According to the Centers for Disease Control and Prevention (CDC), asthma is the leading chronic illness among children and adolescents in the United States. Asthma affects 7.1 million children under the age of 18, is the third leading cause of hospitalizations in children under 15, and is one of the leading causes of school absenteeism. One team of school nurses and community health leaders aim to combat this health issue in Ohio, as part of the Johnson & Johnson School Health Leadership Program (JJSHLP).
Michele Wilmoth, MSN, RN, LSN, NCSN, director of school health services at Akron Children’s Hospital in Akron, Ohio, is a program Fellow who is part of the asthma management project.
NN: What is the asthma management initiative and the work that you did with your team?
Michele: As part of the fellowship training through the JJSHLP, the team conducted a needs assessment to identify community health issues. Asthma was identified as the health issue most salient to the local community and to Akron Children’s Hospital. The team’s overarching project goal was to improve asthma management in the school setting, thereby decreasing overutilization of acute medical services such as emergency room visits and/or hospitalizations for asthma management.
NN: Why did you choose this initiative and why do you think it is important for patients?
Michele: Asthma is a prominent health issue in children and adolescents in Ohio. According to a 2012 study by the Ohio Department of Health and Vital Statistics, one person in Ohio dies of asthma every 2-3 days. Of those asthma-related deaths, one mortality a month is a child. Through the program, I saw a tremendous opportunity to work with our youth to improve asthma management through healthcare in the schools.
NN: What challenges did you face in the process and how did you overcome those obstacles?
Michele: In Ohio, there is no mandate for schools to employ nurses. Many of the actual care providers in Ohio schools are not Registered Nurses/School Nurses but are considered care extenders (unlicensed health professionals and school staff). We started by addressing the knowledge gap around asthma management in the school population (school caregivers) while also setting goals and priorities of working with individual student outcomes to improve asthma management.
NN: How has the project transformed your approach to patient care?
Michele: Sometimes we get excited about a program and what the possible outcomes will be for our patients/students, and we want to jump right in to implementation. One big lesson I learned is for community change to be sustainable, we need to spend a significant amount of time in the planning stage. Also, don’t forget to celebrate milestone achievements. You have to create a lasting momentum for change to occur.
NN: What were the top two key learnings from this experience?
Michele: The Johnson & Johnson School Health Leadership Program introduced us to tools for project management. We developed a logic model to create an enduring change plan. The logic model approach has really helped us tackle a big issue like asthma – establishing planned activities with measurable expected outcomes.
NN: Personally, what is the biggest reward of participating in the Johnson & Johnson SHLP?
Michele: The biggest reward that I did not expect was the amount of networking with other like-minded professionals working in the school community across the nation. It continues to this day. We share best practice ideas, a passion for student health and academic success, and we are a supportive community for school nursing practice.
NN: What advice would you give to nurses wishing to help advance nursing innovation?
Michele: Be a voice at the table. Don’t wait to be asked. If you have an idea, challenge yourself to take the next step.
NN: How has the Johnson & Johnson SHLP impacted you as a nurse or helped you in your nursing career?
Michele: School nurses often work in silo, in their community, in their school. The Johnson & Johnson School Health Leadership Program pushes you outside of your comfort zone and into the community to look at big change with big impact. The program teaches you how to have the courage to do great things, and most importantly, that anyone can make a difference.