Date of Degree

Summer 2024

Document Type

DNP Scholarly Project

Academic Department

School of Nursing

Degree Type

Doctoral

Degree Name

Doctor of Nursing Practice

First Advisor

Dr. Melanie Brewer

Second Advisor

Dr. Corinne Cochran

Abstract

Problem: In a Midwest public school system, students received robust academic education. Health education programs, specifically asthma management, were not offered. Over 400 elementary students with asthma lacked the knowledge and skills to effectively recognize and manage their asthma symptoms resulting in increased school clinic visits and absences, highlighting the urgent need for targeted intervention.

Aim of the Project: The aim of this project was to improve students’ asthma self-management skills by providing education based on the Open Airways for Schools (OAS) curriculum. Improving asthma self-management skills reduces student absences and time away from the classroom.

Review of Evidence: A comprehensive literature review indicates that elementary students with asthma often lack the knowledge to recognize symptom triggers. Evidence showed that a nurse-led, school-based asthma education program such as the OAS reduces absenteeism and improves self-management and inhaler techniques.

Project Design: This quality improvement (QI) project design used the Institute for Healthcare Improvement Model to implement the OAS program. Clinic nurses (CNs) in two elementary schools taught the program. Using Plan-Do-Study-Act (PDSA) cycles, the team conducted timely data reviews, made modifications, and evaluated outcomes. The OhioHealth Change Management Model supported project development, execution, and effective communication.

Intervention: Weekly asthma education classes featured hands-on activities and role-playing to reinforce the curriculum, covering one topic per week for eight weeks. PDSA cycles were used to refine the process for providing and documenting educational sessions. A ten-item OAS pre- and post-intervention questionnaire evaluated the change in student asthma symptom knowledge.

Significant Findings/Outcomes: Students reported improved asthma self-management knowledge and skills, with a score increase of 20 to 60%. Students spent more time in the clinic for asthma-related symptoms which may indicate better symptom recognition. Asthma-related absentee rates could not be determined due to widespread respiratory and other illnesses noted during the project. Although project data were limited, the team observed a promising trend toward increased maintenance visits late in the implementation period. Clinical documentation related to asthma visits also improved over time.

Implications for Nursing: Student self-management knowledge improvement and asthma-related clinic visits may suggest that the educational intervention was effective. This project supports the Institute of Medicine's six domains for healthcare quality and the Institute for Healthcare Improvement's Triple Aim by enhancing the student experience and enabling students to advocate for themselves concerning asthma management effectively.

Rights

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