206855 Using the Omaha System to disseminate evidence-based practice for asthma care at the individual and community levels

Tuesday, November 10, 2009: 9:30 AM

Karen A. Monsen, PhD RN , School of Nursing, University of Minnesota, Minneapolis, MN
Erica L. Fishman, MSW MPH , Asthma Program, Minnesota Department of Health, St. Paul, MN
Madeleine J. Kerr, PhD, RN , School of Nursing, University of Minnesota, Minneapolis, MN
Diane C. Cassady, BSN, RN, CCRN , School of Nursing, University of Minnesota, Minneapolis, MN
Meghan LaVelle, BSN, RN, CEN , School of Nursing, University of Minnesota, Minneapolis, MN
Background and Issues - A State Health Department Asthma Program discovered the widespread use of the Omaha System for individual level practice in local public health (LPH) agencies. However, they noted the lack of individual and community level asthma pathways. One LPH agency created Omaha System pathways based on best asthma care for home visits and community interventions.

Description - Public health nurses, Omaha system expert, respiratory therapist, certified asthma educator, health educator and asthma program planner were convened to develop pathways for asthma care home visits, and for community level asthma interventions. Graduate nursing students critiqued the pathways for alignment with current evidence and national asthma guidelines. Their recommendations were incorporated within the pathways. A KBS rating guide to supplement the two pathways was developed. A program evaluation was conducted using Problem Rating Scale Outcomes data related to the problems incorporated within the pathways. The completed pathways were disseminated to LPH agencies. A survey was conducted to determine alignment with current practice.

Lessons Learned Designing pathways to be incorporated within any electronic documentation system based on the Omaha System was important to ensure use. Creating a multi-disciplinary team including professionals and students improved the pathways. This project is an exemplar of using standardized language combined with evidence from literature to guide practice at the individual and community levels.

Recommendations Using an iterative process is needed for creating and critiquing evidence-based pathways. The pathways should be used to disseminate best asthma care practices in a standardized way to LPH agencies.

Learning Objectives:
1. Explain how the Omaha System can be used to guide evidence-based asthma care at the individual and community levels. 2. List five components of an asthma care plan at the individual level. 3. List three Omaha System problems in the community level pathway. 4. Explain how a multi-disciplinary team can use the Omaha System to measure outcomes.

Keywords: Public Health Nursing, Local Public Health Agencies

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Asthma Program Planner at the Minnesota Department of Health and collaborated with Omaha System experts, researchers and providers to develop the pathways and on this paper.
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.