Over the past few decades, many types of research have been that have been conducted to identify the impact of school-based programs for students who have asthma. Nonetheless, most of the training barely provide sufficient explanation on the constituents of the established programs. Consequently, there occurs a lot of repetition regarding the set-up programs becomes hard. The program is directed towards demonstration of the density of management of the cases that nurses may be faced with. The goal is to enhance the care provided by school nurses and the manner through which positive results can be obtained. The program usually is in support of policies and recommendations that back the significance of professional nurses in schools and in refining the health standards of the students with asthma (Engelke, Swanson & Guttu, 2016). This paper seeks to examine the process of school case management of students with asthma, including the advancement of standardized goals to be in a position to intervene to help students.
Case Management Plan
Management of asthma in the scenario of a school, having a plan shows that the school is sensitive to the students suffering from the subject disease. There should be steps and procedures that the management should ensure that they follow to help the student suffering from the disease. The staff members and fellow students should be aware of several methods that should be developed to help a student that happens to feel unwell suddenly. The program set up, especially in the school, should contain several details as the United States Department of Health and Human Services (2003) asserts. The details in the document are;
- A list of students with asthma- it should be confidential so that the students will be quickly assisted in case they need urgent help.
- Policies and steps to follow to give medication for the student should include the emergency responses- there should be specialized staff who in this case are the nurses who should deal with emergencies.
- Actions that the staff members should take- the guide should provide full details of what they are expected to do.
- An action plan for each student who is known to be suffering from asthma.
- Introduction of education for the staff and the students regarding asthma.
According to the American Academy of Allergy, Asthma, and Immunology (2019), an asthma action plan should have the following details:
- The name of the student
- The severity of asthma, whether it is; intermittent, mild persistent, moderate persistent or severe persistent. The other information should be if they have had acute attacks.
There should be various zones: the green, yellow and red zones. The green zone- the child, should the medicines listed even when they are feeling healthy. The yellow zone- also has medication listed. There is a sick treatment plan in case the child happens to have a cough, wheeze and if the child goes short of breathe. The child should drink the drugs indicated (if the child happened to be at the yellow zone for more than 24 hours, the red zone should be followed.) The red zone- if the breathing gets hard, fast, the ribs begin to stick out and the child is neither able to walk nor sleep. The rescue medicines should be administered and help should be sought immediately. The doctor should be alerted when the child is in the red zone.
There is also additional information like; if the student can administer the drugs by themselves through the inhaler, the nurse should also be aware in such an instance.
Biophysical Factors Affecting the Management of Asthma
Deprived maternal-infant bond is the most common biophysical among the well-known possible risk influences for asthma. Those already well-identified in the remedial works, which suggest that asthma is also identified rather psychological, with the beginning, which is at times prompted by the stress that results from deprived maternal-infant bonding. Triggers such as weak bond also include apparent maternal rejection, fight with parents, parting anxiety, psychological disease, and progressive side effects of young life stress. The fragile relationship leads to a poor mother to child bond that may occur with another known environmental and hereditary risk factors to result in the onset and ferocity of asthma. Nonetheless, similar to other risk factors, weak maternal bonds rarely account for all asthma cases. Evidence for such a concept is explained through an investigation of the associations between asthma, maternal rejection, maternal-infant bonding and internalizing psychiatric disorders. According to this theory, interventions promoting a stronger mother to child bond would reduce the occurrences of asthma across the unborn children especially and therapies made to restore the relationships can help to reduce the brutality of the symptoms (Yatsenko, Pizano and Nikolaidis 2015).
According to, the environment of the children in the family and the school. There have been factors like dysfunction of the family and non-compliance with the requirements of medication that have influenced adverse outcomes of children with asthma. The result is poor control over asthma, and severity of the condition; hence, the children suffer from inadequate care and attention. The same case also applies in the school environment where there is no adequate knowledge if the information affecting the children. The staff members are not aware of the necessary emergency steps that they should take in the event of an emergency for the children. The mental and physical health of the children is essential because there are some factors like aggression, conflict and inadequate nurturing of a child that contribute to acquiring conditions like asthma. The poor environment does not always cause the elements and it is not in all homes with distress that children have asthma.
