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As always, one look at the statistics for any childhood chronic illness, but in particular asthma, and we know we need to do better.
As always, one look at the statistics for any childhood chronic illness, but in particular asthma, and we know we need to do better. We need to improve our care management strategies and to empower the children and their parents to set their personal care management goals and question themselves and their providers when their goals are not met.
Dr Bass’ article entitled “Rethinking asthma prevention & management,” begins with the statistical reality of asthma and a description of the evidence that links lifestyle and obesity to the diagnosis of asthma. Dr Bass describes the evidence that poor childhood control of asthma raises the risks of increased morbidity as the child transitions to adult life. Dr Bass also provides a review of the medications used for children with a diagnosis of asthma.
However for nurse practitioners (NPs), there is much more we need to do to provide a better quality of life for every child we treat with a diagnosis of asthma. We need to ask ourselves several questions:
1) Are we implementing the clinical practice guidelines for every child in our care? 2) Are we diagnosing the child according to the practice guideline and changing the prescribed medications strategies to empower the child to meet his/her personal care management goals?
3) Are we evaluating the SaO2 levels, using spirometers in our offices, and reviewing peak flow readings from the child’s personal diary?
4) Are we providing education to the child and parents at every visit and querying them on what they really know about their personal care?
5. Are we evaluating the child and families’ quality of life at every visit?
I could continue to write numerous questions, but one that I especially want you to consider and evaluate is: What are the overall outcomes from our practice in the care management of children with asthma? Data from the Electronic Medical Record (EMR) will provide us with this information in seconds. Have you used these data to evaluate your practice outcomes? Have you made changes to improve the quality of care for children in your practice based on an analysis of the EMR data?
These questions challenge us as NPs to be better practitioners and to provide better quality care to our patients. Perhaps these strategies will enable us to reduce the incidence of morbidity in childhood and as the adolescents transition to adulthood.
We are at a significant crossroad. We need to be active participants in building communities where children can live, learn, and play within a culture of health. The asthma statistics are screaming at us to be better!