Utilization of Written Asthma Action Plan In a Pediatric Primary Care Setting

Abstract

Problem: Asthma is a common and potentially serious chronic disease that affects over 20 million adults and 6 million children in the United States. Pediatric standard of care supports providing an asthma action plan to asthma patients/families. The use of asthma action plans (AAP) has been associated with improved asthma patient outcomes. Studies have shown poor utilization of AAP by healthcare providers for promoting self-management and self-efficacy. Purpose: The purpose of this DNP quality improvement project was to implement and evaluate the use of personalized written asthma action plans by healthcare providers in a pediatric primary care setting. Methods: The project was implemented over a 13-week period beginning in September of 2019. Participants were existing and newly diagnosed asthma patients less than or equal to 21years old who were receiving care for sick visits or annual physical examination. The conceptual framework of the project was based on Kurt Lewin’s change theory. In addition, a 4-hour education and training on asthma and the importance of the AAP was given to the healthcare providers (a physician and nurse practitioner), the office manager, and supporting members of staff. Healthcare providers and medical assistants were equally trained on how to complete an asthma action plan. The change process included the use of a colored paper asthma action plan and medical assistants provided the AAP sheet with a completed demographic section of the tool before the medical provider completed the other sections. Results: During the implementation period, data were collected on the number of AAP’s completed by the healthcare providers. This information was aggregated through a chart audit of de-identified copies of completed AAP’s. Run charts were used for data analysis. The clinic achieved 90% of AAP utilization rate, which surpassed the 60% goal of the project. Conclusion: The implementation and utilization of a written asthma action plan and in-service training in a pediatric outpatient setting improves patient accessibility to a treatment plan by primary care healthcare providers. The use of an evidence-based AAP can enhance patient management of asthma by giving patients and caregivers a roadmap to asthma care.