The Role and Effectiveness of School Nurses in Promoting Child Wellness: A Systematic Review

Background Child wellness is a multidimensional construct encompassing physical, mental, and social well-being, and schools are recognized as critical settings for integrated health promotion. School nurses play a central role within these systems; however, evidence regarding the scope, contextual variability, and effectiveness of nurse-led interventions remains fragmented. The Whole School, Whole Community, Whole Child (WSCC) framework provides a comprehensive model for understanding how school health services contribute to child wellness across multiple domains. Objective This systematic review aimed to synthesize recent evidence on school nurse–led interventions and evaluate their contributions to multidimensional child wellness within the WSCC framework. Methods A systematic review was conducted following PRISMA 2020 guidelines. Five databases (PubMed, CINAHL, Scopus, Web of Science, and PsycINFO) were searched for studies published between January 2020 and June 2025. Studies were screened independently by two reviewers using predefined inclusion criteria. Methodological quality was assessed using Joanna Briggs Institute tools. Due to heterogeneity in study designs and outcomes, a narrative thematic synthesis was performed, and findings were mapped onto WSCC components. Results Seventeen studies met the inclusion criteria. Interventions were categorized into five domains: health education (n = 9), mental health support (n = 6), chronic disease management (n = 7), hygiene and infection control (n = 5), and interdisciplinary collaboration (n = 8). Interventions were associated with improvements in health knowledge, behavioral outcomes, mental health indicators, and disease management. However, substantial variability in nurse roles and health system contexts limited comparability, and several WSCC components remained underrepresented. Conclusion School nurses play a critical role in promoting multidimensional child wellness. Nevertheless, limited evidence and contextual heterogeneity constrain generalizability, highlighting the need for standardized, context-sensitive, and longitudinal research.