Date of Award


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Cynthia Coviak, PhD, RN, FNAP

Second Advisor

Colleen Chadderton, MSN, PPCNP-BC

Third Advisor

Kimberly Lohr, DNP, RN, NNP-BC, PPCNP-BC


Introduction: Asthma is a life-altering chronic disease that affects many children throughout the state of Michigan. Evidence-based guidelines recommend a written asthma action plan (AAP) be given to all caregivers of children with asthma. This would include schools, but the plans are not making it there. This project focused on collecting school asthma data and designing a process change at a local clinic to send the plans directly to the schools.

Objectives: The goal of this project was to improve communication between healthcare providers and schools for children with asthma. The objectives were to increase the percentage of children with asthma who had asthma action plans and to send the AAP directly to the school from the clinic. Additionally, information was collected from the schools to evaluate asthma care in the community.

Methods: A process change was implemented among staff members in a small, pediatric clinic in southern lower Michigan. Also, a school survey was electronically sent to all schools in the county. The process change tracked the number of AAPs going to schools and counted how many asthma patients received AAPs during appointments. The intervention was guided by the Donabedian model and implementation guided by the Promoting Action on Research Implementation in Health Services (PARiHS) framework.

Results: Responses from the school survey revealed that most county schools (87.5%) did not have a nurse on staff. Additionally, in over 70% of the schools that responded, office personnel were primarily in charge of routine asthma care for students. Most schools had a low rate (< 25%) of AAPs on file for asthmatic students and staff stated that they found having an AAP on file was very useful. The process change was executed over 12 weeks and staff adjusted well to the change, resulting in 73% of eligible children seen in the office receiving written AAPs and having them sent directly to schools via fax at the time of the visit.

Conclusions: Data from the school survey gave insight on current asthma care in schools and the schools’ desires for communication with healthcare providers. Implementing a process change focused on AAPs was successful and the office was able to provide written AAPs to schools for over 70% of asthmatic students seen in the office during the process change.

Implications: This intervention of sending AAPs directly to schools improved communication between healthcare providers and schools where asthma care is given. Asthma management can be improved as communication is improved, and may decrease the number of asthma-related complications for children with this respiratory disease.