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Capella University
NURS-FPX 6026 Biopsychosocial Concepts for Advanced Nursing Practice 2
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The pediatric asthma management initiative in Maplewood addresses a pressing need. Nearly 10% of children are affected by asthma, leading to frequent emergency department visits and hospitalizations. The comprehensive approach integrates patient and caregiver education, leveraging programs and enhancing access to care through community health centers. Guided by evidence-based guidelines from the National Asthma Education and Prevention Program, the initiative aims to optimize asthma control, reduce healthcare utilization, and improve children’s overall well-being and academic success in the Maplewood community.
The interprofessional team is addressing the issue of asthma management within the pediatric population of Maplewood community under the age of 18. Asthma affects nearly 10% of children, making it a prevalent health concern. This population is particularly relevant as asthma exacerbations can significantly impact their daily lives. Despite efforts to improve asthma care, the pediatric population in Maplewood continues to experience suboptimal outcomes. At least 1.7 million emergency department (ED) visits and 200,000 hospital admissions were caused by asthma exacerbations in the United States alone. School absenteeism due to asthma exacerbations is a common issue, affecting academic performance and overall well-being (Hasegawa et al., 2020).
My position on improving asthma care and outcomes in this target population involves a comprehensive approach. Increasing patient and caregiver education is critical. Leveraging programs such as the CDC’s “Asthma Control Program” to provide tailored education on asthma triggers, proper inhaler technique, and the importance of adherence to medication regimens, we can empower families to manage asthma at home better and recognize early signs of exacerbations (Rehman et al., 2020). Community health centers funded by programs such as the Health Resources and Services Administration (HRSA) also provide essential primary care services, including asthma management, to underserved populations.
Enhancing access to care can facilitate early intervention and prevent asthma exacerbations from escalating to emergency situations (Ali et al., 2022). Implementing evidence-based guidelines for asthma management is crucial. Following the recommendations outlined by the National Asthma Education and Prevention Program (NAEPP), such as using appropriate stepwise pharmacological therapy based on symptom severity and developing personalized asthma action plans, optimizing asthma control, and minimizing emergency healthcare services (Rosenberg, 2023).
Acting in this position is imperative to improve the health outcomes and quality of life for children with asthma in Maplewood. Reducing the frequency of emergency department visits and hospitalizations can alleviate the burden on families and the healthcare system. Moreover, empowering children and caregivers to manage asthma effectively can enhance their overall well-being and academic success (Nayak et al., 2022). Assumptions underlying this plan include the belief that education and access to healthcare services are fundamental pillars of effective chronic disease management. Additionally, it assumes that adherence to evidence-based guidelines will lead to improved clinical outcomes and reduced healthcare utilization in the pediatric asthma population of Maplewood.
The interprofessional team in Maplewood, consisting of pediatricians, asthma specialists, nurses, respiratory therapists, pharmacists, educators, and social workers, is pivotal in improving pediatric asthma management. In Maplewood, children have asthma, leading to frequent emergency department visits and hospitalizations. Each member of the team brings specific expertise to the table. Pediatricians provide primary care and oversee asthma management plans, while specialists offer insights into complex cases and treatment optimization (Pijnenburg et al., 2024). Nurses and respiratory therapists educate patients and monitor asthma control, ensuring adherence to treatment plans. Pharmacists ensure proper medication management, including assessing drug interactions and addressing concerns about medication adherence. Educators and social workers address psychosocial factors, such as access to care and environmental triggers, impacting asthma outcomes (Federico et al.,2020).
The interprofessional approach in Maplewood facilitates improvements in pediatric asthma management by leveraging these diverse skill sets. Through collaboration, the team conducts comprehensive assessments and develops tailored interventions to address individual challenges. For example, the team may implement school-based asthma education programs to improve inhaler technique and asthma self-management skills among students (Arekapudi et al., 2020). The complexity of asthma management underscores the importance of an interprofessional team approach.
Asthma is influenced by medical, environmental, and social factors, requiring a multifaceted approach to care. By working together, the team ensures a holistic and patient-centered approach, improving outcomes for children with asthma. Research on interprofessional interventions in pediatric asthma management supports the effectiveness of this approach. Studies have shown collaborative care reduces asthma exacerbations, emergency department visits, and hospitalizations (Nayak et al., 2022). By harnessing the collective expertise of the interprofessional team, Maplewood can optimize asthma care delivery and ultimately improve health outcomes for its pediatric population.
