Asthma Education

Thanks for visiting my blog.  I created it as a place to collect the great asthma information I was collecting for a school project.  

The project started with me trying to create a workflow for improving asthma clinical quality measures (CQMs).  My professor said that it was too big of a project to take on in 7 weeks.  My preceptor recommended peak flow meter patient education.  While focusing on peak flow meter patient education, I was learning how little I knew about asthma and how much asthma education I needed to have before I could educate patients.  During my asthma research, I found the information in this blog.

This is my first blog, so it is not aesthetically pleasing, but it has great information that I hope is helpful and informative to you.  I also add/edit information as I educate myself and receive feedback about my information.  So please comment if you have suggestions or comments.  

There are links to take a pretest and a posttest.  The answers will not be provided for you after taking the test.  You may see the answers on my blog.  Look at December 18, 18 Pretest & Posttest with answers.

Thanks!  Mikey, BSN, RN

Link to Pretest

What Asthma Looks Like

Air Tubes in the Lungs

Swell 

Constrict

Make Extra Mucus

Asthma Symptoms

Difficulty Breathing

Dry Cough

Chest Pain or Tightness

Wheezing 

Night Cough

Link to video below, Confirming the Diagnosis of Asthma

Link to School Asthma Checklist

Link to Child Asthma Symptom Diary

Take the Asthma Control Test (ACT)

The ACT is one of the reference tests used for CQM #398: Optimal Asthma Control.  Asthma well-controlled based on the ACT, C-ACT, or ATAQ score.

C-ACT is the Childhood Asthma Control Test

ATAQ is the Asthma Therapy Assessment Questionnaire

Click here for a print out of asthma control test (ACT) for ages 4-11

Click here for a printable asthma control test (ACT) 11 years and up

Click here for an on-line asthma control test (ACT)

Click here for a print out of ATAQ for ages 5-17

Asthma Education for Kids

Iggy & the Inhalers provide asthma education tools for kids in English and Spanish.

The site provides clinic resources, free downloads, videos, and a store to buy educational materials for patients.

Click here to visit the Iggy & the Inhalers web page 

below is a sample of what the site offers

Asthma Treatments

Rescue Medications

Albuterol (AccuNeb, Proair HFA, Proventil HFA, Ventolin HFA)

Metaproternol

Levalbuterol (Xopenex HFA)

Pirbuterol (Maxair)

Used when asthma symptoms occur

Coughing

Wheezing 
Difficulty Breathing

(Seattle Children's, 2015) link Seattle Children's pdf

Control Medications
Fluticasone (Flovent HFA)
Budesonide (Pulmicort Flexhaler)
Mometasone (Asmanex Twisthaler)
Beclomethasone (Qvar RediHaler)
Ciclesonide (Alvesco)

Asthma control medications are used daily 
to prevent the occurrence of asthma symptoms.

Patients with a diagnosis of persistent asthma, see diagnosis codes under Quality Measure Documentation, should have a prescription ordered for an asthma controller medication for each month that they have an active diagnosis of persistent asthma to meet the quality measure.

(Seattle Children's, 2015)  link to Seattle Children's pdf

The video below is for health workers to use when teaching parents about controlling their child’s asthma. 

This video is over 10 minutes long with lots of great information.

This video is in Spanish with English subtitles

How to use an Inhaler

1. Shake inhaler
2. Take cap off
3. Breath all air out of lungs
4. Place lips tightly around mouthpiece
5. Slowly breath in while administering 1 dose of inhaler
6. Slowly count to 10 while holding your breath
7. Breath medication out after counting to 10
8. If you are prescribed a 2nd dose
9. Wait 1 minute
10. Repeat steps above
11. Clean mouthpiece & replace cap

This video talks about the inhaler.  
If you want to see only the demonstration you can start the video around 3:30.

Please refer to the following links for proper inhaler use with a spacer.  
Spacers can be used by patients of all ages.

