Question: What are the best nursing treatments and preventions for asthma attacks?
Introduction
Asthma is one of the most common chronic inflammatory diseases known worldwide, and its prevalence is increasing, especially among children ( 2005, ). For this essay, a critical evaluation of five research-based articles will be made to explore the reported best nursing treatments and preventions for asthma attacks. After the critical evaluation of each article, a conclusion or synthesis will be made as to indicate which methods are deemed most successful. The topic was of particular interest due to the fact that many individuals, especially children have asthma due to pollution and exposure to harmful elements in the environment. Children are the ones given priority in this essay because being young, they are not yet able to express themselves in terms of the condition they are in and the pain or suffering they are feeling or experiencing. In this regard, this critical evaluation will be able to serve the purpose of informing and educating the readers on the best nursing practices that could help prevent and treat asthma attacks among children.
Article One
Introduction – The first article was written by , . in 2003, and is entitled, “Impact of Nurse-led Outpatient Management of Children with Asthma on Healthcare Resource Utilisation and Costs”. The aim of this research study was to demonstrate the efficacy of hospital-based outpatient follow-up of children with asthma, which is considered comparable to the follow-up done by pediatricians in terms of clinical outcome and quality of life ( 2003). From the introduction, the background of the problem was not explained thoroughly, thus, not furnishing a reasonable weight to identify the problem. It is necessary to describe and put weight on the background of the study, as it clearly establishes the problem existing to identify the research study ( 2006).
Literature Review – The article failed to provide a cohesive literature review, which supposedly must be able to emphasize on putting together theories and findings from other studies done in the same field in order to have a larger picture of the field of research (‘’ 2005). However, despite the lack of a cohesive and a separate discussion for the literature review, the research study was able to use helpful sources that support their findings. There are a number of good literatures to support the argument of the authors. However, 42% of them are more than 10 years old thus, make some of the literatures too old to be used as references. The fast-paced development of the Internet should be useful in this sense.
Methodology – The data needed for the research study were obtained through direct observation and interaction with the respondents of the study. Follow-up check-ups by an asthma nurse or pediatrician were scheduled for 12 months. This type of data collection uses a descriptive approach, specifically a qualitative research that seemed to produce significant lower amounts compared to data collection through surveys or questionnaires or quantitative research. In addition, accurate and relevant data were gathered from respondents, which enable asthma nurses have immediate contact, communication and interaction with the patients. In this regard, the descriptive research method, specifically the qualitative method used by the researchers was appropriate for the study.
Results – Findings of the research study suggest that the costs of nurse-led outpatient management of childhood asthma are lower than traditional asthma management by a pediatrician. This finding was derived based on the analysis of the costs of expenses generated in the research study in the duration of the research study, which was perceived to be realistic.
Implications – This finding presents a number of implications such as the management of wages of asthma nurses, the reallocation of investments in employing asthma nurses, and the considerable public relations efforts to emphasize the new approach.
Article Two
Introduction – The second article considered for this critique is the article done by , in 2006, entitled, “Life-threatening Asthma and Anaphylaxis in Schools: A Treatment Model for School-Based Programs”. The aim of this research study is to implement and study a school-based program for the treatment of life-threatening asthma and anaphylaxis in the Omaha public schools or OPSs. From the introduction, a reasonable weight in furnishing the background information of the research was identified. Primarily, the authors were able to state the significance of the research study to the current situation of schools due to the presence of increased incidences of death caused by asthma attacks in children. Consequently, the authors were also able to diagnose from previous research studies that asthma-related deaths were largely attributed to the lack of life-saving mediations from academic institutions (2006).
Literature Review – Similar to the first article, this article did not provide a separate discussion on the related literature that could support the arguments and the findings of the study. However, a number of good literatures to support the argument of the authors were used, with only a small number of outdated literatures, making up 34% of the total references used. In this regard, the literatures used to support the arguments of the authors are updated and relevant.
