Pediatric Asthma Readmission: Nursing Program

Implementation Steps

The first step in the implementation of this project will be organizing a multicenter follow-up program in several hospitals. This program will include patients from 4 to 11 years who are checking out of the hospitals after admission, emergency admission, or readmission related to asthma. The age limitation is necessary because 4-11 years is a recommended age for the Childhood Asthma Control Test (C-ACT), the results of which are a secondary outcome (Shaoxia et al., 2019). To reach a sufficient number of subjects for a representative sample, the project will enroll patients that visit the hospitals for six months.

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The project will separate the patients enrolled into four groups, including three experimental groups and a control group. Upon checking out, the parents of the patients enrolled in the experimental groups will be asked for informed consent to receive incoming phone calls from the educational nurse during the first six weeks after the discharge. The frequency of the calls will be twice a week, once a week, and one time in two weeks, depending on the group.

The informed consent obtained from the parents will also include their agreement to fill a standardized questionnaire, as in the study conducted by Mangiapan et al. (2018), a year after the discharge. The survey will contain inquiries on the days of school absence and antibiotic use, parental work loss, and medical expenses. Apart from that, parental consent will also be necessary to contact the children to gather the results of the C-ACT.

The project will follow the patients enrolled during the first twelve months after their discharge. The hospitals involved in the project will report the asthma-related readmissions of the participating patients to evaluate the rate of readmission as the primary outcome of the study. In the course of the twelve months after the discharge, children will submit online the results of their C-ACT every month. After the end of the twelve-month period, the parents will fill and submit the standardized questionnaires characterizing the other secondary outcomes. After that, the results will be calculated and compared for the three experimental groups and the control group to answer the research questions.

Time Frame of the Project

Period Steps Comments
December 1, 2019 –
May 31, 2020
Enrolling participants, obtaining informed consent From enrolling the first participant to enrolling the last participant
December 2019 – July 2020 Administering educational phone calls From the first phone call to the first participant to the last phone call to the last participant.
December 2019 – May 2021 Monitoring readmission rates, gathering C-ACT From the discharge of the first participant to the last day of the 12-month period after the discharge of the last participant
June 1, 2021 – June 15, 2021 Filling standardized questionnaires, gathering the results From the last day of the 12-month period after the discharge of the last participant to obtaining the last survey results.
June 16, 2021 – August 30, 2021 Calculating and comparing the results, answering the research questions, preparing the publication. From beginning data evaluation to completing a preliminary version of the publication.

Resources and Tools

The only technical resources necessary for the implementation of this project are steady access to the Internet and telephone communication for administering the educational calls and gathering the C-ACT and questionnaire results. The primary and secondary outcomes are to be calculated as simple percentages for experimental groups and the control group. As a consequence, there is no need for specific statistical tools.

References

Mangiapan, J., Desmettre, T., Prud’Homme, A., Dalphin, J.C., Stach, B., Salmeron, S., & Plaisance, P. (2018). A nurse phone call educational program enhances health status of asthmatic patients after an emergency department of admission for acute exacerbation. European Respiratory Journal, 52(62), PA670. Web.

Shaoxia, K., Xiaohong, Y., Zhijiang, W., Wenfen, X., Yajuan, Q., Weihan, W., … Xubo., Q. (2019). A randomized controlled trial of a mobile application‐assisted nurse‐led model used to improve treatment outcomes in children with asthma [Epub ahead of print]. Journal of Advanced Nursing. Web.

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