Link to Print out of how to use Ventolin HFA 

Proventil HFA Information Video

Asthma Risk Factors

Family History

Viral Respiratory Infection

Allergies

Occupational Exposures

Smoking

Air Pollution

Obesity

Peak Flow Meter use with Asthma

1. Move marker to base
2. Stand up
3. Take a deep breath in
4. Close lips tightly around mouthpiece
5. Blow air out of lungs hard & fast
6. (this should be 1 single blow)
7. Score will be number marker stops at
8. Repeat steps 3 times
9. The highest number recorded is the number you record for the day

Link to below video, American Lung Association-Measuring Your Peak Flow Rate.

There are many types of peak flow meters.  The video above demonstrates one example.  
Below is a photo of another peak flow meter.

Example of a daily Asthma Diary

Peak Flow Readings should be charted daily

(Seattle Children's Hospital, 2015, p. 30) link to Seattle Children's pdf

Links to Visit for more Peak Flow Meter information

AsthmaMD - Peak Flow Meter & Tracking App information & video

Link to below video for Personal Best Peak Flow Meter – Instructions for Use.

Link to Chicago Asthma Consortium – Peak Flow Meter Fact Sheet.

Asthma Triggers

Dust Mites

Pet Dander

Smoke

Colds

Exercise

Pollen 

(Seattle Children's Hospital, 2015, p. 32)

Asthma Action Plan

The below video explains what and Asthma Action Plan is and why it is important to patients with asthma.

Below is an example of an electronic action plan.  The arrow is pointing to the section where the peak flow meter score is entered.  

The example below shows a completed Asthma Action Plan in EPIC and how to print it.

Below is an example of a paper Asthma Action Plan

(Seattle Children's Hospital, 2015, p. 3)

The below video explains why the school nurse needs an updated Asthma Action Plan 

Charting Asthma Information after a 

Nurse Visit in EPIC

Visit diagnosis

Z71.89 Encounter for education, Health education/counseling

Z55.9 Lack of education

Z63.8 Needs parenting support and education

Z78.9 No barriers to education

R06.2 Wheezing

R05 Cough

R06.02 Short of breath

Wrap-Up

Charge Capture

94060 PR EVAL OF BRONCHOSPASM

94015 PR PT RECORDED SPIROMETRY (Spirometry recording, education)

98960 PR SELF-MGMT EDUC & TRAIN, 1 PT, EA 30 MIN (Education & Training face-to-face)

94664 PR DEMO &/OR EVAL, PT USE, AEROSOL DEVICE (Demonstration/evaluation inhaler)

99420R PR HEALTH RISK ASSESSMENT TEST (Test for asthma control)

A4614 PR HAND-HELD PEFR METER (Peak flow meter, handheld)

94640 PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT (Nebulizer treatments)

94760 PR NONINVASV OXYGEN SATUR; SINGLE (Oxygen saturation)

A4615 Nasal Cannula

A4616 Oxygen Tubing

A4617 Mouthpiece

Quality Measure Documentation

Patients who are included in the asthma quality measures

(link to document below)

Quality ID #398: Optimal Asthma Control - 

National Quality Strategy Domain: Effective Clinical Care

Measure Met if 

G9432 Code is charted - Asthma well-controlled based on the ACT, C-ACT, ACQ, or ATAQ score and documented

or

G9434 Code is charted - Asthma not well-controlled based on the ACT, C-ACT, ACQ, or ATAQ score and documented

and

G9521 Code is charted - Patient is not at risk for exacerbation and less than two asthma related hospital visits in 12 months

Link to measure #398 document

Quality ID #444 (NQF 1799): Medication Management for People with Asthma - National Quality Strategy Domain: Efficiency and Cost Reduction

Measure only Met if 

G9810 Code is charted - Patient achieved a portion of days of at least 75% for their asthma controller medication during the measurement year.  (patient was prescribed a controller medication during their treatment period)

Link to measure #444 document

References

Seattle Children's Hospital. (2015). Living with asthma. Retrieved from Seattle Children's Hospital Research Foundation: https://www.seattlechildrens.org/globalassets/documents/for-patients-and-families/pfe/pe127.pdf

 Link to 

Seattle Children's Hospital Asthma Education pdf

Thanks for visiting my blog.  Remember to comment with ideas to help me improve this blog.  I am still working on technical and 

aesthetics of creating a blog.  

Link to Posttest