Project "BREATHE"

Purpose:
To decrease asthma related re-admits to hospital and repeat ER visits by 50% through asthma education and follow up. In collaboration with Asthma Coalition of Long Island (ACLI) Project BREATHE will provide best practice, care and education, using a multi-disciplinary team approach.

Significance:
Pediatric staff recognized high asthma-related readmissions in a high-risk, high-volume patient population. Asthma related Hospitalizations in Nassau County are twice the Healthy People 2010 Goals and many underserved communities have four times this rate. In Long Island the prevalence rate is 11%

Strategy and Implementation:
Active Family participation with the interdisciplinary team involving the physicians, nurses, case management, child life, social work, respiratory therapists, and the ACLI staff was the key to the success of this project. From March 2010- March 2011,96 patients with Asthma related admissions were enrolled in the “Breathe” project . Comprehensive educational programs were introduced to the patient/parents from admission to discharge. These educational programs were provided by the RNs, MDs, and Child Life Specialists using hand outs and flip charts. Patients were discharged with an Asthma Action Plan with detailed information about their medications. This plan also aids the parents in early recognition of signs/symptoms of worsening Asthma. The parents were strongly encouraged to allow home visits from regional home care nurses to provide reinforcement to the educational support. Regular follow up phone calls were done after discharge at 72 hours, 3 months, 6 months, and one year.

Evaluation:
Consistent,comprehensive asthma care and education improve outcomes and quality of life. After one year of enrollment,50% of patients reduced revisits to the ER at least by one visit(p-0.0001)and 87% of patients(N=92)reduced readmissions to the hospital atleast by one admission(p-0.0001)

Implications for Practice:
Childhood asthma is the number one reason for missed school days in school aged children. In addition there is significant reduction in asthma related health care costs. project BREATHE's success depended on three key components: teamwork, attention to care,and partnerships with community services.