The Science Journal of the American Association for Respiratory Care

2004 OPEN FORUM Abstracts

CAN ASTHMA EDUCATION OF INNER CITY SCHOOL CHILDREN DECREASE INHALER USE AND NURSE VISITS?



Anne E. Kwiatkowski, B.Ed, RRT, AE-C
Mary J. McCleery, RRT St. Vincent Mercy Medical Center, Toledo, OH

Background: To determine if educating school children on asthma and its management would increase the students’ ability to assess and monitor symptoms and self administer medications in an appropriate and timely manner.

Method:
We met with teachers and nurses for an overview of the program and to educate them on appropriate interventions for an acute asthma attack. Following this initial meeting we met with 197 elementary, 56 junior high and 25 high school students for a total of 278 children. The students were identified by the school nurse based on their asthma history (missed school days, frequency of inhaler use, and visits to the nurse). We read aloud a 10 question true/false pre test to determine their knowledge base prior to each session. We re-administered the same test following the educational session to assess their comprehension and retention. Information regarding asthma and inflammation vs. bronchospasm was provided at the first session. We also reviewed inhaler technique, which was overwhelmingly incorrect as demonstrated in approximately 80% of the students. We discussed how the medications work, the difference between control and rescue, as well as the importance of compliance. The second session included a review of the first, and we discussed asthma triggers along with ways to pretreat or avoid same. The third session reviewed previous sessions. At this session, the students’ heights were measured and recorded, and peak flow techniques were instructed and practiced. The data to include heights and peak flow readings were given to the nurse. The students were also encouraged to talk about their asthma to their primary care physician at each visit. The final session reviewed all previous information. Also at this session we were able to supply the students with a spacer, due to the generous donation of a pharmaceutical company.

Results: The majority of the students were attentive and interactive. We were able to identify that several students were using their control medication for rescue or did not have access to a rescue inhaler in school. The school nurse was contacted and encouraged to discuss these concerns with the parents. It was suggested to the nurse to have the parents contact their primary care physicians. By the end of the program, 64% of the students could name their inhalers. Upon reviewing the pre and post test results we identified that 63% of the students improved on their scores, 10% worsened, and 24% stayed the same. Included in the 24% group were students who achieved a 100% score on both pre and post tests.

Conclusions:
More than half of the students with whom we worked stated that this was the first time they had heard any/all of this information. One half to three quarters of the students acknowledged that their doctor’s office never showed them the correct use of inhalers. They also indicated that they were never told the purpose of their inhalers. Virtually all of the nurses reported a decrease in both number of nurse visits and frequency of inhaler use. We were unable to ascertain if the emergency room visits decreased. However, based on the previous facts, we found that educating children on their disease process, as well as medications and techniques can be helpful and beneficial. It is also appears to be a necessary service due to the fact that students stated and exhibited minimal appropriate knowledge and skills regarding asthma management prior to the program.