2011 OPEN FORUM Abstracts
ASTHMA RESPONSE TEAM.
Clifton Dennis1, Jennifer Anderson1,2, Natalie Lane1,3; 1Pediatric Respiratory Care, MCG Health Inc, Augusta, GA; 2Adult Respiratory Care, MCG Health Inc., Augusta, GA; 3Pediatric Emergency Medicine, MCG Health Inc., Augusta, GA
Asthma continues to be the number one reason for pediatric admissions to the hospital along with the number one reason patients are seen in the emergency room. Our institution utilizes a Clinical Asthma Score (CAS) to determine severity of asthma. This has allowed us to develop a inpatient asthma pathway that has shown continued decreases in length of stay and cost associated with pediatric asthma. One area that we felt was not being met, was asthma management for patients seen in the emergency room and discharged from the emergency room. we developed a program to address the asthma management of patients discharged from the emergency room. Utilizing certified asthma educators, respiratory care responds to pages from the emergency room to provide asthma management for patients prior to discharge. We start with obtaining a patient history that focuses on current severity and symptoms for the past two weeks. We review their history for the past year as it concerns their asthma to determine risk. The ART therapist then provides asthma education that consists of asthma pathophysiology, medication use, triggers and trigger avoidance, peak flow and holding chamber usage. We use placebo inhalers to teach proper medication and holding chamber usage. We perform peak flows with each patient along with labeling their peak flow meter with the predicated values. Each patient is provided with a Philips Respironics Children's Asthma Care kit prior to discharge that contains a peak flow meter, Optichamber valved holding chamber and mask, asthma self help booklet in English and Spanish, educational DVD and a carrying case. The ART therapist then develops the asthma action plan utilizing current NHLBI EPR-3 guidelines. A follow up appointment is made with the patients PCP; if no PCP is available a walk-in appointment is scheduled with our own continuity clinic. The ART therapist then reviews the asthma action plan with the parent insuring that a signed copy is placed in the patients chart along with providing a copy to the parent. The ART coordinator enters all information in the database as well as providing referral to Childrens Medical Services- asthma management program offered through the state department of health. A copy of the current asthma action plan is securely faxed to all school aged childrens school nurse. One year data has shown that we are meeting or exceeding our targets in all areas except for ICS therapy and bedside Spirometry. Sponsored Research - None Measures and Targets