Introduction:  Asthma is the most common chronic childhood disease and the cause of more than 10,000 hospitalizations in Georgia in 2006.  The pediatric asthma discharge rate at Tift Regional Medical Center (TRMC) for 2006 was more than double the rate of surrounding counties.  According to the NAEPP Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (EPR-3 Summary Report 2007) education is one of the four components of care needed to achieve and maintain asthma control.

To increase the asthma education received by parents and caregivers of children hospitalized with the diagnosis of asthma or with a history of asthma and to achieve and maintain asthma control, TRMC initiated an Asthma Education Program for pediatric in-patients in June 2007.  To accomplish this we have adopted a pre-packaged asthma education packet from Monaghan Medical, Doc Monaghan.  In addition, a folder of educational material from pharmaceutical companies and asthma organizations is prepared for each patient according to age and language spoken.  We developed an Asthma Home Management Plan of Care that includes written instructions for both daily management (long-term control medication, if appropriate, and environmental control measures) and actions to manage worsening asthma (what signs, symptoms, and PEF measurements (if used)indicate worsening asthma; what medications to take in response; what signs and symptoms indicate the need for immediate medical care).  This plan should be shared with other family members or day-care facilities

Method:  Each patient admitted with a diagnosis of asthma or a history of asthma receives Asthma Education while hospitalized.  Along with the Doc Monaghan package and the TRMC Asthma Folder, each patient and family is visited daily by a Certified Asthma Educator or Respiratory Therapist for instruction and to answer any questions.

Thanks to the generosity of TRMC employees through donations to The 30-Minute Club, each patient receives free dust mite covers for their mattress and pillow.  Allergens produced by dust mites are among the most common triggers of asthma.  Dust mites are prevalent in South Georgia due to our high humidity.

Each patient who is of school age is also given a School Asthma Action Plan developed by Breathe Georgia which lists the quick-relief medication that the child may use while at school.  This is given to the school nurse along with the medication.

RESULTS:   During 2006 when there was no Asthma Education Program, there were 114 patients age 2-17 years old with a primary or secondary diagnosis of asthma discharged from TRMC with a total of 280 days of hospitalization.  In 2007 the number of discharges was 81 (a 29% decrease) and 192 days (37.1% reduction) of hospitalization.  In 2008 the number of discharges was 51 (an additional 37.1 decrease from the previous year) with 130 days (an additional 32% reduction) of hospitalization. In the two year period the number of discharges decreased by 55.3% and the number of hospital days was reduced by 54%.  A positive effect was also achieved in ER visits.  During this same time period, ER asthma visits decreased by approximately 30%.

At TRMC we were successful in reducing the frequency and number of hospital days related to asthma by offering an aggressive educational program within the hospital setting for pediatric patients and families.  By improving asthma care, we also improved the quality of life for asthmatic children living in South Georgia.