Asthma management by an inpatient asthma care team.

Recent surveillance data indicates that asthma continues to be a major health problem affecting children and African Americans disproportionately in terms of prevalence, emergency department visits, and hospitalization rates (Centers for Disease Control [CDC], 2002). Death rates due to asthma also remain higher in African Americans as compared to Caucasians. At Children's Hospital of Michigan, the Inpatient Asthma Service manages the majority of children hospitalized for asthma. An allergy/asthma specialist and a pediatric nurse trained in asthma management (asthma nurse specialist [ANS]) direct this service, which provides standardized inpatient asthma management according to current asthma care guidelines and asthma education to patients and their families before discharge, encourages referrals to the outpatient allergy/asthma clinic for further asthma management and education, and addresses other medical or social needs related to asthma care. The positive outcomes measured were a decreased length of hospital stay (LOS) by 12 hours per hospital admission and average cost savings of $300,000 annually for the hospital. Other positive outcomes included improved patient and family understanding of asthma and improved coordination of care. The asthma nurse specialists have had the benefit of further developing their pediatric asthma assessment, teaching, and communication skills.