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School Nurse Peak Performance Actions
- Use the warning signs of asthma presented in this guide to help identify students with uncontrolled asthma. Provide a list of these signs to teachers, homeroom supervisors, physical education instructors, coaches and parents. If a warning sign is observed, ask them to refer the child for peak flow measurement.
- Once students with asthma are identified, obtain an Asthma Action Plan for each student from their health care provider.
- Encourage the student’s independence and self participation in the management of their asthma. Ensure that the student has the knowledge and skills to participate in their self management.
- Get permission from the student’s parents to provide a copy of the student’s Asthma Action Plan to the student’s teacher or homeroom supervisor and physical education instructor or coach. Include all information regarding medication and dosages, triggers and emergency procedures.
- Institute a backup plan for times when you are absent or not immediately available if a student presents with an asthma episode. This should include identification of back up staff with knowledge of the asthma program and access to the student asthma action plans. Backup staff should be trained in proper Metered Dose Inhaler (MDI), Dry Powder Inhaler (DPI), and peak flow techniques; use of a nebulizer; and recognition of the signs and symptoms of acute asthma.
- Review the symptoms and treatment of asthma and be aware of the side effects of the medications used for asthma.
- Review the instructions and practice the use of the peak flow meter and metered dose inhaler.
- Review the list of triggers presented in this program to determine if any identified triggers for individual students are present in their classrooms or elsewhere in the school. When possible, minimize or eliminate the student’s exposure to these triggers, especially known allergens and irritants.
- 47 states presently have laws that protect a student’s right to carry and self-administer their lifesaving asthma medications as prescribed by their physician. If your school does not have their policy in place, work with the administration, school board, school nurse and local physicians to establish policies that comply with state law. If your state does not have a law or you have any questions, visit http://www.breatherville.org/cityhall/ch_childrights.htm. Administer only those medications prescribed by the child’s physician, and monitor response to treatment using a peak flow meter.
- Help students understand asthma by helping them learn and practice the skills necessary to manage their illness.
- Inform parents about any asthma episodes at school, and discuss the student’s general progress in controlling his or her asthma.
- Develop and conduct in-service programs on asthma for staff.
- Offer student and family asthma education programs.
- Encourage parents and students to consult their physician if they have questions or if the student’s peak flow drops below the Green Zone.
- Keep student files secure and confidential.
- Obtain parental permission to send information about asthma episodes (including peak expiratory flow readings) to their health care provider.
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