5/1/2018. Asthma Healthy Schools. New England School Nurse Conference Addressing Asthma Within a Coordinated School Health Program

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1 New England School Nurse Conference 2018 Asthma Healthy Schools Worcester Public Schools Debra McGovern, DNP May 5, 2018 Addressing Asthma Within a Coordinated School Health Program Center for Disease Control and ASCD,2018 School-focused Goals Improve asthma control for students in the Worcester Public Schools (WPSs) Reduce asthma-related school absences, early dismissals, and time in health office Increase academic success 1

2 Community-focused Goals Improve asthma control in the pediatric population Educate students, parents and school staff Decrease emergency room visits Improve asthma medication compliance Decrease healthcare costs Asthma Healthy Schools Pilot Focused interventions in three elementary schools with large percentage of students with asthma & high rates of absenteeism All school staff completed surveys to assess individual concerns and knowledge of asthma triggers Each school had a complete indoor and outdoor assessment by IAQ experts (EPAs Tools for Schools) Members of the Policy Sub-committee provided education about asthma, triggers, prevention, and control to all school staff during monthly meeting times after school hours Created an Asthma Newsletter to share with all district staff Asthma Healthy Schools Pilot (cont.) WPSs hired an IAQ expert to address on-going concerns in all school buildings New green cleaning products Rug Team created HEPA vacuuming and wet cleaning initiated New Policy to request a school assessment, intervention and mitigation Environmental Protection Agency,

3 School Interventions Identification and tracking of students with asthma Care Coordination and education provided by school nurses IHCS provided to students in school 1-2x/day Easy access to rescue medication Asthma education for all school staff Environmental assessment and management of school buildings Outreach and education for families and community groups Healthy Housing outreach and referral Community Legal Aid outreach and referral (Toolkit 2017) City-Wide PWTF Pediatric Asthma Intervention UMass Memorial Pedi- * Pilot assessments resulted Pulmonology in hiring of an Environmental * students with Meds-In-School program Officer for all WPS Training of School Nurses persistent asthma enrolled yearly Policy Task Force Subcommittee Home Visiting: Community Health Workers address home triggers, provide basic education Pediatric Asthma City of Worcester, Healthy Homes Office 17 Total referrals ($117,000): 4 Integrated Pest Management 13- Mold, pest and other trigger remediation Home visiting Community Health Workers Clinical sites Community Legal Aid * 133 referrals made to CLA to address home triggers Edward M. Kennedy Community Health Center Total Home Visits Completed to date: UMass Memorial sites: 635 All partner sites: 1,138 Family Health Center of Worcester UMass Memorial Clinical sites: Plumley Village Health Services Pedi-Primary Care Pedi-Pulmonology ED/In-Patient Connection Evaluation Data Collection and Analysis Pre- and Post-surveys with school staff, students, and families Tracking of students with asthma at school (SNAP, SAGE) Absences/ Dismissals PRN Albuterol use by school nurse Missed PE class/ athletic activities- not able to participate due to asthma symptoms Health office visits with school nurse (time) Individual asthma control tests and self-reports (UMass Pulmonary) Asthma Action Plan on file 3

4 Outcomes Enhanced communication and care coordination among school nurses, staff, clinical and community partners, and families of moderate to high-risk asthmatics School nurse with improved ability to assess, treat, manage, and refer students with poor asthma control Aligned with the City of Worcester CHIP in helping to make Worcester the Healthiest City by 2020 Very strong community partnerships developed Ability to significantly impact population health Challenges Team agreement on the need for environmental assessment and intervention at the individual school level and the subsequent development of a sub-committee Reaching parents/ guardians to provide educational forums Time and commitment involved with developing and enacting new school policies Expanding pilot district-wide Community awareness campaign Sustainability of the great work we have started Questions Thank you! 4

5 References Baisch, M.J., Lundeen, S.P., & Murphy, M.K. (2011). Evidence-based research on the value of school nurse in an urban school system. Journal of School Health, 81(2), Retrieved from Centers for Disease Control and Prevention. (2017). National Center for Health Statistics: Asthma. Atlanta, GA: Department of Health and Human Services. Retrieved from Centers for Disease Control and Prevention. (2006). Strategies for addressing asthma within a coordinated school health program, with updated resources. Atlanta, GA: Department of Health and Human Services. Retrieved from Cheung, K., Rasberry, C.N., Dunville, R. L., Buckley, R., Cook, D., Daniels, B. & Robin, L. (2015). A multicomponent school-based asthma management program: Enhancing connectedness to clinical care. Journal of School Health, 85(2), doi: /josh.1226 Fauteax, N. (2011). Unlocking the Potential of School Nursing: Keeping Children Healthy, In School, and Ready to Learn. Charting Nursing s Future, 14, 1-8. Retrieved from References (cont.) National Association of School Nurses. (2016). Framework for the 21 st century school nursing practice: National Association of School Nurses. NASN School Nurse, 31(1), doi: / X National Asthma Education and Prevention Program, Bethesda, MD (2017). Asthma. Retrieved from National Asthma Education and Prevention Program. (2003). Managing asthma a guide for schools. Bethesda, MD: U.S. Department of Health and Human Services and U.S. Department of Education, PWTF Clinical Data, Massachusetts Department of Public Health. (2015). Prepared by the Massachusetts Department of Public Health. United States Environmental Protection Agency (2017). Asthma: Improving in Communities and Schools. Retrieved from 5