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Organizational Background
According to the Childrens Hospital of Philadelphia (n.d. d), Francis Lewis West, who was inspired by a childrens hospital in London, founded the Childrens Hospital of Philadelphia (CHOP) in 1855. The hospital has since expanded to include a research institute, a pediatric rehabilitation center, and the largest pediatric healthcare network in the U.S. Nowadays, the hospital has 546 beds and processes more than 1 million patient visits every year. CHOP pursues the goal of advancing childrens healthcare through innovative, professional, safe, and family-centered care.
The pulmonary medicine division of the CHOP employs 67 individuals, including seven nurse practitioners, twenty-six physicians, and one advanced practice nurse, with no volunteers. According to the Children Hospital of Philadelphia (n.d. e), the division is ranked No. 2 in the nation on U.S. News & World Reports 2018-19 Honor Roll of Best Childrens Hospitals. The division holds conferences on chronic lung diseases and other relevant conditions that harm children and carries out various community service programs. The community at large can access CHOPs.
The Childrens Hospital of Philadelphia (n.d. c) declares becoming the world leader in the advancement of healthcare for children by integrating excellent patient care, innovative research, and quality professional education into all of its programs as its mission. The Nemours Childrens Health System (n.d.), which the hospital in Delaware is a part of, describes its purpose as providing care and programs that are not readily available to improve the health of children. According to St. Lukes University Health Network (n.d.), its mission is to care for the sick and injured, educate health care providers, and improve access to care in the communities they serve.
Purpose of Request and Anticipated Results
Asthma is a chronic lung disease that expresses itself in airway narrowing and obstruction, leading to breathing issues. The common symptoms of an asthma attack include coughing, wheezing, chest tightness, and shortness of breath. According to the National Institutes of Health (2018), the number of people who have asthma worldwide is estimated at 235 million, with 24.6 million of those people residing in the United States. The Centers for Disease Control and Prevention (n.d.) have created the National Asthma Control Program (NACP) in 1999 with the goals of reducing mortality, hospitalizations, emergency department visits, school or workdays missed, and limitations on activity due to the condition.
Education for effective self-care is a critical aspect of treatment, as asthma is an incurable, chronic condition. The study conducted by Wesley (2015) indicates inadequate levels of knowledge among asthma patients. Liu and Qureshi claim that educating children and their caretakers about the proper treatment and interventions for asthma may significantly improve their success at controlling the illness.
According to Murray and ONeil (2016), changing the lifestyle and behavior of asthma patients can lead to a decrease in hospitalizations and lower the costs of treating asthma as a result. Bayoumy and Osman (2015) state that increased asthma knowledge helps the patient control their condition better. The Childrens Hospital of Philadelphia (n.d. a) incorporates education for the parents in its asthma program. However, while their education program mentions awareness of triggers and attack prevention, it does not include teaching children about the proper use of inhalers.
Inhalers are some of the most common tools used to combat asthma attacks. According to Bickel, Burmester, Morton, OHagan, and Eid (2014), education in the use of inhalers would benefit every category of asthma patients. Sulaiman et al. (2016) come to a similar conclusion, stating that according to their results, the poor general inhaler technique leads to a quarter of all inhalations being wasted. As such, it is necessary to improve inhaler awareness among asthma patients while reinforcing the other aspects of their knowledge on the matter. Furthermore, special care should be taken when teaching children about the use of inhalers, as the attacks may happen in an environment where their caretakers are not present, and the children should be able to administer the necessary degree of care to themselves.
The proposal primarily focuses on the Childrens Hospital of Philadelphias (n.d. b) community asthma prevention program (CAPP). The program offers free education and support to families of children with asthma in Philadelphia in the form of classes held in educational institutions and home visits. The scope of the curriculum will be expanded to incorporate more detailed and relevant information, and the education of children will receive greater attention. A decrease in the number of hospitalizations, emergency department visits, and missed school days among children with asthma in Philadelphia is expected. The results may be evaluated through the hospital records and cooperation with the citys educational institutions, which makes it possible to measure and assess the effects of the program.
