{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:10:24Z","timestamp":1790251824089,"version":"4.1.0"},"reference-count":16,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["NASN School Nurse"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Vision disorders are prevalent among preschool children and can significantly interfere with early learning, literacy development, and school readiness. Although vision screening is mandated in many states, referral completion following failed screenings remains inconsistent, particularly in underserved populations. School nurses are uniquely positioned to address this gap through structured follow-up and family-centered communication. This article describes a school nurse-led quality improvement process using the Small Steps to Eye Care Action Plan to improve referral completion for preschool students.<\/jats:p>","DOI":"10.1177\/1942602x261448503","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T06:57:45Z","timestamp":1779433065000},"page":"164-168","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Improve Vision Referral Completion by Implementing the Small Steps to Eye Care Action Plan"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4774-3626","authenticated-orcid":false,"given":"Mary","family":"Noga","sequence":"first","affiliation":[{"name":"Licensed School Nurse, DNP Graduate Student in Advanced, Population Health Nursing, University of Illinois Chicago, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"e_1_3_3_2_1","unstructured":"American Optometric Association. (2017). Comprehensive pediatric eye and vision examination: Clinical practice guideline. https:\/\/www.aoa.org\/"},{"key":"e_1_3_3_3_1","doi-asserted-by":"crossref","unstructured":"Antonio-Aguirre B. Block S. S. Asare A. O. Baldanado K. Ciner E. B. Coulter R. A. Collins M. E. (2024). Association of sociodemographic characteristics with pediatric vision screening and eye care: An analysis of the 2021 National Survey of Children\u2019s Health. Ophthalmology 131(5) 611\u2013621. https:\/\/doi.org\/10.1016\/j.ophtha.2023.12.005","DOI":"10.1016\/j.ophtha.2023.12.005"},{"key":"e_1_3_3_4_1","doi-asserted-by":"crossref","unstructured":"Donabedian A. (1966). Evaluating the quality of medical care. The Milbank Memorial Fund Quarterly 44(3) 166\u2013206. https:\/\/doi.org\/10.2307\/3348969","DOI":"10.2307\/3348969"},{"key":"e_1_3_3_5_1","unstructured":"Illinois Department of Public Health. (2022). Vision and hearing. https:\/\/dph.illinois.gov\/topics-services\/prevention-wellness\/vision-hearing.html"},{"key":"e_1_3_3_6_1","doi-asserted-by":"crossref","unstructured":"McClendon D. Zeni M. B. (2020). Evaluation of a vision referral program with school-aged children and their parents\/guardians. Journal of School Nursing 36(4) 253\u2013262. https:\/\/doi.org\/10.1177\/1059840518821427","DOI":"10.1177\/1059840518821427"},{"key":"e_1_3_3_7_1","doi-asserted-by":"crossref","unstructured":"Musch D. C. Gillespie B. W. Niziol L. M. Cashwell L. F. (2020). A community-based effort to increase the rate of follow-up eye examinations of school-age children who fail vision screenings: A randomized clinical trial. Journal of AAPOS 24(2) 79\u201384. https:\/\/doi.org\/10.1016\/j.jaapos.2019.10.011","DOI":"10.1016\/j.jaapos.2019.12.012"},{"key":"e_1_3_3_8_1","unstructured":"National Association of School Nurses (NASN). (2021). A model for school nurse-led case management. https:\/\/learn.nasn.org\/courses\/33713\/documents\/48822"},{"key":"e_1_3_3_9_1","volume-title":"National Association of School Nurses: Scope and standards of practice","author":"National Association of School Nurses (NASN)","year":"2022","unstructured":"National Association of School Nurses (NASN). (2022). National Association of School Nurses: Scope and standards of practice (3rd ed.). American Nurses Association.","edition":"3"},{"key":"e_1_3_3_10_1","unstructured":"National Center for Children\u2019s Vision and Eye Health at Prevent Blindness (NCCVEH). (2020). Children\u2019s vision and eye health: A snapshot of current national issues (2nd ed.). https:\/\/preventblindness.org\/wp-content\/uploads\/2020\/07\/Snapshot-Report-2020condensedF.pdf"},{"key":"e_1_3_3_11_1","unstructured":"National Center for Children\u2019s Vision and Eye Health at Prevent Blindness (NCCVEH). (n.d.). Small steps to eye care: Action plan [Unpublished practice tool]. https:\/\/nationalcenter.preventblindness.org\/small-steps-for-big-vision\/"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0000000000002290"},{"key":"e_1_3_3_13_1","doi-asserted-by":"crossref","unstructured":"Rodriguez E. Rivera L. M. Perlroth D. Becker T. M. (2018). Increasing screening follow-up for vulnerable children: A partnership with school nurses. International Journal of Environmental Research and Public Health 15(8) 1572. https:\/\/doi.org\/10.3390\/ijerph15081572","DOI":"10.3390\/ijerph15081572"},{"key":"e_1_3_3_14_1","doi-asserted-by":"crossref","unstructured":"Schlottmann H. Broderick M. Levine R. Ford A. L. (2019). Nurse-led motivational interviewing to improve goal setting for obesity prevention in young children. 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