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September 2008
Asthma in the Schools (Part 2 of 2)
In last month's EBM Tip, we looked at the MUSC Children's Hospital initiative to improve asthma outcomes for children who visit the Emergency Room. Through the institution of evidence-based standards for care that include medication, family education, and new products, the Asthma Outcomes Committee was able to meet the JCAHO standards, reaching 100% in two of the three measures.
The Asthma Outcomes Committee is now working on a second aspect in the prevention and control initiative: working with the schools. With the help of an assistant principal, a parent of one of his patients, Dr. C. Michael Bowman, Director of Pediatric Pulmonology and Professor of Pediatrics, initiated contact with the school nurses group and school PE teacher group in Charleston County. Dr. Bernard Maria, Executive Director of the Children's Research Institute, is interested in looking at school absences as a marker of asthma control. Indeed, an article published in May in Pediatric Allergy and Immunology surveyed Chicago school children in which 31% of students with self-reported asthma missed school because of their condition.
Certified Asthma Educators Aimee Tiller and Barb Hutchinson, both nurses in Pediatric Pulmonology at the MUSC Children's hospital, sent a survey to all 90 public schools in Charleston County. Rather than telling the schools what was needed, they asked them what they knew about asthma, what they would like to know, what their ideas were about how to learn more about asthma, and how MUSC could best help them and their students.
As a result, they were contacted by the director of school nurses for the Charleston County Schools, and invited to speak at last month's Back-to-School Day for student nurses. Dr. Bowman gave an education presentation, accompanied by Ms. Tiller and Hutchinson.
Currently, the Committee is working to fulfill the other recommendations received from the survey. They have ordered and delivered to school nurses the "Initiating Change: Creating an Asthma-Friendly School" toolkits from the U.S. Center for Disease Control and Prevention (CDC) that contain workbooks and audio-visual materials. Ms. Hutchinson is putting together a short list of the best Websites available for asthma education, included MUSC websites. These sites have information for both school personnel and students, and include information sheets that can be printed out and distributed. They are also contacting each of the schools, offering to visit school classrooms, speak at faculty meetings, and give presentations at PTA meetings.
Dr. Bowman is also pursuing more interaction with the physical education teachers and coaches, who often mislabel children with asthma as "lazy kids." He hopes to have future coordination between the asthma program and another MUSC program that working with sports trainers in the schools. This program is led by Dr. C. David Geier, orthopedic surgeon and the Director of MUSC Sport Medicine.
Both the efforts at the MUSC Children's Hospital and the efforts in our schools are ongoing. After all, the nickname for one of the group's projects is "The Endangered Species Project." Their goal is nothing short of making hospitalization for asthma extinct.
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Laura Cousineau, MLS
MUSC Library
Dept. of Pediatrics EBM Faculty |
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