Organizational Capacity
The asthma education program is aligned with CHOPs mission to integrate excellent patient care, and it is also consistent with the purposes of the Nemours Childrens Health System as well as St. Lukes University Health Network. However, the CAPP has been affected by financial constraints that prevent it from providing adequately extensive and in-depth coverage of the target community. This program cannot address the CAPPs width issues, but it will help ensure high-quality services that may lead to improved results. Those results may help the CAPP achieve recognition and grow as a result.
The CAPP has a staff of twelve, including RN clinical and educational coordinators that have conducted over 183 class series in Philadelphia, reaching over 3000 participants, according to the Childrens Hospital of Philadelphia (n.d. b). While an expansion of staff numbers and the scope of activities is desirable, it is beyond the scope of the current proposal. The current staff is likely capable of continuing their work with the new curriculum and goals, and the increased success that is expected from the change may enable an increase in funding for the program, leading to its further growth.
The asthma program of the pulmonary division of the CHOP is overseen by the medical director, Julian Allen, MD. Dr. Allen has been practicing for 34 years, also serves as the chief of the division, is the recipient of a large variety of awards. The CAPP is managed by Tyra Bryant-Stephens, MD, who founded the program in 1997 and has led it ever since. The staff of twelve employees includes coordinators and social workers who conduct classes on asthma and perform home visits for the families of the children with the condition.
The scope of the program is not limited to the CAPP or Philadelphia. The Nemours Children Hospital in Delaware as well as the St. Lukes University Health Network are expected to cooperate in the development and introduction of the new curriculum into their community health programs. This collaboration will result in extensive coverage that will enable greater opportunities for data collection, evaluation of the programs effectiveness, and improvement of the childrens health statewide and outside Pennsylvania. Furthermore, the expertise of those hospitals will be a valuable asset to the development of a curriculum that is comprehensive and manageable.
References
Bayoumy, H. M. M., & Osman, S. M. T. (2015). Development and implementation of an evidence-based self-regulation intervention: Effect on knowledge and perceived control among adult patients with asthma. Web.
Bickel, S., Julie Burmester, R. T., Morton, R., OHagan, A., & Eid, N. (2014). Examining the utility of asthma inhaler education in children with asthma. CHEST, 146(4), 696A.
Centers for Disease Control and Prevention. (2014). CDCs national asthma control program.
Childrens Hospital of Philadelphia (n.d.). About the asthma program.Â
Childrens Hospital of Philadelphia. (n.d.) About the community asthma prevention program (CAPP).
Childrens Hospital of Philadelphia. (n.d.) About the history of Childrens Hospital.
Childrens Hospital of Philadelphia. (n.d.) Our mission.
Childrens Hospital of Philadelphia. (n.d.) Why choose us for pulmonary medicine.
Sulaiman, I., Seheult, J., MacHale, E., ODwyer, S., DArcy, S., Boland, F., McCrory, K., Casey, J., Bury, G., Al-Alawi, M., ODwyer, S., Ryder, S. A., Reilly, R. B., & Costello, R. W. (2016). Irregular and ineffective: A quantitative observational study of the time and technique of inhaler use. The Journal of Allergy and Clinical Immunology: In Practice, 4(5), 900-909.
Liu, Z., & Qureshi, K. (2016). Efficacy of an asthma self-management education intervention for children (9-13 years) with asthma and their caregiver in Wuhan, China. Journal of US-China Medical Science, 13, 117-128.
Murray, B., & ONeill, M. (2016). Nurses role in delivering the message: the value of health promotion and patient education in the self-care management of adults with asthma.
National Institutes of Health. (2018). NIH statement on World Asthma Day 2018.
Nemours Childrens Health System. (n.d.) Our mission.
St. Lukes University Health Network. (n.d.) About St. Lukes University Health Network. Web.
Wesley, C. (2015). A study to assess the knowledge and practice of patients with bronchial asthma regarding prevention of recurrent attacks of asthma. International Journal of Nursing Education, 8(2), 16-18.
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