Methodology – The data collected for the research study was obtained from August 1998 to June 2003, considering 78 schools within the OPS system, where the Emergency Response to Life-Threatening Asthma or Systematic Allergic Reactions Protocol was established and implemented. Treatment was administered through epinephrine and/or albuterol, which was facilitated and documented by the school nurse. Data were gathered through the documentation of cases from schools, thus, monitoring the patients’ medication and progress, dating back from the first asthma attack under the implementation of the protocol. Theoretically, this study employs a systematic random sampling method, which is appropriate in obtaining the needed data and in answering the problem of the study, because with this method, the researchers are able to determine the characteristics of their sample population based on the situation. Particularly, a descriptive method, or a qualitative approach was used.
Results – The finding or result of this study suggests that a number of asthma patients could be treated once undergone the protocol, with the proper supplementation of education regarding asthma and the medication of epinephrine and/or albuterol, with the emphasis on the role of school nurses. This finding was based on the documented cases of school nurses, with the consideration of the number of actual cases of asthma attacks in academic institutions.
Implications – It can be perceived that the method used in the research study was able to produce significant findings, which presents important implications in the society. These include the increased awareness of paramedics and school staffs for the proper care of their students, the increased security and peace of mind given to parents due to their belief with the success of the implementation of the protocol, the emphasis on education about asthma, and the implementation of regulations that mandated schools. In this regard, the protocol was able to become both a preventive measure and treatment of asthmatic children.
Article Three
Introduction – The third article considered for this critique was written by and in 2005, and was entitled, “Chronic Care for Low-Income Children with Asthma: Strategies for Improvement”. The aim of this study was to provide potential strategies that could assist policymakers and purchasers of health care and health insurance improve care for children with asthma. The study was able to provide reasonable weight in furnishing the background information of the research, as the authors were able to emphasize that many children with asthma fail to obtain the care they need, especially in relation to racial or ethnic issues, based on the number of absences among white, African, and Hispanic children ( and 2005). Thus, the background of the article is clearly established to describe the problem existing for identifying the research statement ( 2006), which is the decreased managed care provided to asthmatic children despite the presence of a number of programs.
Literature Review – A substantial and relevant literature review was provided in the study, which supported the essentiality of using a number of asthma management strategies in order to improve the conditions of asthmatic children. Its discussion was able to emphasize the problem of the study, and stress that managed care can be provided to patients with the assistance of proper education and interventions. There are a number of good literatures to support the argument of the authors, as 88% of the total literatures were updated, recent and relevant set of literatures, compared to 12% of literatures, dating more than 10 years. This means that the authors have used updated literatures in support of their research study.
Methodology – This research study included clinicians at 73 practice sites, who answered a survey to assess how frequently their practices correspond to asthma care for poor populations. Personal survey techniques are appropriate for this research study based on the reasons of obtaining feedback, probing for complex answers, the high probability of completing the questionnaire, and the high participation of respondents ( 2006). However, although the data collection methods provide advantages, adopting the technique is too costly or expensive compared to other means. Specifically, this study used a descriptive approach, employing a quantitative method of data gathering, as indicated with the use of surveys and questionnaires.
Results – This study maximized the use of secondary research data more than primary research data, which allowed the researchers to conclude that intervention strategies, including social-based programs involving asthma education, interactive seminars for physicians, and training programs for intervention staff found to be successful in improving asthma care ( and 2005).
Implications – This study emphasizes on the importance of education in addressing the problems with asthma attacks, regardless of race or ethnicity. Providing education is one of the low-cost strategies that can be implemented in order to allow improvement in management and care of asthmatic children.
Article 4
Introduction – The article was written by and in 1995, and entitled, “Proactive, nurse-run asthma care in general practice reduces asthma morbidity: scientific fact or medical assumption?”. The aim of this study is to compare the outcome of asthma care in two similar practices, where the other one involves a traditional approach and the other a proactive, nurse-run care for asthma. From the introduction, the background of the problem was not explained thoroughly, thus, not furnishing a reasonable weight to identify the problem.
Literature Review – This article did not provide a separate discussion on the related literature that could support the arguments and the findings of the study. It also failed to provide support or discussion on the arguments that the paper have presented, thus, not thoroughly substantial and coherent. Because the article was written more than 10 years ago, it follows that its references or sources were written a few more years back. This is considered acceptable as only one reference used was aged more than 10 years old.
