Aims The purpose of this service review was threefold. We aimed to assess whether our asthma action plans were being utilised for acute attendees, as advised by the British Thoracic Society guidelines, and if so whether they were useful for caregivers. In addition we asked caregivers how we could improve the information provided.
Methods Using the hospital coding system and electronic medical records we identified patients attending ED with a diagnosis of ‘asthma’ or ‘viral induced wheeze’ who were discharged home the same day. The period covered was 01/09/2013–14/10/13.
Caregivers were contacted by telephone to complete a questionnaire about their experience of the action plans. Thematic analysis of qualitative data was performed.
Results 50 patients were identified. In total 14 (28%) had received an action plan; 5 received one at discharge, 7 received theirs at the specialist asthma nurse clinic and 2 had plans from a previous inpatient admission.
13 out of the 14 with an action plan participated in the questionnaire. 11 used the plan and 11 rated it as helpful. Common themes discussed were: 1. Plans help to avoid/reduce medical input (n = 5). 2. Plans increase confidence and knowledge for future attacks (n = 8). 3. Plans are useful as a reference resource (n = 8). 4. Plans may be useful for others looking after the child (n = 6).
Suggestions for improvement were; more information about long term care of wheeze (n = 4), a weblink to further resources (n = 4) and better correspondence and consistency between hospital and GP (n = 11).
Conclusions Action plans are currently not being utilised efficiently in our ED. Education and improved accessibility to the plan for ED clinicians are to be recommended.
Carers find action plans empowering. They can increase confidence in carers’ ability to manage the child at home and aid other people looking after the child.
The internet is a useful resource for parents. Links to credible websites could ensure correct advice is provided for the longer term management.
Information sharing and consistency of advice between secondary and primary care may promote confidence in carers managing these children at home.