The Science Journal of the American Association for Respiratory Care

1999 OPEN FORUM Abstracts

ASTHMA MANAGEMENT IN A RURAL ER

Lisa Monchil, RRT, Mark Henderson, MD, Paul Firth, MD, Anthony Ferguson, RRT, Cathy Dirickson, RN, Great Plains Regional Medical Center, Elk City, Oklahoma

The purpose of this study was to improve assessment and management of patients presenting to our ER with an asthma exacerbation. The death of a pediatric patient, during transport to another facility, provided the opportunity for our facility to examine our current practices and identify areas for improvement.

Methods: Using the NHLBI guidelines we targeted two specific outcomes: (1) Reduce the number of return visits to the ER within 72 hours (2) Documentation of patient/ family education. All asthmatic patient charts are reviewed on a concurrent basis for compliance with guidelines and documentation of education and action plans.

Results: Return Visits Within 72 Hours:

1996 1997 1998
12% 6% 5%
Asthma Admissions through ER
22% 21% 19%

Development of a patient/family education program significantly improved our efforts in encouraging patient's role in managing their asthma. Intensive staff education in delivering and documenting this education has significantly improved compliance.

Physician use of the guidelines was initially low among our ER staff. Education and results of this study have proven to be successful in changing practice in our ER and in our area primary care practitioners. This has contributed to the success of our program.

Conclusions: Creating a successful asthma management program in a rural ER is a dynamic process requiring input from everyone involved in a patient's care. Our study has expanded from the ER to our inpatients. The success of our program has been an uphill battle but positive results are turning the tide. Future areas to be included are rural health clinics and area schools.

OF-99-183

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