Chronic Conditions

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Asthma

(Updated October 31, 2017)

Asthma Definition:

Asthma is a chronic lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing, chest tightness, shortness of breath, and coughing . The coughing often occurs at night or early in the morning. National Heart Lung and Blood Institute

Asthma Guidelines:

University of Michigan Health System, asthma care guidelines

Michigan Quality Initiative Consortium, asthma care guidelines

Care Management Interventions

Click Here for an example of an Asthma action plan

Diagnosis Specific Concerns

Care Management Intervention

Patient Specific Interventions

Care Manager Quick Tools

Patient Quick Tools

Assessment

Assess patients knowledge level on diagnosis

Preparing for the visit

 

Comprehensive Assessment tool

Comprehensive Assessment Tool - Pediatrics

What to Expect at the Physician Appointment

 

Handout - Preparing for the Appointment

 

Diagnosis Education

Provide education regarding asthma diagnosis

  • Causes
  • Risks
  • Symptoms
  • Treatment

Discuss diagnosis with care manager

 

Review educational materials provided

 

Provide teach-back

Asthma publications and fact sheets from the National Heart,  Lung and Blood Institute

Asthma Action Plan

Asthma Action Plan for Child 0-5 Years

Asthma Fast Facts for Kids

Understanding Asthma

Care Guide from the University of Michigan

Shortness of Breath

Discuss Asthma action plan

 

Keep an asthma journal

 

Work with care manager to establish personal goals of care

Asthma Initiative of Michigan

Michigan Asthma Resource Kit

Free asthma educational materials for adults and children from the Asthma and Allergy Foundation of America

 

 

Asthma Control Test

Triggers Discuss triggers Eliminate possible triggers at home and at work

Allergy Testing, FAQ

Removing Asthma Triggers EPA

How Lung Friendly is Your Workplace

Controlling Asthma at Work

Medication Management

Medication education

  • Inhalers
  • Oral agents
  • Nebulizer education

Provide teach back on inhaler use

 

Discuss side effects of medications

 

Discuss interactions

Demonstrate use of inhalers and spacers

Understand differences between short and long acting medications

Take medications as prescribed

Asthma Care Quick Reference from the National Institute of Health

Asthma Medication Card - U of M

Medications and Older Adults from the American Academy of Allergy, Asthma, and Immunology

 

Using a Meter Dose Inhaler with Spacer

Using a Meter Dose Inhaler with Spacer Video - CDC

Nutrition

Educate on diet recommended by physician

Provide education on diet and tools for maintaining diet

Refer patient to a dietitian or nutritionist

Create diet plan

Demonstrate understanding of prescribed diet:

  • Rest just before eating.
  • Eat more food early in the morning if you're usually too tired to eat later in the day.
  • Avoid foods that cause gas or bloating. They tend to make breathing more difficult.
  • Eat 4 to 6 small meals a day. This enables your diaphragm to move freely and lets your lungs fill with air and empty out more easily
  • If drinking liquids with meals makes you feel too full to eat, limit liquids with meals; drink an hour after meals.

Nutrition for Better Breathing

Diet and Asthma

 

 

Healthy Diet

Action Plan

Educate patient on when to call primary care physician

 

Provide patient with asthma action plan

 

 

 

 

Demonstrate understanding of asthma action plan and when to call physician’s office versus go to Emergency Room

Asthma Action Plan

Electronic Asthma Action Plans from Asthma Initiative of Michigan

Asthma Action Plan

Smoking

Advise

Assess

Encourage

Assist

Review smoking cessation literature

 

How to create a quit smoking plan

 

Quit Smoking - MDHHS

Smoke Free.gov

Activity

Instruct on activity level

Discuss exercise induced asthma

Review information regarding exercise

Develop an exercise plan with CM

Asthma and Physical Activity in School

Exercise Induced Bronchospasm - Clinicians

 

 

Activity Tracker

Exercise Induced Bronchospasm - Patients

 

Physical Activity, A Way of Life

Managing Stress

Educate patient on healthy ways to manage stress

Refer patient to a behavioral health specialist

Demonstrate understanding of healthy ways to manage stress

Breathing Problems: How to Control Stress

Stress and Inflammation with Exacerbations

How to Lower Your Stress

 

Four Ways to Deal with Stress: American Heart Association

Common Tests

Instruct patient on peak-flow

Pulmonary function test

Review test information

Complete tests as ordered by physician

Common Tests in Asthma

 

 

For a printable version of the care mangement interventions Click Here

*This chart is not meant to be an inclusive list of interventions or resources for care management but a starting point in working with patients with asthma. Always check with your practice regarding the use of guidelines, resources and education.

Pathophysiology

Article

Asthma Pathophysiology

Information on the pathophysiology of Asthma from the National Heart, Lung and Blood Institute

Tools

Asthma Pathophysiology

Understanding Asthma Pathophysiology, Diagnosis and Management from American Nurse Today

Toolkits

This section provides information on various toolkits to assist with the care management of asthma patients.

Tools

Asthma Toolkit

Asthma toolkit from the Pennsylvania Asthma Partnership

Tools

Asthma Toolkit - Wee Breathers

Wee Breathers from the Asthma Allergy Foundation of America. Toolkit is designed for children, however works well with individuals as a low-literacy tool.

Tools

Asthma Guideline Implementation Steps & Tools

(GIST) program combines provider education and practice redesign to improve the use of asthma guideline-based care by clinicians. The materials condense the guidelines into five tools that include all of the age groups.

Care Management Learning Resources

This section is for care managers who would like to get additional more specific information relating to asthma.

Clinical Guidelines

Clinical Care Guidelines

Asthma clinical care guidelines from the University of Michigan Health System

Tools

MARK

Michigan Asthma Resource Kit (MARK) from the Asthma Initiative of Michigan to assist health care professionals and their office staff members in caring for persons with asthma in accordance with nationally established guidelines.

Tools

Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS)

A how-to guide on the implementation of the CHAMPS interventions. Includes education materials, questionaires and forms.

Website

Michigan Department of Health and Human Services

Provides information related to primary care and chronic disease.

Tools

Asthma Care Quick Reference

Guidelines from the National Asthma Education and Prevention Program, US Depratment of Health and Human Services

Webinars and Presentations

MiPCT Webinar

Feb 20 2013

To receive a certificate of completion Click Here

Webinar replay video

Presented by

Karen Meyerson, MSN, RN, FNP‐C, AE‐C Tisa Vorce, RRT, MA