Yen, Zhou - Poster.pdf

Implementing Asthma Action Plans in a Local School District

Stephanie Yen, MD; Amy Zhou, MD; Maura R. Reilly, MPH; Albina Gogo, MD

Background: Asthma is a common chronic disease among school-aged patients and remains a leading cause of school absenteeism. In many schools, staff are inadequately prepared to recognize and manage acute asthma attacks in the classroom. Written asthma action plans are known to improve effective usage of asthma medications during acute exacerbation and reduce asthma-related morbidity.

Objective: To evaluate the efficacy of asthma action plans by school health office staff in the Folsom Cordova Unified School District (FCUSD). To increase the number of returned asthma action plans and improve the staff’s comfort level of using the plans.

Methods: Asthma action plan forms were created and distributed to the FCUSD. After discussions with the district health administration and staff, black and white versions as well as colored posters were created. Using Qualtrics, we surveyed health office staff to evaluate the impact of providing asthma action plans and identify any barriers to care. We integrated the asthma action plan into the required school form to increase return rate and held a teaching session to educate school staff on asthma. A survey was given to assess the effect of the teaching session.

Results: The survey was completed by health office staff and 91% have seen an asthma action plan, compared to 79% on the previous survey. The degree of access to a written plan was similar to prior. Staff felt equally as likely to send students home due to respiratory symptoms, but they were much less likely to dial 911 (100% responded never compared to 41% prior). Feedback stated it was difficult for parents to return the action plan separately from the district medication form. To address this, the asthma action plan was integrated into the required medication form and approved by the district. Another significant barrier to care was that students do not have inhalers at school. For the teaching session, 48 health office staff were present - 90% have seen the asthma action plan and 48% felt more comfortable with using the asthma action plan.

Conclusion: We improved FCUSD staff awareness and competency with the asthma action plan through enhanced plan distribution and staff teaching. Barriers of care were identified and addressed by integrating the asthma action plan with a required medication form for the upcoming school year. While these initial results are promising, further steps are required to optimize asthma management in schools.

Resident Statement of Involvement: We conceived the project objective and methods, met with district health service coordinator and staff, created surveys and analyzed data.