Methodology – In both practices, 100 respondents were considered, having the age range of five to 65 years old. A random sampling method was used, which considered all respondents to have equal chance of being included in the research study (. 1978). The data needed for the research study were obtained through direct observation and interaction with the respondents of the study. Thus, employing a descriptive research data collection method, specifically, a qualitative approach that seemed to produce considerable results, as accurate and relevant data were gathered from respondents, which enable nurses to have immediate contact, communication and interaction with the patients.
Results – A total of 141 patients were able to participate and complete the study, entailing tedious efforts and long periods for conduction and completion. In addition, nurses, who need to put extra work with the computer, accomplish letters, and increase telephone enquiries from patients involved in the study, experienced additional work pressure ( and 1995). In the end, the findings of the study indicate that no observable difference can be detected between the two practices. In essence, the effectiveness of nurse-run asthma care cannot be answered directly.
Implications – With such finding, one of the implications of this research study is to emphasize on training and practice of asthma nurses to be able to instill in them the importance of providing extra care for patients with asthma because of the need ( and 1995). In addition, an implication that can be stressed upon is the improvement of practice teams to become innovative and well resourced to provide good asthma care. Lastly, it can be understood that this article was able to make readers realize that effective and careful planning must be done accordingly before adopting and implementing new practices in addressing asthma.
Article 5
Introduction – The last article considered for this critique is the research study done by in 2004, entitled, “Tracking Pediatric Asthma: the Massachusetts Experience using School Health Records”. The aim of this study is to describe the results of the Massachusetts pediatric asthma surveillance project, which could be used for its project goals for 3 years. From the introduction, the authors were able to successfully provide a reasonable background for the problem of the study, which emphasizes the lack of useful data regarding asthma cases in the area.
Literature Review – The literature review of the research study is relevant and simple, such that its discussion of the perceived related concepts in line with the problem of the study is basic and direct. However, it would be more helpful if the authors were able to provide a separate and thorough discussion of related literatures that would further support their argument. In addition, the study used relevant and good references, which are all recent and updated. This proves to show that the research study is reliable and credible.
Methodology – To be able to obtain the needed data, school nurses were asked to complete a pediatric asthma surveillance form that would indicate the number of children with asthma by gender and by grade. It employs a systematic random sampling, where the target population includes all schools participating in the MDPH Essential School Health Service program. School nurses were asked to provide information contained in school health records, which involve the distribution of forms, emailing them or calling them to update records and instigate response. This also employed a descriptive type of data collection method, specifically a quantitative approach. However, although the descriptive quantitative data collection method provides advantages, it is too costly or expensive compared to other means.
Results – The research study was successful in indicating that the school-based pediatric asthma surveillance system was effective in obtaining data from schools regarding the conditions of asthmatic students. In addition, through the collaboration with school nurses, a surveillance system was obtained, which is responsive to the concerns regarding impacts on schools ( 2004). In this regard, the surveillance system developed acts as a preventive measure, which could be helpful for nurses to track down and monitor the conditions of asthmatic children in Massachusetts.
Implications – This research study can be used in order to implement a nationwide surveillance tracking system for pediatric asthma that would increase the awareness of citizens regarding the situation. In this regard, the role of nurses would be given emphasis, being responsible for obtaining relevant data and keeping records.
Conclusion
From the discussion, it can be deduced that with the increase in the knowledge and information of individuals in terms of nursing practices, several methods and strategies are being developed in order to address the problem with asthma attacks. Based on the critique done, majority of the programs or systems discussed in the five articles can be regarded as preventive measures, which emphasizes the role that education play in the improvement of asthma care and management in children and adults as well. In addition, it can be concluded that further research needs to be done before an adequate judgment can be made. However, most of the articles pointed out that along with the administration of medicines, such as epinephrine and albuterol are the support, care, and knowledge of nurses, who play a very important role in the treatment and prevention of asthma in children.
References
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