School Nurses' Perspectives on Barriers to Implementing School-Based Asthma Management Plans
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Margee Louisias, MD, Donald Goldmann, Wanda Phipatanakul, MD MS FAAAAI

School-based asthma management plans have been considered important for decades; however, barriers to effective implementation remain. This is a current 2015 AAAAI presidential initiative.


School nurses were queried in June 2015 regarding: barriers to communication with caretakers and providers, obtaining accurate records of asthma diagnoses, and availability of student asthma management plans in their respective schools. 


187 school nurses responded and 61% of respondents’ students had asthma management plans. 98% of nurses reported that communication between themselves and providers would improve if management plans included prescriptions

59.6% “most preferred” to identify students by written provider orders, yet only 41% of nurses “most commonly” identified students with asthma by written provider orders. 47.3% of nurses “commonly” identified students with asthma only upon presentation to their office at school. 

0% and 39.5% of nurses “always” communicated with providers and caretakers respectively, when seeing students with asthma in their office. Notably, 1.4% communicated to providers via caretakers. 73.5% and 77.6% “most preferred” directly communicating with providers and caretakers via phone. 

Among responding nurses, the most common obstacles in school-asthma management are: caretaker nonadherence with medication regimen, students not having medication, lack of office medications/supplies, asthma triggers at home and poor caretaker health literacy of asthma.


School nurses report significant barriers to school-based asthma management, including infrequent communication between themselves and providers. None of the nurses surveyed reported “always” communicating to providers regarding asthmatic students they had seen. Understanding these concerns may help find new ways to decrease barriers, increase communication and improve care.