The number of children with chronic and complex health care needs in schools is rapidly increasing (National Center for Education Statistics, 2012). Public schools are required under federal laws to provide health services for children with complex student health needs (NASN, 2013). There is a shortage of school nurses in the United States and school nurse to student ratios vary greatly. Due to the shortage of school nurses and budget constraints, schools have no choice but to delegate traditional nursing services to unlicensed assistive personnel (UAP’s) (Resha, 2010). This poses educational, clinical, legal, and financial concerns for the school nurse because they are accountable for student health outcomes. This systematic review found that areas of training and supervision varied for UAP’s and school nurses’ perceptions related to delegation of UAP’s varied also. In addition to these findings, the systematic review found that UAP’s with inadequate training were responsible for most medication administration errors and adherence to policies on documentation of medication administration by UAP’s was difficult. This poster emphasizes that more nurse-led research is required to ensure that the delegation process is safe and effective to manage children with health conditions in the school setting.