Nurse practitioner adherence to national asthma guidelines .

摘要

Asthma is the most common childhood disease. It affects nearly 5 million children. The National Asthma Education Prevention Program (NAEPP) published guidelines for the diagnosis and management of asthma in 1991. There have been numerous studies examining the guidelines and their impact on care; however, no study describes nurse practitioner compliance with guidelines. This study's purpose was to determine the extent to which nurse practitioners, who care for children with asthma in the primary care setting, follow asthma guidelines. Self-reported typical practice answers were collected from participants, who were either members of the National Association of Pediatric Nurse Practitioners, or members of a listserv through Nurse Practitioner Central. Results. The final number of participants was 262. Five domains: classification, evaluation and monitoring, medication, follow-up, and referral were analyzed. The mean score for the case vignettes was 75%. There was no correlation between how well NPs did with the vignettes and years of experience. Conclusions. Nurse practitioners are familiar with asthma guidelines and use them in their practice. They show adherence to guidelines in the step approach to pharmacotherapy, when to refer, and in evaluation and monitoring. Areas for improvement include more frequent monitoring, and optimizing the dose of daily-inhaled steroids.