Severe allergy: an audit and service review

In 2002, a paediatric respiratory service in South Wales carried out a study to identify children in local schools who had a diagnosis of severe allergy, requiring them to carry an epipen. This investigation was carried out as a result of three schools seeking advice. Three children were identified as suffering from severe allergy; one child from each of the three schools. It was evident that sufficient education and support was not available for these children, their families and school staff regarding allergy management. This led to further investigation to see if there were others experiencing similar problems.

To identify school-aged children with a diagnosis of severe allergy, a survey took place of the three schools mentioned above plus a further 111 schools. Sixteen additional children were noted to be carrying epipens in 16 separate schools. An audit pro forma was devised and used to collect relevant data to establish previous allergy management and current allergy status. The 16 children and their families were invited to an assessment clinic where they were interviewed by a respiratory nurse specialist.

There were deficiencies in allergy management relating to: assessment, diagnosis, medication provision, education, support and ongoing follow up. These deficiencies highlighted the need for the development of a paediatric allergy service and a multi professional collaborative approach to care.

The findings from the five phases of this study have influenced the development of an allergy clinic. This has led to collaborative working between healthcare professionals, school staff, children, and their families. The findings have promoted practice in terms of conducting thorough nursing and medical assessment, appropriate diagnosis, education and ongoing support for children and their families.