Primary Care Providers Not Recording Peak Flows
As a certified school nurse in NJ, we too utilize an AAP/ATP similiar to what was just shown.... it is extremely frustrating when PCP's do not fill them out on behalf of their asthma patients, but when they do and are submitted to our school (as per our district and health office protocols) they never have PEAK Flows recorded. I am at a loss as to why these forms are being filled out by their PCP's, but are leaving off the most important element that can be so easily utilized by a School Nurse during a student's asthma attack, guiding our assessment in a much better light in order to provide the best intervention without lost of crucial time - why does this seem to be so consistent among PCP's? Is there any way that during National MD conferences this one point can be addressed and emphasized in order for school nurses to provide the best care possible, along with addressing better patient / family asthma education within those primary health offices as well?
As a follow up to my question above, many families or students within my high school setting will tell me that "they've outgrown it", or "I don't need my inhaler anymore.... I haven't been to the doctor's in years for it" - follow up by those PCP offices to the home is also crucial in regards to these misbeliefs.
28 May 2020 - 3:36pm
Hi, great question about peak flow usage in PCP offices. in a recent review of the literature with the use of asthma action plans, there is a great deal of support to follow AAPs based on symptoms and not peak flows. What you are seeing may be related to this change in the literature. Have you been able to reach out and speak to any of the PCP offices to understand their process for asthma care? Great questions and comments and I can imagine how frustrating this is for you as a school nurse. PCPs definitely need to keep asthma on the forefront as children grow up.
28 May 2020 - 3:54pm
Thank you for your reply! - I
Thank you for your reply! - I was unaware of these most recent guideline changes within the literature pertaining to recording of PEAK Flows.... PACNJ (Pediatric / Adult Asthma Coalition of NJ) is still using them on their AAP's, most recently updating those forms just a year or two ago - could you provide the best evidence-based peer reviewed journal (&/or article) referencing these changes, as I would love to read it to so my practice within the health office can be based on the most current research regarding this important assessment point. Will PACNJ be changing or modifying their AAP soon?, based on these most recent changes within the literature? I am familiar with asthma algorithm logs or sheets (re; based on symptomatology), having attended many many school health conferences and conventions with asthma experts in attendance - are these the ones that you may be referring to also during assessment? (i.e., how mant times are you waking up in the middle of the night with symptoms?, how many rescue canisters do you go through each year?, how many times have you need to go to your PCP or visit the ER for an asthma exacerbation?, etc.)....
I look forward to your reply, as asthma is my niche and am very interested in learning about these most recent changes within the literature (I am studying for my AEC!) ~ Thank you!