An Intervention to Increase the Use of Asthma Action Plans in Schools: A MASNRN Study

Abstract

School nurses, in collaboration with primary care providers (PCPs), can work to better manage asthma by using the Asthma Action Plan (AAP) with peak flow monitoring. The aim of this pilot study was to determine the effectiveness of an intervention to increase the number of AAPs in schools for students with asthma by having school nurses provide the students' peak flow measurements to their PCPs with a request for an AAP. The study found a significant increase in AAPs when school nurses provided PCPs with accurate peak flow data and requested an AAP from the PCP than when school nurses requested an AAP via the students' parents and did not provide peak flow data to the PCP. This study provided data on the importance of collaboration with PCPs in order to affect better care for children with asthma.

Availability of Asthma Quick Relief Medication in Five Alabama School Systems

“…[25][26][27] For example, many schools with appropriate policies in place often fail to implement them fully. [28][29][30][31][32][33] Others face similar challenges obtaining asthma action plans from physicians and parents, 29,[34][35][36][37] securing physician time to complete personalized asthma action plans, 29 ensuring that school personnel have the knowledge needed to manage asthma at school, 32 and obtaining access to asthma specialists. 8 These reports and our experience suggest that school policies, while necessary, are not sufficient to ensure student access to albuterol while at school.…”

Asthma and Adolescents

“…All four studies reported improvement in asthma knowledge. Pulcini et al (2007) and Buckner et al (2005) noted improvement in peak flow meter technique and results. Buckner et al also reported that adolescents improved medication management.…”

“…These subcategories were program evaluations (Brasler & Lewis, 2006;Joseph et al, 2007;Magzamen et al, 2008;Splett et al, 2006) and specific educational interventions (Buckner et al, 2005;Mosnaim et al, 2008;Pulcini et al, 2007;van der Meer et al, 2007). These studies varied in purpose but evaluated the effectiveness of programs and specific interventions in improving asthma outcomes for adolescents.…”

“…Four studies fell into this subcategory. The intervention strategies varied from the use of MP3 players to deliver tailored asthma messages from celebrities to one-to-one coaching on the use of peak flow meters by the school nurse (Mosnaim et al, 2008;Pulcini et al, 2007). All intervention strategies could be used across settings such as the home, school, and residential asthma camp (Buckner et al, 2005;van der Meer et al, 2007).…”

“…Four of the strategies for asthma control reappear in the four components of the NHLBI 2007 guidelines for all persons with asthma: asthma education, monitoring asthma symptoms, control of environmental factors and comorbid conditions, and medications for prevention of symptoms, treatment of attacks, and comorbid conditions (NHLBI, 2007). For adolescents, the success of asthma control is measured by these outcomes: (a) asthma knowledge, (b) school absenteeism, (c) appropriate use of asthma medications, and (d) the decreased use of health care services including ER visits, hospitalizations, and visits with the school nurse (Brasler & Lewis, 2006;Bruzzese, Evans, & Kattan, 2009;Bruzzese, Unikel, Gallagher, Evans, & Colland, 2008;Coffman et al, 2009;Davis et al, 2008;Erickson, Splett, Mullett, Jensen, & Belseth, 2006;Joseph et al, 2007;Magzamen et al, 2008;Mosnaim, Cohen, Rhoads, Rittner, & Powell, 2008;Pulcini, DeSisto, & McIntyre, 2007;Sadof & Kaslovsky, 2011;van der Meer et al, 2007;Wheeler et al, 2009). …”