678:
Chicago Public School Nurse Opinions About School Asthma Care Coordination
Monday, March 5, 2018
South Hall A2 (Convention Center)
Andrea A. Pappalardo, MD, Allison Stinson, Robin Bruscato, Molly A Martin, MD, MAPP
RATIONALE:

Asthma disparities are well documented in Chicago. Chicago Public Schools (CPS) is the 4th largest school district in the country and serves predominantly minority children.

METHODS:

Coordinated Healthcare for Complex Kids (CHECK) is large health care demonstration project funded by a Centers for Medicare and Medicaid Services Health Care Innovation Award. A collaborative partnership was formed between medical directors in CHECK and CPS nurse administration to address asthma disparities. With CHECK support, CPS administered a survey in December 2016 to 160 school nurses in order to understand the asthma problems nurses perceived and their interest in intervention options. Data included Likert scale questions and open-ended queries. Analyses were conducted using SAS 9.4.

RESULTS:

Seventy–five percent of nurses completed the survey. While asthma was a top diagnosis managed by 95% of respondents, 72% felt gaps existed in their understanding of asthma. Appropriate communication between school nurses and providers was reported 33% of the time; 18% of nurses believed that they receive the support needed to follow-up on deficient paperwork. In open-ended responses, the most common barriers mentioned were lack of medications (73%), time (67%), and communication (61%). When asked their opinions on a variety of interventions, 78% of nurses supported a web-based application, 66% supported community health workers, 66% supported stock albuterol policy for schools, and 61% supported directly observed therapy.

CONCLUSIONS:

The greatest barriers for CPS school nurses with asthma management are time and communication. Potential interventions such as web-based communication applications and community health workers involvement in schools were well received.