Improving Asthma Management in Children: A QI Project at SACC

Abstract

Purpose: The goal of this quality improvement project was to develop, implement, and evaluate a structured asthma education program in collaboration with a local school-age childcare program. Background: Asthma is a significant public health issue, affecting an estimated 262 million people worldwide (Global Asthma Network, 2022). According to the Centers for Disease Control (CDC), asthma affects 8.4% of children in the United States (US) (Lizzo & Cortes, 2023). It is the number one chronic medical reason children are absent from school (Lizzo & Cortes, 2023). Studies have shown that education is important in improving asthma management. Currently, staff at School Age Child Care (SACC) do not receive asthma-specific education. Methods: All SACC staff were invited to participate in a pre-questionnaire designed to measure awareness and existing knowledge levels. An in-person 30 minute educational session was subsequently conducted. Following this intervention, a post-survey was administered to evaluate the outcomes and assess the effectiveness of the educational session. Results: 48 staff members attended the presentation with 23 paired questionnaires used for data analysis. Nearly all participants showed improvement or maintained their scores from the pretest to the posttest. A Wilcoxon signed-rank test confirmed that this improvement in knowledge was statistically significant post-intervention, with a Z value of -2.7147 and a p-value of .00672. Wilcoxon signed-rank tests indicated significant gains in staff confidence in recognizing asthma exacerbation signs (Z = -2.301, p = 0.01072, r = 0.58), comfort with assisting children using inhalers (Z = 3.0594, p = 0.00111, r = 0.88), and staff comfort responding to asthma exacerbations at SACC (Z = 3.4078, p = 0.0032, r = 0.88). Conclusions: This project found that a nurse led structured asthma education presentation increased SACC staff confidence. However, the results are limited by the study being conducted in a single setting. The findings may not apply to other childcare environments with different cultures, resources, or staff. Further studies across multiple sites are needed to verify broader effectiveness.