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学校护士主导的哮喘项目可减少缺勤:学校轻松呼吸计划评估。

A School Nurse-Led Asthma Program Reduces Absences: Evaluation of Easy Breathing for Schools.

机构信息

Department of Pediatrics (T Simoneau, J Marrero, and JP Hollenbach), UCONN Health, Farmington, Conn; Connecticut Children's Medical Center (T Simoneau, J Marrero, and JP Hollenbach), Hartford, Conn; The Asthma Center (T Simoneau, CR Langton, MM Cloutier, and JP Hollenbach), Connecticut Children's Medical Center, Hartford, Conn.

The Asthma Center (T Simoneau, CR Langton, MM Cloutier, and JP Hollenbach), Connecticut Children's Medical Center, Hartford, Conn.

出版信息

Acad Pediatr. 2020 Jan-Feb;20(1):73-80. doi: 10.1016/j.acap.2019.07.007. Epub 2019 Jul 28.

DOI:10.1016/j.acap.2019.07.007
PMID:31365880
Abstract

OBJECTIVE

To evaluate whether school nurses can assist pediatricians in providing asthma care and reduce school absenteeism through a program called Easy Breathing for Schools (EzBfS), a 5-element school nurse-led asthma management program and the effectiveness in reducing school absenteeism.

METHODS

Fifteen public school nurses in an urban community implemented EzBfS during the 2015-16 and 2016-17 school years. Program elements included assessment of asthma risk and asthma control, asthma education, medication review, and a pediatrician communication tool. School absence for any reason was the primary outcome; absentee rates for students with asthma enrolled in the program were compared to students with asthma in the entire school population using negative binomial regression.

RESULTS

School nurses enrolled 251/2,126 students with physician-confirmed asthma (2015-16: n = 114 and 2016-17: n = 137). Sixty eight percent of participants were Latino and 25% were Black with a mean age of 8.7 ± 2.2 years. Absentee rates were higher in children with asthma compared to children without asthma (8.3% vs 7.0% absent, respectively P < .001). Students enrolled in the program experienced a 25% decrease in absentee rate after adjusting for age, sex, race/ethnicity, and school year (rate ratio = 0.75, 95% confidence interval, 0.67, 0.85) as compared to students with asthma not enrolled in the program. Participants also demonstrated improvement in inhaler technique score (P < .001). Ninety two percent of the nurses were satisfied with the program.

CONCLUSION

EzBfS, a pragmatic, nurse-led asthma management program, was successfully implemented by school nurses and significantly decreased school absences among a sample of students with asthma.

摘要

目的

评估学校护士是否可以通过名为“学校轻松呼吸计划”(EzBfS)的计划协助儿科医生提供哮喘护理,并减少学校缺勤率。这是一个由学校护士主导的、包含五个元素的哮喘管理项目,旨在评估该项目在减少学校缺勤率方面的效果。

方法

在 2015-16 和 2016-17 学年期间,15 名城市社区公立学校护士实施了 EzBfS。该项目的元素包括评估哮喘风险和控制水平、哮喘教育、药物审查以及儿科医生沟通工具。任何原因导致的缺勤均为主要结局;通过负二项回归比较参加该计划的哮喘学生和整个学校哮喘学生的缺课率。

结果

学校护士共招募了 2126 名有医生确诊哮喘的学生(2015-16 年:n=114;2016-17 年:n=137)。68%的参与者是拉丁裔,25%是黑人,平均年龄为 8.7±2.2 岁。与没有哮喘的儿童相比,哮喘儿童的缺勤率更高(分别为 8.3%和 7.0%缺勤,P<.001)。调整年龄、性别、种族/族裔和学年后,参加该计划的学生缺勤率降低了 25%(率比=0.75,95%置信区间,0.67,0.85),而未参加该计划的哮喘学生则没有显著变化。参与者的吸入器技术评分也有所提高(P<.001)。92%的护士对该计划表示满意。

结论

EzBfS 是一种实用的、以护士为主导的哮喘管理项目,被学校护士成功实施,并显著降低了哮喘学生样本的学校缺勤率。

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