Implementation of Asthma Treatment Guidelines: An Evidence-Based Practice for Clinicians

Asthma is a chronic respiratory disease that affects adults, children, and the elderly. Asthma has taken a toll on the economy of its sufferers, families, and health care providers. In the United States, approximately 23 million people have asthma. More than half of these individuals had at least one asthma attack in the previous year. This translates into an average of four days missed from school each year per asmthmatic child and two and a half days missed for work per asthmatic adult; 11 million outpatient medical visits; 2 million emergency room visits; nearly 400,000 hospitalizations; and approximately 4,000 deaths annually. In Maryland, approximately 12.9% of adults and 13.6% of children have a history of asthma. In 2007, asthma accounted for 9,800 hospitalizations and roughly 38,000 emergency department (ED) visits. Foreground: Students with asthma at a historically Black university were more likely to use the hospital ED than students with other chronic illnesses. A quality improvement (QI) needs assessment project conducted in the University Health Clinic (UHC) from February 2010 to April 2010 showed than 935 students with asthma visited the ED comapred to the 351 students with asthma that attended the clinic. The purpose of this project was to develop a Clinical Practice Guidelines (CPG) and a protocol for Evidence-Based Practice (EBP) for clinicians in the UHC. Goal: The short-term goal for this capstone project was to ensure that clinicians adhere to the Guidelines for the Diagnosis and Management of Asmthma CPG in the UHC for the treatment and management of asthma. The long-term goal is to decrease the frequent ED visits by students with asthma. Plan: The Change Theory, “unfreezing, movement, and refreezing” in Marquis and Houston was used as a theoretical foundation to accomplish the plan project. Rosswurm and Larrabee’s EBP Model was used to guide the implementation of the capstone project. The plan included a pre- and post-test and a self-education package based on the CPG. The pretest assessed the clinician’s base knowledge.