Journal Article

7753 Easy wheezy lemon squeezy- the simple yet effective act of discharging a child with a personalised asthma action plan

Hargreaves Aiden, Neill, Philip, Hollis, Annie

2025

Overview

Why did I do this work The National Review of Asthma Deaths (NRAD) found that for children that died from asthma, their parents/carers had extremely poor understanding of how to manage the condition and when to seek help. A Personalised Asthma Action Plan (PAAP) has been demonstrated to educate and empower children, young people and their families in effective self-management of their asthma. (BTS/SIGN).The capitalise the benefits of PAAP, we undertook a Quality Improvement Project (QIP) to maximise its deployment at the Children’s Unit at Royal Oldham Hospital.What did I do Retrospective record reviews were performed for all children admitted with the diagnoses of ‘asthma’ or ‘exacerbation of asthma’ to the Children’s Unit at the Royal Oldham Hospital in 2022, and subsequently in 2024.The reviews were carried out using the Electronic Patient Record systems: evolve and healthviews.Patients coded with viral induced wheeze, chest infection, croup, or were under the age of five at the time of presentation were excluded.For patients that met the inclusion criteria, evidence of PAAP deployment was searched for within their medical records.As an accessory element of this project, an anonymous questionnaire was circulated to assess the awareness of a PAAP and to identify barriers to its use.What did I find 0/16 patients were discharged with a PAAP in the 2022 cycle, and 3/23 in the 2024 cycle – a modest increase of 12%.In 2022, all surveyed staff members on the Children’s Unit were aware of the PAAP; and 94% in 2024.Despite this, only 45.5% of staff knew where to find it in 2022, compared to 69% in 2024, an increase of 23.5% due to the inclusion of PAAP in induction.81% of respondents to the anonymous staff survey selected time limitation as a barrier as a consequence of the fast-paced nature of the unit and the constant pressures to discharge patients to free up spaces – A conflict between quality and efficiency, sadly also commonly seen in most other hospitals.Respondents were asked to suggest interventions that would improve compliance. The highest-ranking suggestions were being shown PAAP’s at an induction to increase awareness and having an automatic option to add it on the computers when discharging with inhalers.What does it mean It is clear that the educational interventions in 2022 did not achieve the intended results, evidenced by the poor uptake in the 2024 cycle. Therefore, non-educational strategies must be implemented such as coupling the deployment of PAAP (e.g. as a pop-up) during online discharges to facilitate its use. We are confident that this proposed automated, coupled process will increase number of children discharged with Personalised Asthma Action Plans. A further cycle will confirm this.ReferencesNICE Guidance AsthmaBTS/SIGN – British guideline on the management of asthma

• Publisher: BMJ Publishing Group LTD
• Subject: Asthma / Children / Computers / Croup / Educational Methods / Educational Strategies / Medical records / Patients / Quality control / Self Management