Our interprofessional team addressing pediatric asthma management in Maplewood has reviewed various evidence and position papers to support their approach to improving care quality and outcomes. One essential study evaluated the effectiveness of different asthma management strategies, finding that personalized asthma action plans, regular follow-up visits, and patient education programs significantly improved asthma outcomes. This evidence supports the team’s approach of implementing personalized asthma action plans and prioritizing patient education.
By focusing on these interventions, our team can develop practical implementation plans. Furthermore, these findings emphasize the applicability of evidence-based interventions in improving asthma outcomes for children in Maplewood (Hei et al., 2021). Additionally, a study by Workman et al. (2021) highlights the need for comprehensive asthma management programs, “Healthy Homes” addressing both medical and environmental factors. The paper advocates for reducing exposure to indoor asthma triggers and improving indoor air quality, which aligns with the team’s comprehensive approach to pediatric asthma management.
Our team has also drawn from a community needs assessment conducted by the local health department, identifying gaps in asthma care services, such as limited access to specialty care and suboptimal medication adherence. This data informs the team’s initiatives to improve access to care and promote medication adherence among pediatric asthma patients in Maplewood (Rehman et al., 2020). In evaluating the evidence and positions of others, our team has identified knowledge gaps and uncertainties. For instance, there needs to be more data on the long-term outcomes of these interventions in suburban communities like Maplewood. Further research is needed to explore the feasibility and effectiveness of implementing specific interventions in resource-constrained settings.
By critically evaluating existing evidence and positions, the interprofessional team can develop a well-informed, evidence-based approach to improving pediatric asthma care in Maplewood. Incorporating evidence-based interventions, addressing environmental factors, and conducting ongoing evaluations will be essential in optimizing asthma outcomes for children in the community (Pijnenburg et al., 2024).
In evidence and positions contrary to our team’s approach to improving pediatric asthma management in Maplewood, we have encountered specific viewpoints that challenge our strategies. Intensive asthma education programs have limited long-term impact on health outcomes, citing data showing only marginal improvements in asthma control and healthcare utilization following such interventions. This finding contrasts with our approach, emphasizing the importance of comprehensive asthma education to empower patients and families to manage the condition effectively (Dailah, 2021).
Additionally, a local health policy advocacy group suggests prioritizing medical management over environmental interventions may be more cost-effective in communities like Maplewood with limited resources. The paper argues that diverting resources towards intensive education programs and environmental interventions may yield little returns on investment, especially if underlying medical needs still need to be addressed. While this perspective challenges our emphasis on environmental interventions, it underscores the need for careful resource allocation and a pragmatic approach to pediatric asthma management (Chuang & Safaeinili, 2023).
In responding to these contrary viewpoints, we must contextualize our approach within the specific needs and realities of the Maplewood community. Our strategy integrates evidence-based interventions tailored to address the unique challenges pediatric asthma patients face in Maplewood. For instance, the local health department’s needs assessment data highlights critical gaps in asthma care services, including limited access to specialty care and suboptimal medication adherence rates. These findings underscore the necessity of our multifaceted approach, which aims to improve access to care and promote medication adherence through targeted interventions (Nayak et al., 2022).
Moreover, while the study questioning the effectiveness of asthma education programs raises valid concerns, it is essential to consider the broader impact of such interventions when implemented alongside complementary measures. Programs like the “Healthy Homes” initiative have successfully improved asthma outcomes through comprehensive management strategies (Workman et al.,2021). By leveraging these evidence-based programs and tailoring them to the specific needs of the Maplewood population, we can address the underlying causes of pediatric asthma exacerbations and improve overall health outcomes. Ultimately, by engaging with contrary viewpoints thoughtfully and providing evidence-based responses rooted in local data and context, we can build buy-in for our approach to pediatric asthma management in Maplewood. This approach ensures that our interventions are effective and sustainable in addressing the community’s diverse needs.
