Welcome to the training on Effective Asthma Management at School provided by the Texas Department of State Health Services (DSHS) and the Texas Health and Human Services Commission (HHSC).
The goal of this module is to equip school nurses to implement and sustain an effective asthma management program that facilitates self-management, access to prescribed medications, trigger reduction, emergency treatment, and how to build universal program support by educating students, parents, and staff.
School nurses and other interested health-care professionals and school staff.
Specific Learning Objectives
After completing the activities of this module, you will be able to:
- Describe at least two family-centered barriers to successful asthma management.
- Summarize how asthma impacts a child’s ability to learn.
- Use health history records to identify students with or at risk for asthma.
- Use a student’s asthma action plan to support effective asthma management.
- Use an asthma control test to assess a student’s current level of asthma control.
- Determine which students with asthma would benefit from case management services.
- Summarize the link between a school’s indoor air quality and asthma.
- Employ at least two Environmental Protection Agency guidelines to control indoor environmental asthma triggers.
- Determine when outdoor air quality may impact student activities.
Please note this module expires on 7/14/2018.
Continuing Nursing Education
The Texas Department of State Health Services, Continuing Education Service is an accredited provider (P0180) of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.5 contact hour(s) of Continuing Nursing Education.
Certified Community Health Worker
The Texas Department of State Health Services, Promotor(a)/Community Health Worker Training and Certification Program has certified this course for 1.5 contact hour/s of continuing education for Certified Community Health Workers.
Certificate of Attendance
The Texas Department of State Health Services, Continuing Education Service certifies that this attendee participated in the educational activity listed above. The Texas Department of State Health Services, Continuing Education Service has awarded 1.5 hour(s) for attendance.
One of the requirements of continuing education is disclosure of the following information to the learner:
- Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
- Create a Texas Health Steps account.
- Complete on-line registration process.
- Thoroughly read the content of the module.
- Complete the on-line examination.
- Complete the evaluation.
- Commercial Support.
The THSTEPS Web-based Continuing Education Series has received no commercial support.
- Disclosure of Relevant Financial Relationships.
The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose. Planning Committee/ Author Name of Commercial interest Nature of the Relationship LeAnn Kridelbaugh Salary Employment (Director of Medical Home Initiatives).
- Non-Endorsement Statement.
Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center.
- Off-Label Use.
Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).
The following are policies and definitions of terms related to continuing education disclosure:
The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.
All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.
Glossary of Terms
Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.
Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.
Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).
- Akinbami, L. J., Moorman, J. E., & Liu, X. (2011). Asthma Prevalence, Health Care Use, and Mortality: United States, 2005-2009. National Health Statistics Reports, Number 32. Hyattsville, MD: National Center for Health Statistics.
- American Academy of Allergy, Asthma,& Immunology. (n.d.). Allergy Statistics.
- American Lung Association. (2014). Every School Should be Asthma Friendly.
- American Lung Association. (n.d.). Sample Asthma Action Plan.
- American Lung Association. (n.d.). Sample Communications Flow Chart.
- American Lung Association. (2008). Sample Emergency Response Poster.
- American Lung Association and school and health-based national organization partners. (2013). Joint Statement for Improving Asthma Management in Schools.
- Asthma and Allergy Foundation of America. (n.d.). Allergy Facts and Figures.
- Blaakman, S. W., Cohen, A., Fagnano, M., & Halterman, J. S. (2014). Asthma medication adherence among urban teens: a qualitative analysis of barriers, facilitators and experiences with school-based care. Journal of Asthma, 51(5): 522-9. doi: 10.3109/02770903.2014.885041.
- Bloom, B. Jones, L. I., & Freeman, G. (2013). Summary Health Statistics for U.S. Children: National Health Interview Survey, 2012.
- Branum, A. M. & Lukacs, S. L. (2008). Food Allergy Among U.S. Children: Trends in Prevalence and Hospitalizations. NCHS Data Brief, 10.
- Bridges, B. (2002). Fragrance: emerging health and environmental concerns. Flavour and Fragrance Journal, 17: 361-371. doi: 10.1002/ffj.1106.
- Bruzzese, J., Sheares, B. J., Vincent,, E. J., Du, Y., Sadeghi, H., Levison, M. J., Mellins, R. B., & Evans, D. (2011). Effects of a School-based Intervention for Urban Adolescents with Asthma: A Controlled Trial. [Abstract.] American Journal of Respiratory and Critical Care Medicine, 183(8): 998-1006. doi: 10.1164/rccm.201003-0429OC.
- Centers for Disease Control and Prevention. (2013). Asthma and Schools.
- Centers for Disease Control and Prevention. (2013). CDC Asthma Friendly School.
- Centers for Disease Control and Prevention. (2012). Strategies for Addressing Asthma within a Coordinated School Health Program.
- Cicutto, L., To, T., & Murphy, S. (2013). A Randomized Controlled Trial of a Public Health Nurse-Delivered Asthma Program to Elementary Schools. Journal of School Health, 83(12): 876-884.
- Curtis, L. M., Wolf, M. S., Weiss, K. B., & Grammer, L. C. (2012). The Impact of Health Literacy and Socioeconomic Status on Asthma Disparities. Journal of Asthma, 49(2): 178-183. doi:10.3109/02770903.2011.648297.
- GlaxoSmithKline Group of Companies. (2015). Childhood Asthma Control Test for children 4 to 11 years old.
- Moricca, M. L., Grasska, M. A., Marthaler, M., Morphew, T., Weismuller, P. C., & Galant, S. P. (2013). School asthma screening and case management: attendance and learning outcomes. The Journal of School Nursing, 29(2): 104-12. doi:10.1177/1059840512452668.
