Hawai‘i Keiki program designated as an American Academy of Nursing Edge Runner


University of Hawaiʻi at Mānoa
Desiree Uyeda, (808) 956-2904
Marketing Manager, Nancy Atmospera-Walch School of Nursing
Posted: Sep 20, 2023

Link to video and sound (details below): https://go.hawaii.edu/ymj

The Hawai‘i Keiki: Healthy & Ready to Learn (Hawai‘i Keiki) Program, a partnership with the University of Hawai‘i at Mānoa Nursing and the Hawai‘i State Department of Education (HIDOE) has been designated as an Edge Runner by the American Academy of Nursing. Edge Runners are evidence-based, nurse-designed models that demonstrate significant clinical, financial, community and policy outcomes with proven sustainability and replicability. Each of these programs highlights nurses’ ingenuity and collaboration in developing new methods to provide care and promote health equity. 

The program was developed in 2014 to address the impact of health on student attendance and learning, especially focused on the needs of Title 1 schools. Hawaiʻi Keiki enhances and builds school-based health services that screen for treatable health conditions; provide referral to primary health care and patient-centered medical home services; prevent and control communicable disease; and provide emergency care for illness or injury.

“This national recognition is a testament to the dedication of our nurses and so many people behind the scenes who are committed to ensuring that public school students in Hawai‘i have equitable access to health care,” said Deborah Mattheus, senior practice director and dental sealant program director for Hawai‘i Keiki. “Studies show that students succeed academically when they come to school healthy and ready to learn. Our program puts health care right into the schools. Hawai‘i Keiki makes sure every child who needs health care, receives it at no cost and regardless of insurance status. In addition, our nurses provide health education and collaborate with community partners to expand health services, such as vision, hearing and dental screenings.”

School-based health services

The program was designed to be flexible and agile to respond to emerging and ongoing student, school and community needs as well as funding availability. The Hawai‘i Keiki RNs (registered nurses) and APRNs (advanced practice registered nurses) are a resource to the entire school community. They lead the coordination of school health services and assist in school wellness promotion and health careers readiness. Hawai‘i Keiki nurses collaborate with and make referrals to health systems and individual care providers. 

By utilizing technology such as telehealth, Hawai‘i Keiki has expanded equitable access to care for physical and mental health needs. A Hawai‘i Keiki RN can virtually connect a student to a Hawai‘i Keiki APRN. With the presence of dedicated nurses in schools, it allows principals and teachers to focus on education rather than students' health care.

Health care delivered the local way

Hawai‘i Keiki nurses are compassionate and engaged health care providers. Many serve in the communities they were born and raised in, and others travel across the state to communities they have adopted as family. Every school, community and island experiences different challenges and health disparities. Hawai‘i Keiki nurses adapt and respond to the unique medical, socio-economic and geographic issues for their complex area. 

“When we created Hawai‘i Keiki, our goal was to find nurses who would build an academic nurse-led school-based health program from the ground up,” said Mary G. Boland, dean emerita, UH Mānoa Nursing. “We focused on creating a program custom designed for the unique qualities of Hawai‘i and our public school education system because HIDOE is one system across all islands, separated by geographic distance and size. Hawai‘i Keiki is currently the largest school-based health program in the state, and I am so proud of how the program has grown over the past nine years. I find deep satisfaction knowing that nurses have truly made a difference in the lives of thousands of Hawai‘i students.”

Evidence of Success

The Hawai‘i Keiki: Healthy and Ready to Learn model has expanded access to health care and reduced health disparities for children and contributed to an emerging body of evidence on school health. During the COVID-19 pandemic, Hawai‘i Keiki continued to grow in size and scope to meet the needs of the students, community and schools. When the state’s public schools closed during the pandemic, the program launched a hotline answered by Hawai‘i Keiki nurses to provide health advice, information on community services as well as to conduct telehealth visits upon requests. 