The pediatric asthma management initiative in Maplewood adopts a holistic approach encompassing education, access to care, and evidence-based guidelines. The initiative aims to reduce emergency healthcare utilization by leveraging interprofessional collaboration and evidence-based interventions, enhance asthma control, and improve overall well-being. Despite challenges and contrary viewpoints, the team’s strategy remains grounded in local data, ensuring tailored solutions to address Maplewood’s specific needs. Continuous evaluation and adaptation are essential for sustained improvements in pediatric asthma care and outcomes in the community.
Ali, A. M., Gaglioti, A. H., Stone, R. H., Crawford, N. D., Dobbin, K. K., Guglani, L., & Young, H. N. (2022). Access and utilization of asthma medications among patients who receive care in federally qualified health centers. Journal of Primary Care & Community Health, 13, 215013192211012. https://doi.org/10.1177/21501319221101202
Arekapudi, K. L., Norris, C., & Updegrove, S. (2020). Improving self-efficacy of student asthma management in elementary and preschool staff. The Journal of School Nursing, 37(6), 105984052090476. https://doi.org/10.1177/1059840520904760
Chuang, E., & Safaeinili, N. (2023). Addressing social needs in clinical settings: Implementation and impact on health care utilization, costs, and integration of care. Annual Review of Public Health, 45(1). https://doi.org/10.1146/annurev-publhealth-061022-050026
Dailah, H. G. (2021). Investigating the outcomes of an asthma educational program and useful influence in public policy. Frontiers in Public Health, 9, 736203. https://doi.org/10.3389/fpubh.2021.736203
Federico, M. J., McFarlane, A. E., Szefler, S. J., & Abrams, E. M. (2020). The impact of social determinants of health on children with asthma. The Journal of Allergy and Clinical Immunology: In Practice, 8(6), 1808–1814. https://doi.org/10.1016/j.jaip.2020.03.028
Hasegawa, K., Craig, S. S., Teach, S. J., & Camargo, C. A. (2020). Management of asthma exacerbations in the emergency department. The Journal of Allergy and Clinical Immunology: In Practice, 9(7). https://doi.org/10.1016/j.jaip.2020.12.037
Hei, S. J. van de , Dierick, B. J. H., Aarts, J. E. P., Kocks, J. W. H., & Boven, J. F. M. van. (2021). Personalized medication adherence management in asthma and COPD: A review of effective interventions and development of a practical adherence toolkit. The Journal of Allergy and Clinical Immunology: In Practice, 9(11). https://doi.org/10.1016/j.jaip.2021.05.025
Nayak, S. S., Borkar, R., Ghozy, S., Agyeman, K., Juboori, M. T. A., Shah, J., & Ulrich, M. T. (2022). Social vulnerability, medical care access and asthma related emergency department visits and hospitalization: An observational study. Heart & Lung, 55, 140–145. https://doi.org/10.1016/j.hrtlng.2022.04.017
Pijnenburg, M. W., Rubak, S., Skjerven, H. O., Verhulst, S., Elenius, V., Hugen, C., Jauhola, O., Kempeneers, C., Melén, E., Nilsen, T. R., Rutjes, N. W., Ruotsalainen, M., Schaballie, H., Zwitserloot, A. M., Proesmans, M., & Mäkelä, M. J. (2024). Optimizing care for children with difficult-to-treat and severe asthma through specialist paediatric asthma centres: Expert practical experience and advice. BMC Pediatrics, 24(1). https://doi.org/10.1186/s12887-024-04707-0
Rehman, N., Almeida, M. M., & Wu, A. C. (2020). Asthma across childhood: Improving adherence to asthma management from early childhood to adolescence. The Journal of Allergy and Clinical Immunology: In Practice, 8(6), 1802-1807.e1. https://doi.org/10.1016/j.jaip.2020.02.011
Rosenberg, D. (2023). Approaches to management of asthma: Guidelines for stepped care and self-monitoring. Advances in Experimental Medicine and Biology, 355–375. https://doi.org/10.1007/978-3-031-32259-4_15
Workman, B., Beck, A. F., Newman, N. C., & Nabors, L. (2021). Evaluation of a program to reduce home environment risks for children with asthma residing in urban areas. International Journal of Environmental Research and Public Health, 19(1), 172. https://doi.org/10.3390/ijerph19010172
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