- National Association of School Nurses. (2015). School Nurse Workload: Staffing for Safe Care, Position Statement.
- National Association of School Nurses. (2013). Cultural Competency in School Nursing.
- National Asthma Education and Prevention Program. (n.d.). Asthma Basics for Schools. Part 2 - Asthma Goals for School Health.
- National Asthma Education and Prevention Program. (2014). Managing Asthma: A Guide for Schools.
- National Asthma Education Certification Board. (2014). Annual Report.
- National Center for Children in Poverty, Columbia University Mailman School of Public Health. (2012). Children in Texas, by Income Level, 2012.
- National Heart, Lung, and Blood Institute. (2014). Managing Asthma: A Guide for Schools.
- National Heart, Lung, and Blood Institute. (2012). Reducing Asthma Disparities.
- Rhodes, D. (n.d.). Sample Asthma Symptoms Survey for Parents.
- Rhodes, D. (n.d.). Sample Asthma Inquiry Letter for Parents.
- Sawicki, G. & Haver, K. (2015). Patient information: Asthma treatment in children (Beyond the Basics). UpToDate®.
- Smith, K. & Rhodes, D. (2012). Asthma Management in the School Setting: Education, Medication, & Environment.
- Texas Department of State Health Services, Office of Surveillance, Evaluation and Research. (2015). 2014 Texas Asthma Burden Report.
- Texas Department of State Health Services. (2014). 2012 Child Fact Sheet for Texas and All Health Service Regions Combined (updated 2014).
- Texas Department of State Health Services, Child Health and Safety Branch - School Health Program. (2014). The Texas Guide to School Health Programs.
- Texas Department of State Health Services. (2014). Texas Health Steps Medical Checkup Periodicity Schedule for Infants, Children, and Adolescents.
- Texas State Legislature. (2013). Texas Education Code: Sec. 38.015. Self-Administration of Prescription Asthma or Anaphylaxis Medicine by Students.
- Toole, K. P. (2013). Helping children gain asthma control: bundled school-based interventions. Pediatric Nursing, 39(3): 115-24.
- U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. 2009. Asthma care quality improvement: a resource guide for state action, Table 1.4. Medicaid Eligible Population and Their Estimated Asthma Prevalence and Expenditures for Medical Care, for People 0-18, 19-64, and 65 and Over, by State, 2004.
- U.S. Environmental Protection Agency, Indoor Environments Division, Office of Air and Radiation. (2013). Asthma Facts.
- U.S. Environmental Protection Agency. (2015). Creating Healthy Indoor Environments in Schools.
- U.S. Environmental Protection Agency. (2010). Managing Asthma in the School Environment: Indoor Air Quality Tools for Schools.
- U.S. Environmental Protection Agency. (2009). IAQ Tools for Schools Action Kit.
- American Lung Association. (n.d.). AIR™ (Asthma Incidence Reporter) Database.
- American Lung Association. (2005). Assure Immediate Access to Medications as Prescribed.
- American Lung Association. (2014). Asthma & Children Fact Sheet.
- American Lung Association. (n.d). Asthma-Friendly School Initiative Toolkit™.
- American Lung Association. (n.d.). Tip Sheet: Using the AIR (Asthma Incidence Reporter) Database.
- Centers for Disease Control and Prevention. (2012). Initiating Change: Creating an Asthma-Friendly School.
- Corjulo, M. T. (2011). Mastering the Metered-Dose Inhaler: An Essential Step Toward Improving Asthma Control in School. NASN School Nurse, 26: 285. doi: 10.1177/1942602X11416989.
- GlaxoSmithKline Group of Companies. (2015). Childhood Asthma Control Test for Teens.
- National Asthma Education and Prevention Program. (2012). Asthma & Physical Activity in the School Making a Difference.
- National Heart, Lung, and Blood Institute. (2012). Guidelines for the Diagnosis and Management of Asthma (EPR-3).
- RTI International. (2014). Electronic cigarettes may cause, worsen respiratory diseases, among youth, study finds. New York, NY: RTI International.
- Texas Department of State Health Services. (2012). Guidelines for the Care of Students With Food Allergies At-Risk for Anaphylaxis.
- Texas Department of State Health Services. (2015). Texas Asthma Control Program.
- Texas Department of State Health Services (2015). Case Management for Children and Pregnant Women.
- U.S. Department of Education. (2015). Family Educational Rights and Privacy Act (FERPA).
- U.S. Environmental Protection Agency. (2012). Student Health and Academic Performance.
- Zuniga, G. C., Kirk, S., & Hernandez, T. (2010). A Focus on Asthma and Individual Health Plans: A Survey of Texas Schools. Journal of Asthma & Allergy Educators, 1: 23-27. doi:10.1177/2150129709356705.
Resources for Parents and Caregivers
- Asthma and Allergy Foundation of America.
- Allergy and Asthma Network, Mothers of Asthmatics.
- American Lung Association. For Parents of Children with Asthma.
- Center of Excellence for Medical Multimedia (CEMM).
- Centers for Disease Control and Prevention. Know How to Use Your Asthma Inhaler videos.
- National Heart Blood and Lung Institute. (2014). How is Asthma Treated and Controlled?
- U.S. Environmental Protection Agency.
- U.S. Environmental Protection Agency. Attack Asthma. Learn More.
Resources for Children and Adolescents
- Centers for Disease Control and Prevention. Asthma Resources for Kids.
The medical definitions provided in this module are based on information from the CDC’s Behavioral Risk Factor Surveillance System.