Statewide Implementation of Stock Inhaler Programming: Respiratory Distress De-Escalation, Implementation and...

Asthma is common in children, but many do not have access to a personal inhaler at school. The Resources for Every School Confronting Unexpected Emergencies- Illinois (RESCUE-IL) program provided stock undesignated asthma medication for respiratory distress to 77% of Illinois schools over the first implementation year (2023-2024). A qualitative study was conducted to examine utilization experiences with emphasis on program benefits and barriers in the inaugural year of RESCUE-IL.

Interviews were conducted from March to May 2024. Primary data was collected from trained Illinois school health staff who had administered a stock inhaler in the 2023-2024 school year. Semi-structured interviews were transcribed, de-identified, and qualitatively coded in Dedoose. Thematic data analysis using a hybrid inductive and deductive approach based on grounded theory was performed by trained researchers.

Out of 37 nurses interested, 24 participated. The first theme surrounding stock inhaler benefits included the program's ability to address asthma burden, health equity concerns, and improve student-level outcomes. Barriers included administrative support and non-health staff training, among others. Stock inhaler utilization experiences referred to events leading up to the respiratory event, its management, student disposition and follow-up demonstrating the program's effectiveness. The final theme-RESCUE-IL implementation and support-pertained to logistics regarding program startup, training, supplies, and event documentation. Overall, participants felt the program enhanced accessibility and ability to de-escalate events, but there were concerns regarding protocols and reporting.

A statewide stock inhaler program allowed respiratory distress de-escalation in schools. These real-world experiences by nurses highlight the need for ongoing funding and expansion. Further research is needed to ensure comprehensive training is universally available.