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Asthma self-management in children: a best practice implementation project
Yingxia He1,2, Matthew Stephenson3, Ying Gu1
1Children's Hospital of Fudan University, Shanghai, People's Republic of China.
Insights
Implementing a pediatric asthma self-management program significantly improved clinical practice and parent education. This initiative enhanced asthma care for children and reduced healthcare burdens.
Area of Science:
- Pediatric Respiratory Medicine
- Evidence-Based Practice
- Healthcare Quality Improvement
Background:
- Asthma is a prevalent childhood disease, necessitating effective management strategies.
- Self-management programs offer a pathway to improve pediatric asthma outcomes and alleviate healthcare system strain.
Purpose of the Study:
- To integrate evidence-based asthma self-management into a pediatric respiratory clinic.
- To enhance adherence to best practices in pediatric asthma care.
Main Methods:
- Development of seven audit criteria based on best evidence for pre- and post-audits.
- Utilization of the Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System and Getting Research into Practice tools.
Main Results:
- Baseline audit revealed a practice-evidence gap, with only inhaler guidance at 100% compliance.
- Post-implementation showed significant compliance improvements: clinician training rose from 13% to 67%.
- Parent education saw marked increases: asthma triggers (55% to 100%), warning signs (30% to 85%), and treatment options (40% to 85%). Written asthma action plan use increased from 0% to 25%.
Conclusions:
- The implemented strategies effectively enhanced parent education and evidence compliance.
- Further strategies and audits are required to optimize asthma action plan utilization and review.
Introduction:
Asthma is one of the most common diseases in children. A self-management program can effectively improve the outcomes for children with asthma and reduce the burden on healthcare services.
Objectives:
The aim of this project was to integrate the best evidence on asthma self-management with practice in a children's respiratory clinic and to improve compliance with best practice.
Methods:
Seven audit criteria were developed for the pre- and post-audit based on the best available evidence. The Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tools were used in this project.
Results:
The baseline audit showed a gap between clinical practice and the best evidence. The only criterion that achieved high compliance was provision of inhaler guidance (100%). After implementation, there were substantial improvements in compliance for many criteria. Training of clinicians increased from 13% at baseline to 67% at follow-up. Education of parents improved, with specific education about asthma triggers increasing from 55% to 100%, education about warning signs from 30% to 85% and education about effective asthma treatment options from 40% to 85%. Use of written asthma action plans increased from 0% to 25%.
Conclusion:
Strategies developed in this project were effective at providing necessary information for parents and improved the compliance with evidence. Further implementation strategies and audits are still needed to improve the use of asthma action plans and ensure they are reviewed periodically.
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