Asthma remains one of the most prevalent diagnoses in children admitted to hospitals (Wesseldine, McCarthy & Silverman, 1999). Despite the rapid development of new medical solutions, the number of asthma cases and hospital admissions due to this disease is quite high (Wesseldine et al., 1999). Surprisingly or not, the quality of medical assistance provided to children with asthma during hospitalization is not as significant as the quality of planning and education at discharge. Much more essential is considered the quality of self-management among pediatric patients. As Wesseldine et al. (1999) write, self-management through patient education has profound implications for the risks of readmission due to asthma. The quality of discharge planning also impacts patients’ health literacy. Unfortunately, many patients with asthma display low asthma knowledge upon discharge and, for this reason, lack the skills needed to use their metered dose inhalers properly and make adequate health decisions (Paasche-Orlow et al., 2005).
Needless to say, an effective discharge plan for a 6-year-old patient with asthma will be intended primarily to minimize the risks of hospital readmissions. This plan will emphasize on the importance of self-management and patient education. Given the young age of the patient and his general level of literacy, parental involvement will also become a crucial element of the proposed discharge plan. This plan will be based on the recommendations provided by Wesseldine et al. (1999), and it will enable the parent to guide the child’s self-management efforts, while ensuring that these efforts are effective to prevent disease exacerbations and further hospital admission risks.
Thus, the discharge plan for a 6-year-old child will include an educational component, meaning one or several training sessions designed to provide the child and his parents with the fullest information about the disease, its risks and outcomes, expected disease progression, and the actions to be accomplished at home to avoid further complications. Such training sessions will incorporate oral and written information. The responsible nurse will inform the child and parents of what they must do to guarantee effective self-management of asthma, while the written booklet or handout will serve as a reminder for the child and his parents if they fail to follow the nurse’s fundamental recommendations. Such knowledge has proved to be particularly valuable in overcoming barriers to improved health literacy and improving self-management skills in vulnerable populations, including pediatric patients (Paasche-Orlow et al., 2005).
As part of the hospital discharge plan for the child, oral and written information on the use of metered dose inhalers and nebulizer instructions will be provided. The learning session with the nurse, the child, and the parent will include teaching the child the technique for using the metered dose inhaler properly (Heslop, 2008). The responsible nurse will also focus on the proper use of nebulizers, which is extremely important for the success of the learning and educational interventions for the child with asthma (Coffman, Cabana, Halpin & Yelin, 2008). More specifically, the nurse will inform the child and the parent when and how nebulizers should be used. The patterns of use will depend upon the recommendations provided by the physician. The child should know that the purpose of using the nebulizer is to provide the medication needed to make breathing easier. It can be assumed that one session will not be enough to ensure high quality of education upon discharge. Consequently, home visits may become one of the central components of discharge planning. Still, nurses are in a position to provide complete health and self-management information to the patients before they go home. Therefore, it is always better to plan the patient’s discharge before it takes place.
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