At the center of the NASN Framework for 21st Century School Nursing PracticeTM is the student - surrounded by the family and school community. This visual has a message for you when supporting the student with mild persistent asthma: advocating for student-centered care means engaging and educating the family.
Mild persistent asthma means the student may have symptoms two or more days each week. And on those days, staying fully engaged at school can be a challenge. While daily control inhalers are often prescribed by the healthcare provider, students may face challenges with sticking to this routine (e.g., cost of the medication, remembering to use their inhaler) and as a result experience more asthma symptoms and more challenges to staying fully engaged at school.
Caring for students with asthma means building trusting and caring relationships with both the student and their family.
Caring for students with asthma means building trusting and caring relationships with both the student and their family. Leaning into this trust and relationship, school nurses are well positioned to bring up another option for the management of mild persistent asthma: Instead of daily use of a control inhaler, what if using a control inhaler ‘as-needed’ is a better approach to their asthma management?
A PCORI-funded (Patient-Centered Outcomes Research Institute) study of children and teens with mild persistent asthma found that using the control inhaler as needed worked the same as daily use in improving asthma control, the number of asthma flares, how well the lungs work, and quality of life. Do you know if your students with mild persistent asthma and their families know about this new evidence-based approach to care? Knowing what you know about your students, based on your ongoing holistic nursing assessment of these students, would this evidence-based option to asthma management be a better approach for controlling asthma symptoms?
Consider having this conversation with families, asking them:
- Would you like to consider a different treatment approach for your child with mild persistent asthma?
- Is this a conversation you would like to have with your child’s healthcare provider?
- What can I do to help you to prepare to have this conversation with your child’s healthcare provider?
Yes, engaging families in this way is part of being a school nurse in the 21st century and demonstrates competence in the Standards of Practice and Professional Performance of school nursing. Use motivational interviewing skills to support students and families to identify action steps they want to take to better care for themselves; engage in collaborative communication among students, families, and healthcare providers; advocate for student-centered care that involves evidence-based best practice; and address the social determinants that challenge students and families to adhere to treatment plans.
For the school nurse, providing student-centered care means being aware of the student and family’s point of view about what effective asthma management means to them, identifying and addressing knowledge gaps to support informed health care decision making, and advocating for an evidence-based plan of care that results in the best health and education outcomes for the student.
See a related blog, Evidence for Symptom-Based Medication Adjustment for Mild Persistent Asthma, here.