• Improving Asthma Management Through a School-Based Asthma Education Program

      Brown, Blanche (2015)
      Background: Asthma is the leading cause of chronic illness among children in the United States and efforts to improve care and control are of concern. Evidence suggest that children with asthma who participated in an interactive, comprehensive education program can improve their asthma knowledge, self-management skills and overall quality of life. Purpose: The purpose of this scholarly project was to determine if a school-based asthma educational program, Open Airways for Schools (OAS) increases knowledge of asthma and self care management skills among elementary school children. Methods: A convenience sample of 14 school children was recruited to participate in the OAS program. The project entailed six 45-minute educational classes based on the asthma management program called Open Airways For Schools (OAS). Wilcoxon signed-rank test was used to determine if there was a difference in rank of the scores following the intervention and a McNemar test was used to estimate a change in proportion of the students demonstrating correct medication administration following the educational intervention. Results: Two of the six questions were statistically significant between pre-and post-test scores and two of the four questions were statistically significant in demonstrating a change in knowledge. All four questions targeted at skills competency were statistically significant in demonstrating an improvement in performance of correct technique following the intervention. Implications: The educational intervention results support that children benefit from an asthma educational program and offers an effective way to improve asthma knowledge, self-confidence and self-care practices. The school environment provides an excellent foundation and offers many advantages over the traditional clinic-based setting for identifying children with asthma as well as delivering asthma education.
    • Improving Inhaler Technique Education in a Pediatric Emergency Department

      Bell, Lisa M.; Bundy, Elaine (2019-05)
      Background: Efficacy of inhaled medications for asthma is dependent upon proper administration technique. Rates of metered dose inhaler and spacer misuse are high among both patients and healthcare providers, and gaps in patient education practices are widespread. Practice guidelines recommend patient technique be demonstrated and assessed at every encounter using a checklist of critical steps with repetition until competency is achieved. Local problem: The purpose of this project was to improve metered dose inhaler and spacer technique education provided by registered nurses in a pediatric emergency department. Nurses in this setting do not receive training on metered dose inhaler technique, and patient technique demonstrations are not routinely assessed or documented utilizing checklists. Interventions: All nurses working in the pediatric emergency department (n=20) received education on metered dose inhaler and spacer technique at the initiation of the project. Training checklists were developed and incorporated into the electronic medical record based upon practice guidelines. Prior to discharge, patients with asthma were asked by a nurse to demonstrate their technique using a metered dose inhaler and spacer. The nurse used the checklist in the patient’s electronic medical record to assess and document competency in the critical steps of metered dose inhaler and spacer technique. Instruction was provided by the nurses to remedy any patient errors until competency was demonstrated. Results: In patient chart audits conducted over a 10-week period 138 charts met audit criteria; 95 of which had documented checklists. One-hundred percent of patients and/or caregivers with documented checklists were able to demonstrate competency in all critical steps prior to discharge, with 35% requiring additional education to correct errors in technique. Conclusions: This project demonstrated the benefit of maximizing a pediatric emergency department encounter to provide evidence-based asthma education on a critical component of asthma management. Similar projects are needed that focus on inhaler technique in other settings, as well as with other inhalation devices.