Journal of Asthma & Allergy Educators

In conjunction with a community partnership with the American Lung Association, the Broome County Health Department, the Asthma Coalition of the Southern Tier, and the Decker School of Nursing, the American Lung Association’s Open Airways for Schools program was integrated into a nursing curriculum and implemented by nursing students in several local elementary schools. Analysis of pretest/posttest data demonstrated a statistically significant improvement in asthma self-management for the students enrolled in the program. Improvements included knowing when to take medicine, ability to determine when they might start to wheeze or cough, ability to identify asthma triggers at home or at school, ability to remember the steps to take when having asthma symptoms, ability to stay calm during an asthma episode, ability to talk with their teacher about asthma and classroom triggers, ability to determine when to go to school with asthma symptoms, and ability to know when to contact the doctor or go to the emergency room (P < .05). Feelings about having asthma also demonstrated improvement (P < .05). No significant findings were found for knowing how much asthma medicine to take or being able to tell an adult that they are having asthma symptoms. Results of this study suggest that a collaborative partnership with a school of nursing has the potential to affect the health status of the community and provide sustainability for those activities that created the positive change. Integrating Open Airways into a nursing curriculum addresses a well-documented need for increased asthma management education for the student with asthma.

Biomarkers, or “markers,” are used to measure an aspect of the biology or physiology of health and clinical disease. In the case of asthma, the most desirable biomarkers measure airflow obstruction caused by inflammation. Although many biomarkers have been proposed to assist in the diagnosis of asthma and to indicate the degree of disease severity or responsiveness to treatment, few are noninvasive, inexpensive, or measure clinically important aspects of disease activity. Currently, spirometry is the only established biomarker used to confirm the diagnosis and determine lung health. However, the National Heart Lung and Blood Institute’s Expert Panel characterizes other biomarkers of particular interest in asthma. This review will compare and contrast spirometry (something old) with one of the newly proposed biomarkers–fractional exhaled nitric acid (something new)–with respect to what aspects of asthma they propose to measure, what they do measure, and what sources of systematic and random error arise in the measurement of these variables.

Spirometry is a valuable tool for diagnosing asthma, establishing the severity, and assessing the control of asthma over time in those patients who can perform the procedure. Response to bronchodilator also helps in diagnosing the disease and assessing control. Guidelines and standards are available to help perform and interpret spirometry and response to bronchodilator tests. These guidelines come from the American Thoracic Society, the European Respiratory Society, the National Asthma Education and Prevention Program—Expert Panel Report-3, and the American Association for Respiratory Care Clinical Practice Guidelines. The objective measurements, especially in the forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and the FEV₁/FVC, enable proper management and provide continuing assessment to check the effectiveness of therapy and to follow the disease over time.

Introduction: The Centers for Disease Control and Prevention report that the number of individuals with asthma in the United States has increased by 4.3 million, or 12.3%, between 2001 and 2009, creating an increasing burden on our health care system. Effective patient education is a key component of asthma management. The National Asthma Educator Certification Board (NAECB) promotes “optimal asthma management and quality of life by advancing excellence in asthma education through the Certified Asthma Educator process.” Methods: Following completion of the asthma educator certification examination, applicants were invited to participate in a voluntary, anonymous Web-based survey. The survey was developed and approved by the Executive and Research Committees of the NAECB, with the objective of reviewing the experience of applicants seeking initial certification and of those seeking recertification. Results: Completed surveys were obtained from 988 applicants. Seventy-six percent of respondents were first-time test takers; the remaining respondents were repeat test takers. Eighty percent reported having passed the examination. Approximately 85% felt that the time allotted for the examination was “just right”; the level of difficulty was “ just right” for 65% of the respondents, and the clarity of the examination questions was rated as “good” or “excellent” by 72% of the respondents. Seventy-two percent responded that the examination reflected the role of the asthma educator and 88.1% would recommend the examination to others interested in asthma education. Open-ended responses highlighted benefits and barriers. Discussion: The asthma educator certification examination is reflective of the professional responsibilities of the asthma educator. Benefits and barriers are discussed in the context of published literature.