Hello all,                                                                                                                      I work at a children's medical. We are trying to develop an asthma boot camp in hopes of getting families actively engaged in the treatment and care of patients while in the hospital, in other words, patient/family "activation". The boot camp will be for families and patients. The asthma educator, nurses, respiratory therapists, case managers, and physicians will all have responsibilities in teaching families and patients as part of the boot camp. I pose these questions to anyone who would like to answer them, and I thank you in advance.                                  1. How do we assess family and patient prior asthma knowledge/skills?                2. How do we help families and patients recognize their knowledge/skill deficits? 3. How do we ensure they understand the knowledge/skills they are taught?

Carolyn: great idea!  In the past when we have done group in-patient asthma education we utilized pre and post-tests for assessing knowledge. If you go that route, I suggest limiting the questions to 3-4 at the most and make sure the literacy level is at a 3rd or 4th grade level (5th grade is the absolute highest you should go) and that you assure participants there is no pass/fail.  Explain to them that the pre-test helps you know, as an instructor, what you need to focus on and the post-test lets you know how effective your teaching was.  If more than one person is providing the education then make sure all teaching from the same script, so to speak. I agree with Mike to focus on just a few things because of what he explained. However, we did touch on triggers because our AAP is individualized to include the patient's known triggers. We, too, did not focus on potential triggers but those that have been identified as that patient's specific triggers. (It was rare that no triggers were identified.  In that case we used URIs and smoke, especially tobacco smoke.) 

We no longer use group in-patient education and do our education one-on-one at the bedside. Education is primarily provided by RTs although nurses and MDs / APRNs also provide education. We have developed a bedside education check-list (hard copy that is scanned into the EMR at discharge) so that all can see what education has been given and what is still needed. As Mike said, the length of stay is so short (about 1 day) that we have to limit what we focus on: what is asthma, asthma symptoms (the 3 S's: swelling, squeezing, and snot), meds used for control and symptoms (ICS and SABA),  how delivered (especially correct spacer technique and that spacer deposits med into lungs more efficiently than no spacer), trigger control and/or avoidance, and and using the AAP (that is at the bedside) as our vehicle to explain daily meds, how to treat symptoms, and when to seek urgent / emergency care, 

Hope this helps, too!

Ellen O'Kelley, PNP, AE-C, Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Vanderbilt University School of Medicine and Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN