Pioneer Valley Asthma Coalition Springfield Public School Nursing Department Springfield Department of Parks, Buildings and Recreation Management

Transcription

1 Pioneer Valley Asthma Coalition Springfield Public School Nursing Department Springfield Department of Parks, Buildings and Recreation Management

2 A little about us. Pioneer Valley Asthma Coalition Community based coalition established in 2001 Mission: to improve the quality of life for individuals, families and communities with asthma in the Pioneer Valley Target area greater Springfield area because of high asthma rates resource for all communities in Western Massachusetts Programs: Healthy Schools Healthy Homes Asthma home visiting for older adults/children Climate Change

3 Asthma Friendly School Initiative Champion Silver Awards Indian Orchard Elementary Kensington International

4 PVAC- Springfield Public Schools Asthma Disparities Initiative Goals Improve Asthma Management through collaboration with SPS Nursing Department Increase asthma education for school nurses, teachers, parents and students Implement asthma friendly protocols Track asthma trends Implement EPA Tools for Schools model Support Springfield Department of Parks, Buildings & Recreation Management to implement IAQ policies and procedures to creating healthy indoor environment

5 Collaborations SPS Nursing Department SPS Wellness Committee Springfield Parks, Building & Recreation Management Dr. Matthew Sadof, Baystate High Street Pediatrics/PVAC Chair/SPS School Physician. Springfield Department of Parks, Buildings and Recreation Management American Lung Association Baystate Pulmonary Rehabilitation Department certified asthma educators Asthma and Allergy Foundation of America Elms College and University of Massachusetts Nursing Schools ARISE for Social Justice Mason Square Health Task Force Partners for a Healthier Community Funding: MA DPH Asthma Disparities Initiative Community Foundation of Western Massachusetts Children s Miracle Network

6 SPS Asthma Protocol Standing order for emergency medication administration Combination Asthma Action Plan/Medication Order developed by the school nurse asthma champion and encouraged physicians to complete AAPs Asthma Action Plans requested for students with controller medication and for students seen more than twice a week for symptoms Self-administration procedures as required by MA law New fragrance-free protocol

7 Combined Asthma Action Plan & Medication Order

8 APHA Poster Implementation of Evidence-Based Practices to Improve Asthma in an Urban School System Jamie Klingensmith, MPH, MPPA, RD 1, Kathleen Szegda, MPH, MS 1, & Matthew Sadof, MD 2 1Partners for a Healthier Community, Inc, 280 Chestnut Street, Springfield, MA 01101; 2Pediatrics, Baystate Children's Hospital, 140 High Street, Springfield, MA 01199

9 Asthma Education Topics Asthma management Proper use of asthma medications Use of spacers Use of Asthma Action Plans Identification and reduction of environmental triggers Indoor/Outdoor Home and School

10 Asthma Education-School Nurses Professional development days by Baystate Pulmonary Rehabilitation Dept. Certified Asthma Educators and school nurse asthma champions Special event training by ALA/AAFA national speakers Yearly updates

11 Asthma Education- Teachers Online training at Northeastern University School Health Institute website- Presenter: Michele Hart RN, BSN, AE-C, Pulmonary Rehabilitation, Baystate Medical Center Developed by PVAC, ALA and Baystate Pulmonary Rehab Marketing to Teachers have children with asthma in class bring inhalers on school field trips Free Professional Development Points available

12 Asthma Education Students and Parents Students Elms and UMass nursing students facilitate ALA evidence-based self-management Open Airways and Kickin Asthma programs Presentations for school assemblies and classes Parents Weeding out Asthma Triggers School Nurse 1:1 Train-the-trainer modules for parents, students, teachers

13 School Asthma Champions Provide leadership and training on asthma to other SPS nurses, teachers, parents and students Advocate for best practices on asthma management in schools including increase use of Asthma Action Plans Increase use of spacers reduce environmental triggers in classroom Coordinate and conduct outreach on trainings and asthma-related activities Share asthma resources Encourage and support better data tracking on asthma Participate in planning committees

