PEDIATRIC ASTHMA: USING A MOBILE CLINIC TO REACH OUT TO THOSE IN NEED TEAM MEMBERS: SUSAN FINN, MSN; LINDA RUSH, PCT; KAREN JUDY, MD; JOHN ZINKEL, RCP; NURSING AND ADMINISTRATION AT CE HUGHES SCHOOL
Loyola’s PEDIATRIC MOBILE HEALTH UNIT • Began operation in 1998 with a grant from the Ronald McDonald House Charities. Loyola’s Pediatric Mobile Health Unit is the prototype of Mobile Health Units and has been replicated internationally. • Operational expenses are paid for by community grants and gifts. • Has seen over 73,000 children since inception, providing no cost health screening, immunizations and disease management. • The PMHU staff work collaboratively with school employees and other community members to increase access for underserved populations in the city of Chicago and suburban areas. • The PMHU APN provides education related to community medicine for pediatric residents, medical and nursing students, paramedics and others. • CURRENTLY expanding programs by APPLYING FOR RESEARCH GRANTS
PROJECT AIM • The goal of the Pediatric Mobile Health Asthma Outreach Program was to improve asthma management among pediatric students at a Chicago Public School in North Lawndale by providing increased access to ongoing health assessment and education.
NEEDS ASSESSMENT Chicago has a significant pediatric asthma population, with inner-city hospitalization for asthma at over twice the national average(42.8/10,000 compared to 19.5/10,000) A needs assessment related to the impact of asthma on students was performed in Fall 1999, working with the school nurse at CE Hughes School. The school was selected because of a high prevalence of children with poorly controlled asthma in an underserved community for health care. In collaboration with school administration, information was given to parents/guardians of children with asthma. Parent/guardian consent and participation required.
SOLUTIONS IMPLEMENTED • The PMHU created a schedule to visit the specific school on a monthly basis to provide on-going education, assessment and asthma follow-up care. • PMHU staff collaborate with school nurse and administration to schedule students and to work with families for disease management. • Initial assessment of students enrolled in the program included: • SURVEY OF PATIENT/FAMILY HISTORY • SURVEY OF ENVIRONMENT(FAMILY REPORT) • ASSESSMENT OF PARENT/CHILD KNOWLEDGE OF ASTHMA • Pulmonary Function Testing • Follow-up provided: • MONITORING(PEAK FLOWS), • Monitor MEDICATION compliance, • Assist with obtaining medication as needed • Education reinforcement • Communication with parent/guardian
Missed School Days due to Asthma 14 12 10 8 Number of Days Missed 6 4 2 0 FY00 FY01 FY02 FY03 FY04 FY05 FY06 FY07 (thru December 06) Number of Missed School Days Before Number of Missed School Days After • TEACHERS NOTICED IMPROVEMENT IN STUDENT’S ABILITY TO FOCUS(IMPROVED ATTENDANCE, SLEEP, AND BETTER CONTROL OF SIGNS/SYMPTOMS OF ASTHMA.)
Emergency Department Visits due to Asthma 7 6 5 4 Number of ER Visits 3 2 1 0 FY00 FY01 FY02 FY03 FY04 FY05 FY06 FY07(thru December06) ER Visits Before ER Visits After • STUDENT AND PARENT/GUARDIAN FOCUS ON CONTROL OF ASTHMA HAS ENHANCED CONTROL OF THEIR DISEASE SIGNIFICANTLY.
NEXT STEPS • Recruit new participants as original students graduate or move. • Work with new administration within the school to enhance collaboration • Assess opportunity to expand program to additional schools in at-risk communities.