Reviewing Effectiveness of Nurse-Led Pediatric Asthma Education Programs in Preventing Hospital Recidivism and Missed-School Days

Asthma is a chronic disorder that is a serious health issue in the United States. The respiratory disease affects millions of children and asthma exacerbation adversely impacts their quality of life, along with their caregivers. The economic impact is in the billions of dollars and asthma is the most common non-communicable disease among children. The National Asthma Education and Prevention Program established guidelines in the Expert Panel Report 3 to help healthcare providers in their decision-making process in assessment of asthma severity and to maintain control of symptoms. This literature review assesses the effectiveness of interventions based on the guidelines. Outcomes were measured through quality of life indicators along with reduced hospital recidivism and missed school days. Interventions included school-based education programs as well as hospital-based/acute care education programs. The use of technology was focused on, especially in they way it is used to reduce disparities in care among under-served populations. Inclusion criteria for the literature review included studies with patient populations aged 5-18 with a diagnosis of asthma. All genders, races, and ethnicities were considered. The studies encountered included randomized controlled trials, qualitative descriptive design, and retrospective cohort. The search aimed to find published studies within five years of June 1, 2018, when the search was completed. Databases reviewed included CINAHL, Cochrane, MEDLINE, and OVID. Search parameters included “nurse-based asthma education” or “nurse-led asthma education” and “missed school days” or “hospital recidivism”, “nurse based asthma education” and “hospital readmission”, and “nurse-based asthma education” and “technology”. Heterogeneity of the studies did not allow for meta-analysis or pooling but a focus on the statistical significance was applied to assess the effectiveness of study data. Overall, nine studies were included in the literature review. Three directly involved school-based asthma education, four involved asthma education within acute care/hospital settings, and four included the use of technology in health education, with three specific to asthma. The literature review found that the Expert Panel Report guidelines did serve to create programs to help maintain control. Positive impact was found in school programs for children that included the caregiver in education. Outcomes were measured in increased compliance with maintenance medications, reduction of allergens, use of Peak Flow Metering, decreased absenteeism from school and work, as well as a reduction in hospital readmission. Hospital-based education programs had positive outcomes when they were tailored to the specific area they were in and had extended hours. Technology served to reduce disparity among disadvantaged children as long as the technology was included with a comprehensive plan that involved regular face-to-face provider evaluation. The poster will focus on the effective school-based and hospital-based education programs with a special focus on technology involved, including translation services and tele-health.