The child is affected easily by their relationship with their parents. Sticking to the appropriate medication ensures that the child can deal with the disease. When the child shows the symptoms, whether at home or school, the staff r the parent can help the child stick to the medication requirements. There may be difficulties when the child is being brought up. The result may be to be restricted from undertaking various tasks because they cannot take care of themselves adequately. The behavior of the family significantly affects the severity of asthma in a child. The child should be shown attention and care to make them feel wanted therefore will be able to respond positively to medication and will rarely suffer from emergencies (Kaugars, Klinnert & Bender, 2004).
Health System Factors and Behavioral Factors
Following the prescription and maintaining excellent conditions for the child while at school and home will help to maintain good health for the students. The students should be often involved in their treatment so that they understand why a particular action that has been done on them and to help them understand why it has been done. The people around the student should understand the behavioral changes that the child may portray sometimes. The staff management should be in a position to give adequate care and support for the students. The personal beliefs, needs and traits should be evaluated so that they can be in an excellent place to work with the patient despite not showing the expected behavior. At a particular age, they tend not to take keen attention to the action expected (Ahmad & Sorensen, 2016).
Evaluation of Case Management Plan
The first move while evaluating is to have a service plan in the school where there are enough staff members prepared to handle asthma situations when they are faced with an emergency case. There should be various contacts like a pediatric practitioner and a doctor who is identified to have adequate techniques of asthma. The school should also take measure to ensure that they have medical records for the students with asthma that will help determine the stage; therefore, treatment gets easy. There should be various criteria to show friendly dealing with the students with individual cases. The first steps are like; offering guidance in the schools, having a directory for the students with asthma, having several emergency inhalers in case the student does not have one and have plans to care for the children at the time that thy experience an attack (Nursing Times, 2015).
The schools should also have an alert to know when it is a case of asthma when the notice signs like coughs when at rest, wheezing from the chest, breathing difficulty and being unav=ble to talk or walk. In case a child collapses, happens to turn blue, has blue tinge around the lips, an ambulance should be called immediately. The child should be given positive energy in case they have an attack, the child should use their inhaler, and the person helping they should ensure that they stay with the child. There should be intervals of two puffs at a time in case they do not get well after the puffs. Providing adequate knowledge for both staff and students is helpful and is a sign of a useful, friendly community; hence, there are less emergency cases.
Ahmad, A. & Sorensen, K. (2016). Enabling and hindering factors influencing adherence to asthma treatment among adolescents: A systematic literature review. Journal of Asthma 53(8). https://www.tandfonline.com/eprint/Fpg2B2eR6PDAY575Dke5/full
American Academy of Allergy, Asthma, and Immunology, (2019). Asthma Action Plan for Home and School. https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Libraries/16-asthma-action-plan-v10_hires.pdf
Engelke, K., Swanson, M. & Guttu, M. (2016). Process and Outcomes of School Nurse Case Management for Students with Asthma. https://www.ncbi.nlm.nih.gov/pubmed/24097969
Kaugars, A., Klinnert, M. & Bender, B. (2004). Family Influences on Pediatric Asthma. Journal of Pediatric Psychology 29(7). https://academic.oup.com/jpepsy/article/29/7/475/968155
Nursing Times (2015). Providing better asthma care for children in school. https://www.nursingtimes.net/Journals/2015/09/28/x/f/f/300915_Providing-better-asthma-care-for-children-in-school.pdf
United States Department of Health and Human Services. (2003). Managing Asthma: A Guide for Schools. https://www.nhlbi.nih.gov/files/docs/resources/lung/asth_sch.pdf
Yatsenko, O., Pizano, J. & Nikolaidis, A., (2015). Revisiting maternal-infant bonding's effects on asthma: A brief history. Journal of Cogent Psychology 3(1). https://www.tandfonline.com/doi/full/10.1080/23311908.2016.1161267
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