1. The Challenge Before Us: Development, Implementation and Evaluation of a Paediatric Asthma Resource Nurse Workshop Tracey Marshall and Jane Gauci Asthma Educators The Department of Respiratory Medicine The Children’s Hospital at Westmead

2. Challenge To build capacity of the existing nursing workforce at The Children’s Hospital at Westmead (CHW) and Western Child Health Network (WCHN) To build capacity of the existing nursing workforce at The Children’s Hospital at Westmead (CHW) and Western Child Health Network (WCHN) To develop a comprehensive and interactive Paediatric Asthma Resource Nurse Workshop (PARNW) To develop a comprehensive and interactive Paediatric Asthma Resource Nurse Workshop (PARNW)

3. Development Why was this workshop needed? No asthma workshop that met the needs of nurses working in paediatric clinical setting in our Area Health Service No asthma workshop that met the needs of nurses working in paediatric clinical setting in our Area Health ServiceFunding: From WCHN and Department of Respiratory Medicine CHW for the Asthma Education and Management Project From WCHN and Department of Respiratory Medicine CHW for the Asthma Education and Management Project

4. Development Asthma education and management is a vital part of our role in caring for the child and family with asthma Asthma education and management is a vital part of our role in caring for the child and family with asthma Improving organisational culture: Team approach from nursing, medical, allied health staff and the community Improving organisational culture: Team approach from nursing, medical, allied health staff and the community

5. Implementation Pilot workshop in 2002 Pilot workshop in 2002 2 -3 workshops per year 2 -3 workshops per year PARNW is a two day workshop - held on consecutive days PARNW is a two day workshop - held on consecutive days Offered free of charge to nursing staff at CHW Offered free of charge to nursing staff at CHW

6. Challenge and Change Overcome perception that asthma education is one person or one service responsibility Overcome perception that asthma education is one person or one service responsibility Asthma education and management is a part of our everyday clinical practice Asthma education and management is a part of our everyday clinical practice Underpin clinical and educational practice with Practice Developments concepts Underpin clinical and educational practice with Practice Developments concepts Advanced accreditation for Registered Nurses on Medical Wards to stretch Inhaled Ventolin Advanced accreditation for Registered Nurses on Medical Wards to stretch Inhaled Ventolin

7. Aim and Objective Aim: Increase the knowledge, skills and confidence of nurses caring for children with asthma in an acute setting Increase the knowledge, skills and confidence of nurses caring for children with asthma in an acute settingObjective: Identify and address clinical, community issues related to paediatric asthma management and education Identify and address clinical, community issues related to paediatric asthma management and education

8. Program Design Developed using feedback from nursing staff at CHW Developed using feedback from nursing staff at CHW Frame work is the NAC six step asthma management plan Frame work is the NAC six step asthma management plan Modules contextualised to paediatric setting using case studies Modules contextualised to paediatric setting using case studies Pre and post confidence, knowledge, skills assessment and process evaluation Pre and post confidence, knowledge, skills assessment and process evaluation

9. Program Design Based on adult learning principles Based on adult learning principles Small and large group work Small and large group work Interactive teaching sessions and role play Interactive teaching sessions and role play Comprehensive resource folder Comprehensive resource folder

10. Program Content-Day One Registration and welcome Registration and welcome Overview of National Asthma Council Overview of National Asthma Council Pathophysiology review Pathophysiology review Assessing asthma Assessing asthma Asthma medications Asthma medications Monitoring asthma Monitoring asthma Asthma in the community Asthma in the community Respiratory assessment Respiratory assessment Homework Homework

11. Program Content-Day Two Stretch inhaled ventolin- asthma care path Stretch inhaled ventolin- asthma care path Inhalation devices Inhalation devices Triggers Triggers Adherence Adherence Reducing medication and asthma action plans Reducing medication and asthma action plans Asthma education Asthma education Knowledge to practice Knowledge to practice Evaluation Evaluation

12. Results Asthma Knowledge Score

14. Results Confident & Very Confident in:

16. Results Example of some performed steps correctly when using a puffer with spacer

17. Process Evaluation Interactive sessions Interactive sessions Increased skills and confidence using inhalation devices Increased skills and confidence using inhalation devices Understanding of asthma severity Understanding of asthma severity Understanding of asthma action plans Understanding of asthma action plans Great workshop and should be a part of new graduate education days Great workshop and should be a part of new graduate education days

18. Self Reported Confident Level-Day One XXX XX Not at all Confident Very Confident Confident XXX

19. Self Reported Confident Level- Day Two Not at all Confident Very Confident Confident XXXX XXXX XXX

20. Future Directions Continue to challenge existing practice Continue to challenge existing practice -Stretching of Inhaled Ventolin -Asthma Care Path -Underpin workshop with Practice Development concepts Evidence based practice Evidence based practice 5 year outcome evaluation 5 year outcome evaluation

21. Future Directions Publication of results Publication of results Capacity building at CHW and SWAHS Capacity building at CHW and SWAHS Clinical assessment tools for: Clinical assessment tools for: -Asthma education sessions

22. Child and Family Research Education lies at the interface of research, clinical and community management Clinical Management Health Professionals Community Management