Written Asthma Action Plan Implementation and Evaluation in Pediatric Primary Care

Abstract

Problem & Purpose: Asthma guidelines recommend the use of written asthma action plans (WAAPs) in the management of pediatric asthma patients, but this is not always practiced in the primary care setting (Global Initiative for Asthma [GINA], 2019; National Asthma Education and Prevention Program [NAEPP], 2007; Ring et al., 2015). Lack of proper asthma management can lead to an increase in asthma related unscheduled sick visits. The purpose of this quality improvement project is to implement and evaluate a WAAP for pediatric asthma patients in a pediatric primary care clinic in the Eastern Shore Maryland area. Methods: Implementation of a WAAP involved one pediatrician, two pediatric nurse practitioners, and the pediatric patients between the ages of 1 to18 years old being seen for asthma management. The project took place at a pediatric primary care clinic on the Eastern Shore Maryland beginning August 31, 2020 and concluding on December 11, 2020. Early on, staff were educated on the WAAP via email that included a recorded PowerPoint presentation as well as a post-test, instructional asthma videos, a WAAP template, and the Asthma Quick Reference Guidelines pdf. After implementation began, weekly chart audits assessed WAAP utilization. Data collected were organized using Excel sheets. Run charts were created and updated weekly to trend the data. Flyers were created and disseminated in the in the office to encourage staff and patient engagement. Weekly WAAP update emails were sent out to staff to update them on the progress of the project. No personal patient or provider information was collected for this quality improvement project. Humans Research Protections Office (HRPO) approval was gained through the University of Maryland. Results: All eight staff members completed the staff education before September 15. The WAAP utilization goal was met, and 100% of asthma patients being seen were given a WAAP by week fifteen. Unscheduled sick visits decreased to 0% by week fifteen. Conclusion: This quality improvement project demonstrated that WAAP utilization by providers for pediatric asthma patients can decrease unscheduled sick visits.