Natasha McClure1, Melanie Lutenbacher2, Ellen O'Kelley3, Mary S Dietrich4. 1. Vanderbilt University School of Nursing, Nashville, TN United States. Electronic address: Natasha.j.mcclure@vanderbilt.edu. 2. Vanderbilt University School of Nursing, Nashville, TN United States. Electronic address: melanie.lutenbacher@vanderbilt.edu. 3. Department of Pediatrics, Vanderbilt University School of Medicine, Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN United States. Electronic address: ellen.okelley@vanderbilt.edu. 4. Statistics and Measurement, Schools of Medicine (Biostatistics, Psychiatry) and Nursing, Vanderbilt University School of Nursing, Nashville, TN United States. Electronic address: Mary.dietrich@vanderbilt.edu.
Abstract
BACKGROUND: Home environmental assessments and interventions delivered via academic practice partnerships (APP) between clinics and schools of nursing may be a low or no cost delivery model of pediatric asthma care and professional education. Patients receive enhanced clinical resources that can improve self-management and healthcare utilization. Additionally, students can practice chronic disease management skills in actual patient encounters. OBJECTIVE: To describe outcomes of the implementation of an APP between a school of nursing and a pediatric asthma specialty clinic (PASC) to deliver a home visit program (HVP). The HVP was designed to reduce emergency department visits and asthma related hospitalizations in PASC patients and provide clinical experiences for nursing students. METHODS: PASC referred patients to the HVP based on their level of asthma control. Students provided an individualized number of home visits to 17 participants over a nine month period. A 12-month pre- and post-HVP comparison of emergency department visits and asthma related hospitalizations was conducted. Additional information was gathered from stakeholders via an online survey, and interviews with APP partners and HVP families. OUTCOMES: Children had fewer asthma related hospitalizations post HVP. Findings suggest a reduction in exposure to environmental triggers, improved patient and family management of asthma, and increased PASC knowledge of asthma triggers in the home and increased student knowledge and skills related to asthma management. CONCLUSIONS: Multiple clinical and educational benefits may be realized through the development of APPs as an infrastructure supporting targeted interventions in home visits to pediatric asthma patients and their families.
BACKGROUND: Home environmental assessments and interventions delivered via academic practice partnerships (APP) between clinics and schools of nursing may be a low or no cost delivery model of pediatric asthma care and professional education. Patients receive enhanced clinical resources that can improve self-management and healthcare utilization. Additionally, students can practice chronic disease management skills in actual patient encounters. OBJECTIVE: To describe outcomes of the implementation of an APP between a school of nursing and a pediatric asthma specialty clinic (PASC) to deliver a home visit program (HVP). The HVP was designed to reduce emergency department visits and asthma related hospitalizations in PASC patients and provide clinical experiences for nursing students. METHODS: PASC referred patients to the HVP based on their level of asthma control. Students provided an individualized number of home visits to 17 participants over a nine month period. A 12-month pre- and post-HVP comparison of emergency department visits and asthma related hospitalizations was conducted. Additional information was gathered from stakeholders via an online survey, and interviews with APP partners and HVP families. OUTCOMES: Children had fewer asthma related hospitalizations post HVP. Findings suggest a reduction in exposure to environmental triggers, improved patient and family management of asthma, and increased PASC knowledge of asthma triggers in the home and increased student knowledge and skills related to asthma management. CONCLUSIONS: Multiple clinical and educational benefits may be realized through the development of APPs as an infrastructure supporting targeted interventions in home visits to pediatric asthma patients and their families.
Authors: Hadley S Sauers-Ford; Michelle Y Hamline; Leah Tzimenatos; Heather McKnight; Charlaine M Hamilton; Maureen G McKennan; Jennifer L Rosenthal Journal: Hosp Pediatr Date: 2019-03-08