Effect of hospital asthma nurse appointment on inpatient asthma care

Abstract

While asthma nurses are funded by many health authorities within the U.K. National Health Service, for the improvement of clinical management in both inpatient and outpatient settings in secondary care, the effect of asthma nurse appointment on acute asthma care in hospitalized children has been inadequately studied. Here, we test the hypothesis that the employment of a full-time hospital asthma nurse improves quality of care for children admitted to hospital with acute asthma. Prospective in design, the study compares analyses of indicators of good clinical practice for hospitalized asthmatic children (2-16 yrs) before and after the appointment of a hospital asthma nurse. Both management [oxygen saturation check (35/106 vs. 111/126, P<0.05)] and discharge planning [self management plan/asthma education (17/106 vs. 49/126, P<0.05), follow-up arrangements with general practice (8/106 vs. 25/126, P<0.05)] improved. There was, however, no significant change in oral steroid administration, peak flow check, inhaler technique assessment, inhaled drug prophylaxis or arrangements for hospital follow-up at discharge. Employment of a hospital-based children's asthma nurse leads to significant improvement in aspects of routine in-patient asthma management. However, other important areas of in-patient asthma care did not improve following nurse-led interventions. A clearer evidence base may improve compliance with asthma management guidelines, and could make the role of hospital asthma nurse more effective.

A Matched-Cohort Evaluation of a Bedside Asthma Intervention for Patients Hospitalized at a Large Urban Children’s Hospital

“…[4][5][6][7] Of hospital-based programs targeting children, 3 were multifaceted and included provider quality improvement activities, education, and support. [8][9][10] Three other studies, each reaching fewer than 100 children, focused primarily on patient/caregiver education and support in the hospital during the child's stay. [11][12][13] These latter studies demonstrated a reduction in repeat ED visits and hospitalizations among participants.…”

British Guideline on the Management of Asthma

“…Asthma specialist nurse education of adults and school-age (but not pre-school) children at or shortly after hospital attendance improves symptom control, self management and re-attendance rates . [678][679][680][681][682][683] Making an appointment for review in primary care prior to discharge improves follow-up rates (but not outcomes). 684 Review within 30 days after hospital attendance with acute asthma is associated with reduced risk of further acute episodes.…”

Nursing interventions in monitoring the adolescent with Cystic Fibrosis: a literature review

“…Results also show clear evidence on the nurse's role as a caregiver, particularly in what concerns inhaled and intravenous medication administration, enteral and parenteral nutrition, ventilator weaning and oxygen administration 9 . However, in addition to these nursing interventions, related to the know-how, the educational domain is also highlighted by several authors as an important competence of nurses who provide support to patients and also to their family caregivers, thus contributing to extended home care 9 - 12 .…”

“…This professional is responsible for interacting with community services and governmental institutions, aiming to provide the best quality care to these patients, namely in what concerns pre and post pulmonary transplantation 9 - 11 .…”