Maximizing the Role of the Nurse: Strategies to Address Gaps in Asthma Care in Schools.

PURPOSE: The purpose of this project was to describe differences in the numbers of children with a diagnosis of asthma identified through two methods, determine barriers to receiving asthma interventions in elementary school settings, and make recommendations for action and advocacy for school nurses to increase the number of children with access to asthma medications at school. DESIGN AND METHODS: The authors conducted a review of the asthma diagnosis process from the initial identification of a diagnosis to the delivery of interventions with 349 enrolled students in one large, urban public school in Tennessee. RESULTS: Sixty children were identified using the school's existing parent identification process and 91 children who participated in a concurrent asthma education program self-identified or were referred by a teacher, staff, or administrator. Only seven students identified through the combined methods had access to asthma medication (albuterol) at school. CONCLUSION: Missing asthma action plans, medication forms and inhalers emerged as major barriers to intervention even when a child's diagnosis is documented. PRACTICE IMPLICATIONS: The Asthma School Readiness Process (ASRP) was developed, which describes recommendations for nurses in school and community settings to promote safety and access to asthma medication in schools.