14 Asthma Resources Open House toolkits Asthma resource library PVAC materials PVAC videos/website

15 Asthma Education

16 Other Policy Activities Support for IAQ policies and procedures Support for PBRM IAQ efforts Education for teachers on how to report IAQ issues Implementation of anti-idling law Fragrance concerns added to Asthma protocol

17 Asthma documentation Modified the student electronic medical record (SNAP) to more effectively track asthma measures Asthma measures for reporting Asthma treatments Asthma alerts Asthma action plans Medications Contacts Dismissals Trained school nurses on how to document asthma data so it can be accurately retrieved for asthma reports

18 Asthma Alerts Increase accuracy of asthma alerts Alerts based on physician diagnosis, Possible additional decrease 24% 23% 23% 22% 22% 21% 21% 20% 20% 19% 19% SPS Percentage of Students with Asthma Alert mid year

19 Asthma Action Plans Requested for students on controller medications in the nursing office 2x /week 800 SPS Asthma Action Plans Requested Signed/filed

20 Asthma Treatments Unexpected visits Usually longer, more complex Decreasing trend Scheduled visits Shorter, quick return to class Increasing trend in scheduled visits 3500 SPS Asthma Treatments Unexpected asthma visit Scheduled asthma visit

21 Asthma Dismissals down by 1/ SPS Asthma Dismissals dismissals for asthma & breathing concerns :

22 ER Dismissals down by 2/3 70 SPS ER Dismissals ems activation for asthma & breathing concerns :

23 More kids in class Estimated 780 dismissals are avoided Back to Class Ratio % ( ) 93% ( )

24 More kids in class Back to class ratio increases from 85% to 93% 780 more kids sent back to class over 3 years

25 Lynn Rose Environmental Health and Safety Coordinator Springfield Department of Parks, Buildings and Recreation Management

26 Program Goals Improve student and staff performance and attendance rates. Reduce health impacts due to building environmental conditions. Benchmark and improve EHS compliance in Springfield s school and municipal buildings.

27 School Contractors IPM, Asbestos Haz & Solid Waste Food Service HVAC/Energy Developed a Multi-Disciplinary Team-Based Structure School Departments Facilities Business Custodial Career and Tech Ed Science and Art Nurses/Health Human Resources Safety State & Federal Agencies Public Health Occupational Safety Environmental School Community Parents Unions Professional Associations District Level Environmental Team Municipal Departments Health Public Works Fire/LEPC Parks Capital Construction Human Resources

28 Methodology Created a Environmental Committee with technical staff and high level administrators that meets bimonthly. Created a modified version of an Environmental Management System (EMS) with these components: EHS roles and responsibilities An environmental budget An assessment system An environmental recordkeeping system An EHS Training Program Environmental management plans for specific environmental issues Operational Controls and Tools

29 How Does an EMS Work? It guides you to work together across all departments and job titles to develop and implement a system to: identify your EHS issues, evaluate them, prioritize them, strategize how to address them develop tools and plans, and check your progress!

30 IAQ Management Plan - Elements Conducted a gap analysis - IAQ surveys, environmental health surveys, building & compliance assessments as a basis to develop program Created and implemented the following program components: An IAQ complaint system An HVAC Preventative Maintenance Program A training program for nurses, teachers, custodians, tradesmen, administrators, etc. Guidance documents and work practices to prevent contamination Third party certified standards for cleaning/maintenance materials Toxics use reduction standards for curriculum products Mitigation of moisture intrusion and proper mold mitigation Capital Projects - window projects, roof projects, carpet removal, etc.

31 Outcomes Increased awareness of IAQ issues, prevention and response Faster and more effective response to IAQ complaints Improved maintenance planning based on identified building conditions Reduced occupant and worker exposures to toxic cleaning and curriculum products, FFE, etc. Improved pest management

32 Asthma Friendly Schools

33 Next steps City ordinance to cover IAQ issues for both schools and municipal buildings City ordinance to prohibit new schools near major roadways/mitigation for existing schools Sustainable funding for school nurse asthma champions