202992 Challenges of asthma management in school districts with high asthma hospitalization rates

Wednesday, November 11, 2009: 1:15 PM

Penny Liberatos, PhD , School of Health Sciences & Practice, New York Medical College, Valhalla, NY
Jennifer S. Klein, RD, CHES, MPH , Department of Behavioral Sciences & Community Health, New York Medical College School of Public Health, Valhalla, NY, NY
Ann Marie Craig, RN, BSN, MPH , Division of Intervention Services, Orange County Department of Health, Newburgh, NY
Elizabeth Mary Frei, MPH , School of Public Health, New York Medical College, Valhalla, NY
Natalie Fuentes, MPH , School of Public Health, New York Medical College, Valhalla, NY
India Marie Harris, RN, BSN, MPH , Westchester County Department of Health, New Rochelle, NY
Makeda J.N. James, BA, MPH , American Lung Association/POW'R Against Tobacco, Elmsford, NY
Marci Lewis, BS, MPH , Westchester Medical Center, Maria Fareri Children's Hospital, Valhalla, NY
Ellen J. Parrinelli, RN, BSN, MPH , Orange County Department of Health, Goshen, NY
Wendy Sue Shindler, RN, BSN, MPH , Rockland Community College, Suffern, NY
Background: In 2003, a survey of 1,550 school nurses in NYS was conducted to learn about asthma management in an elementary school environment.

Purpose: To focus on school districts in Westchester County, NY with the highest asthma hospitalization rates among children ages 5-14 and compare the results with the state-wide results of 2003.

Significance: To gain an increased understanding of the challenges facing schools in areas with high rates of hospitalizations for elementary school-aged children.

Methods: School districts with the highest rates of asthma hospitalization among children 5-14 years were contacted for inclusion in the study. Within these, 56 elementary school nurses were contacted and 44 agreed to participate. School nurses completed a survey with 33 closed-ended questions, including many from the NYS survey and a short telephone interview with 12 open-ended questions.

Results: Responses from study nurses were compared to those of the NYS nurses. For example, NYS nurses were more likely to report lack of time and lack of funding for supplies as major challenges, while study nurses were more likely to emphasize poor communication with parents, poor parental support and lack of supplies from families. NYS nurses were most likely to find out that a student had asthma from parents or school records, while study nurse were more likely to find out from school records and when children manifested asthma symptoms.

Conclusion: Communication with parents, parental support and understanding about asthma appear to be major challenges for asthma management in this environment.

Learning Objectives:
1) Describe the role that elementary school nurses play in the management of asthma. 2) Identify the top three challenges to asthma management in elementary schools for nurses in school districts with high asthma hospitalization rates as compared to the challenges faced by school nurses on a state-wide level. 3) Explain how linguistic and cultural competency may influence the quality of school nurse-parent communication.

Keywords: School-Based Health Care, Asthma

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceptualized and directed the project. I will be mostly responsible for preparing the paper or poster for presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.