School Nursing Services (in operation since 2014)

  • Expanded from 59 schools to all 258 public schools across the state
  • 75% of students in 2022–23 returned to class instead of being sent home after a visit to a Hawai‘i Keiki clinic
  • Grown from four nurses to approximately 160 registered nurses, advanced practice registered nurses, dental hygienists, dentists and health technicians in 2023
  • The program now offers: school nursing, telehealth, mental health services, dental services, health hotline, Vaccines for Children and recently expanded services to Hawai‘i Charter Schools
  • 82% of Hawai‘i public schools participated in the Hawai‘i Keiki Narcan/CPR training initiative to reduce potential opioid overdose on school campuses

Dental Services (in operation since 2020)

  • Provides no-cost dental screening focused on high-need schools and has received on-going grant funding from Hawai‘i Dental Service Foundation since 2019
  • Expanded services from six schools on one island in 2020, to 68 schools on three islands in 2023
  • 61% of students in 2022–23 who received dental assessments received dental sealants 

Promotion of Health Professions

  • Provides training and education for School Health Assistants (HIDOE employees) to increase their lifesaving and first-aid skills
  • Provides clinical experiences for UH students from nursing, dental hygiene, pharmacy, sociology and psychology departments 
  • Actively supports the HIDOE Career Pathways by engaging with high school student health academies and career fairs

“The Academy is proud to designate unique and solution-oriented initiatives as Edge Runners. The diverse focus of Edge Runner models highlight the wide range of services, vital support, and team-based approaches that the nursing profession provides,” said American Academy of Nursing President Kenneth White. “The Hawai‘i Keiki: Healthy & Ready to Learn Program applies nurses as innovative change agents who are addressing a specific health care challenge.”

All of the Edge Runner profiles are available to view online. The program leads for each of these innovative models of care will be honored at the 2023 Health Policy Conference, taking place October 5–7, in Washington, DC. 



About the American Academy of Nursing
The American Academy of Nursing serves the public by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. Academy Fellows are inducted into the organization for their extraordinary contributions to improve health locally and globally. With more than 2,900 Fellows, the Academy represents nursing’s most accomplished leaders in policy, research, administration, practice and academia. 

About Hawaii Keiki: Healthy & Ready to Learn
Hawai‘i Keiki is a partnership between UH Mānoa Nursing and the Hawai‘i Department of Education and sits at the intersection of education and health to support HIDOE to achieve student, school and system success. The program is designed to improve access and quality of health services in the school by coordinating and expanding existing efforts of the partners and community resources. The program is enhancing and building school based health services that screen for treatable health conditions; provide referral to primary health care and patient centered medical home services; prevent and control communicable disease and other health problems; and provide emergency care for illness or injury.


Link to video and sound (details below): https://go.hawaii.edu/ymj

B-roll (trt 1:19):

  • Hawaiʻi Keiki registered nurse (RN) conducts a temperature check on student
  • Hawaii Keiki RN uses telehealth to conduct a virtual appointment with an advanced practice registered nurse (APRN)
  • Hawaiʻi Keiki RN conducts student health assessment for ears
  • A HIDOE student participating in a vision screening
  • Hawaiʻi Keiki APRN hosts a “Teddy Bear” clinic for young students so they understand what happens during a routine health assessment
  • Hawaiʻi Keiki dental hygienist prepares a student’s teeth for dental sealant application
  • Hawaiʻi Keiki dental hygienists conduct dental screenings at HIDOE schools 
  • CPR training on HIDOE teachers at a Maui HIDOE school
  • Hawaiʻi Keiki APRN provides vaccinations for students
  • Hawaiʻi Keiki nurses and staff throwing shakas


Deborah Mattheus, Hawaiʻi Keiki Senior Practice Director, UH Mānoa


“This national recognition is a testament to all of our Hawaiʻi Keiki nurses and all the people that work in the background to make sure that our students in public schools receive equal access to healthcare.” 


“Having a school nurse available to students really allows the teachers and administrators to do the work that they need to do. They are able to provide education while our nurses are there to be able to take care of the health, physical and mental needs of our students.”