctor of Nursing Practice (DNP) students (n=112) enrolled in NSG 552: Social Determinants of Health and Health Equity at the University of Washington during Winter 2017 quarter. Students completed a 10-item survey at the beginning of the quarter and again at the end of the quarter. Survey domains included cultural awareness, knowledge of homelessness, and self-efficacy to provide care to homeless populations. Students also completed a professional reflection related to how their service learning experience influenced their practice. The survey responses were analyzed using descriptive statistics. The written reflections were reviewed to identify common themes. This study contributes to our understanding of how a quarter-long course with a service learning component can impact nursing students’ attitudes, perceptions and intentions of working with homeless populations. By better understanding the effect of the course on students, UW health sciences faculty can better tailor coursework to ensure nursing students are equipped with the knowledge and skills necessary to deliver culturally competent care to patients experiencing homelessness.

Early identification of homeless students (as defined by the McKinney-Vento Homeless Assistance Act of 1987) allows school nurses to partner with other school staff to address social, emotional, and physical health barriers to learning and academic success. School nurses are generally aware of the McKinney-Vento Homeless Assistance Act provisions but face barriers when providing effective care. These barriers include high caseloads, lack of flagging homeless students in the school-nursing database, and lack of a systematic plan to address the myriad issues homeless students face. This survey asked 80 nurses from the School Nurse Organization of Washington to identify barriers to providing care for homeless students and their perceptions about priorities in providing care. Areas of improvement are identified to better standardize nursing care of McKinney-Vento-identified students. Survey results specifically makes policy recommendations for Washington state school nurses to increase their frequency of interaction with homeless students by classifying them as a higher level of nursing care. It is important to increase the frequency of interactions and flag homeless students because school nurses may be the only healthcare professional homeless students have access to.