Page 2 of 4    Main Menu   <<Back   Next>>

Practice Recommendations: 

• Assessment of Asthma Control
• Athsma Education
• Action Plans
• Medication
• Referrals

Assessment  of Asthma Control

Recommendation
1.0 All individuals identified as having asthma, or suspected of having asthma, will have their level of asthma control determined by the nurse.
1.1 Every client should be screened to identify those most likely to be affected by asthma. As part of the basic respiratory assessment, nurses should ask every client two questions: Have you ever been told by a physician that you have asthma? Have you ever used a puffer/inhaler or asthma medication for breathing problems?
1.2 For individuals identified as having asthma or suspected of having asthma, the level of asthma control should be assessed by the nurse. Nurses should be knowledgeable about the acceptable parameters of asthma control, which are: Use of inhaled short-acting ß2 agonist < 4 times/week (unless for exercise); Experience of daytime asthma symptoms < 4 times/week; Experience of night time asthma symptoms < 1 time/week; Normal physical activity levels; No absence from work or school; and Infrequent and mild exacerbations. Indicators of Acceptable Asthma Controls
1.3 For individuals identified as potentially having uncontrolled asthma, the level of acuity needs to be assessed by the nurse and an appropriate medical referral provided, i.e., urgent care or follow-up appointment. Indicators of Immediate Medical Attention

[back to top]

Asthma  Education

Recommendation
2.0 Asthma education, provided by the nurse, must be an essential component of care.
2.1 The client’s asthma knowledge and skills should be assessed and where gaps are identified, asthma education should be provided.
2.2 : Education should include as a minimum, the following: Basic facts about asthma Roles/rationale for medications Device technique(s) Self-monitoring Action plans Smoking cessation if applicable (refer to RNAO guideline Integrating Smoking Cessation into Daily Nursing Practice)

[back to top]

Action   Plans

Recommendation
3.0 Every client with asthma should have an individualized written asthma action plan for guided self-management.
3.1 An action plan should be developed in partnership with the health care professional and be based on the evaluation of symptoms with or without peak flow measurement.
3.2For every client with asthma, the nurse needs to assess for use and understanding of the asthma action plan. If a client does not have an action plan, the nurse needs to provide a sample action plan, explain its purpose and use, and coach the client to complete the plan with his/her asthma care provider.
3.3 Where deemed appropriate, the nurse should assess, assist and educate clients in measuring peak expiratory flow rates. A standardized format should be used for teaching clients how to use peak flow measurements.

[back to top]

Medication 

Recommendation
4.0 Nurses will understand and discuss asthma medications with their clients.
4.1 Nurses will understand and discuss the two main categories of asthma medications (controllers and relievers) with their clients.
4.2Clients with asthma will have their inhaler/device technique assessed by the nurse to ensure accurate use. Clients with sub-optimal technique will be coached in proper inhaler/device use.

[back to top]

Referrals 

Recommendation
5.0 The nurse will facilitate referrals for clients with asthma as appropriate.
5.1 Clients with poorly controlled asthma will be advised to see a physician.
5.2 Clients with asthma should be offered links to community resources.
5.3 CClients with asthma should be referred to an asthma educator in their community, if appropriate and available.

[back to top]

 

Page 2 of 4    Main Menu   <<Back   Next>>