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A School Nurse-Led Asthma Program Reduces Absences: Evaluation of Easy Breathing for Schools
Tregony Simoneau1, Christine R Langton2, Chia-Ling Kuo3
1Department of Pediatrics (T Simoneau, J Marrero, and JP Hollenbach), UCONN Health, Farmington, Conn; Connecticut Children's Medical Center (T Simoneau, J Marrero, and JP Hollenbach), Hartford, Conn; The Asthma Center (T Simoneau, CR Langton, MM Cloutier, and JP Hollenbach), Connecticut Children's Medical Center, Hartford, Conn.
Objective:
To evaluate whether school nurses can assist pediatricians in providing asthma care and reduce school absenteeism through a program called Easy Breathing for Schools (EzBfS), a 5-element school nurse-led asthma management program and the effectiveness in reducing school absenteeism.
Methods:
Fifteen public school nurses in an urban community implemented EzBfS during the 2015-16 and 2016-17 school years. Program elements included assessment of asthma risk and asthma control, asthma education, medication review, and a pediatrician communication tool. School absence for any reason was the primary outcome; absentee rates for students with asthma enrolled in the program were compared to students with asthma in the entire school population using negative binomial regression.
Results:
School nurses enrolled 251/2,126 students with physician-confirmed asthma (2015-16: n = 114 and 2016-17: n = 137). Sixty eight percent of participants were Latino and 25% were Black with a mean age of 8.7 ± 2.2 years. Absentee rates were higher in children with asthma compared to children without asthma (8.3% vs 7.0% absent, respectively P < .001). Students enrolled in the program experienced a 25% decrease in absentee rate after adjusting for age, sex, race/ethnicity, and school year (rate ratio = 0.75, 95% confidence interval, 0.67, 0.85) as compared to students with asthma not enrolled in the program. Participants also demonstrated improvement in inhaler technique score (P < .001). Ninety two percent of the nurses were satisfied with the program.
Conclusion:
EzBfS, a pragmatic, nurse-led asthma management program, was successfully implemented by school nurses and significantly decreased school absences among a sample of students with asthma.
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