Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-8-2020

Graduate Advisor

Laura Kuensting

Committee

Laura Kuensting

Vanessa Loyd

Katherine Rivera

Abstract

Problem. Children with severe asthma are more likely to be non-adherent with their prescribed medications, often related to barriers. A holistic assessment of these patients has been suggested, but is not typically performed in most pediatric asthma clinics. The purpose of this project was to evaluate the effects of severe pediatric asthma clinic services designed to perform holistic assessments and provide comprehensive care.

Methods. An observational, descriptive design was used to evaluate the Severe Asthma Clinic for Kids (SACK) created in 2013 using a retrospective database review. A convenience sample of data collected on all children treated in the clinic from January 2014 through January 2020 was evaluated.

Results. A total of 144 SACK patients (N=144) revealed 121 (84%) had more than one visit to the clinic. During their initial visit, 94 (65.28%) reported at least one barrier to care; however, the number of barriers steadily decreased to zero for those experiencing at least six clinic visits. Caregiver’s quality of life scores increased 31% per visit (p=0.0009), asthma control test scores increased 89% per visit (ppp=0.1157), the number of emergency (ED) visits and hospitalizations was essentially zero.

Implications for Practice. The SACK clinic for children provided a multidisciplinary approach to the evaluation and management of children with asthma. A multidisciplinary team approach allowed for removal of barriers to care and improved the control of asthma and quality of life for children.

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