Introduction
Nurses’ role in raising the parents’ awareness about pediatric asthma and post-discharge phone calls as a means of preventing readmission rates in asthmatic children is not the most studied topic in the field. However, there still are works that concentrate on the bordering topics. Jat and Kabra (2017) demonstrate that asthma among children and adolescents is often underdiagnosed and undertreated. According to them, the low levels of the parents’ awareness about the illness contribute to this problem significantly, as many taboos and unfounded myths surround pediatric asthma and its treatment (Jat & Kabra, 2017).
Literature Review
Searle, Jago, Henderson, and Turner (2017) also stress that parents as caregivers should optimize their management of childhood asthma with the help of health professionals. The authors emphasize that developing and delivering asthma management plans should play a prominent role in the nurses’ interaction with the parents, but do not discuss specific forms of such communication (Searle et al., 2017). Thus, there is a consensus that educational efforts of greater scope are necessary to increase the parents’ awareness of asthma in children and maximize the effectiveness of all caregivers.
There are also several studies concentrating specifically on the nurse-administered contacts with the asthmatic children s parents after the discharge. Pinto, Navallo, and Petrova (2019) have evaluated the effectiveness of the Community Outreach for Asthma Care and Healthy lifestyles (COACH) program in reducing the rates of subsequent emergency department (ED) visits and readmissions in asthmatic children. The study is relevant to the topic because nurse-administered prone calls to asthmatic children’s parents are one element of the COACH program. The authors have found no difference in readmission rates in the 12 months following for those engaged and not engaged in the COACH program (Pinto et al., 2019). They also discovered lower rates of readmission and ED visitation in the first 30 days after discharge, suggesting that the effectiveness of the intervention is short-term (Pinto et al., 2019). However, nurse-administered phone calls are only one element of the multimodal COACH programs, and its effectiveness was not the focus of this particular study
Other scholars attempted to analyze the role of nurses raising the levels of pediatric asthma awareness via phone more specifically. Shaoxia et al. (2019) have studied the use of a mobile application to deliver post-discharge nurse-led asthma management. According to the authors, the use of the application resulted in better outcomes, including lower results of asthma exacerbations (Shaoxia et al., 2019).
Hence, the study confirms that nurse-administered models of raising awareness of childhood asthma may be effective in improving the patients’ outcomes. Still, this study analyzed mobile applications rather than phone calls, concentrated on children and not parents, and the rates of post-discharge hospital readmission were neither primary nor secondary outcomes.
A study closest to this one was conducted by Mangiapan et al. (2018). The scholars have analyzed the effectiveness of nurse-administered post-discharge educational phone calls. According to the author’s findings, only 9 percent of the patients recurred during the six months after discharge, which was an improvement (Mangiapan et al., 2018). Still, this study had no focus on child patients and nurse-parent interaction specifically.
Thus, there is a consensus among health professionals that nurse-administered post-discharge programs are pivotal for reducing readmission rates in patients with asthma, including children. Educational phone calls to the patients’ parents are one of the ways to administer such programs. Still, to the best of eh author’s knowledge, there is no study examining the role of nurses in increasing pediatric asthma awareness and decreasing the rates of hospital readmissions by administering phone calls.
Design and Methodology
This study is designed as a multi-center randomized clinical trial. Pediatric patients with asthma enrolled in the study will be divided into four groups. The parents of the first three groups will receive nurse-administered phone calls with the purpose of improving awareness and reducing readmission visits in the course of six weeks. The parents of the first group will receive the calls twice a week, the parents of the second group – on a weekly basis, and the parents of the third group – one time in two weeks. The fourth group will be the control group.
The primary outcome for the study is the rate of readmission visits in 12 months after the patients’ discharge. Comparative analysis of the primary outcome in all four groups will answer research question 1 regarding the effectiveness of nurse-administered phone calls in reducing readmission rates in patients with pediatric asthma. Additionally, comparative analysis of the primary outcome in the first there groups will answer research question 3 regarding the optimal frequency of the phone calls. Secondary outcomes will include the days of antibiotic use, days of school absence, parental work loss, medical expenses, and the children’s Childhood Asthma
Control Test scores. Comparative analysis of the secondary outcomes in all four groups will answer research question 2 regarding the effectiveness of the phone calls in increasing the overall awareness of asthma-related complications in families.
References
Jat, K.R., & Kabra, S.K. Awareness about childhood asthma. Indian Journal of Medical Research, 145(5), 581-583.
Mangiapan, J., Desmettre, T., Prud’Homme, A., Dalphin, J.C., Stach, B., Salmeron, S., & Plaisance, P. (2018). A nurse phone call educational program enhances the health status of asthmatic patients after an emergency department of admission for acute exacerbation. European Respiratory Journal, 52.
Pinto, J.M., NAvallo, L.J., & Petrova, A. (2019). Does participation in the community outreach for asthma care and healthy lifestyles (COACH) program alter subsequent use of hospital services for children discharged with asthma? [Epub ahead of print]. Journal of Asthma.
Searel, A., Jago, R., Henderson, J., & Rurner, K.M. (2017). Children s, parents and health professionals’ views on the management of childhood asthma: a qualitative study. Primary Care Respiratory Medicine, 27.
Shaoxia, K., Xiaohong, Y., Zhijiang, W., Wenfen, X., Yajuan, Q., Weihan, W., … Xubo., Q. (2019). A randomized controlled trial of a mobile application‐assisted nurse‐led model used to improve treatment outcomes in children with asthma [Epub ahead of print]. Journal of Advanced Nursing.