Data Analysis of Arizona Stock Inhaler Program in Pima County, Arizona

Abstract

Purpose: The purpose of this quality improvement (QI) project was to conduct a literature review and formal analysis of a deidentified data set of the Stock Inhaler for Schools program in Pima County, Arizona, and present data-informed recommendations to increase school staff compliance to the standardized protocol for stock albuterol medication administration and future implications to the Arizona Asthma Coalition’s Stock Inhaler Steering Committee. Background: Asthma is a common pediatric respiratory disease contributing to emergency room visits, high health care costs, and missed school days. The number of children diagnosed with asthma in Arizona is higher than the national average, 10.9% versus 9.2% in 2014, contributing to over 7,200 emergency room visits and more than 700 inpatient stays in 2019 for children ages 5-18 years. Symptoms of asthma include difficulty breathing, wheezing on exhalation, cough, chest tightness, and decreased ability to move air out of the lungs due to inflammation in the respiratory tract. In Arizona schools it is not mandatory to employ a licensed nurse, so training to recognize the symptoms of uncontrolled asthma and administer life-saving medication is necessary. The Stock Inhaler for School program is supported through Arizona H. B. 2208 which allows for emergency administration of this medication even if a licensed nurse is not present at the school. Methods: A secondary analysis of deidentified data on compliance with a standardized decision support tool was performed for participating schools in Pima County during the 2022-2023 school year. Recommendations for program improvements were presented to the steering committee. Results: Three school districts with lower compliance rates were identified to complete interviews to determine facilitators, barriers, and understanding of program requirements, specifically the decision support tool. Further evaluation of disposition status was conducted and provided to the committee. The analysis of the data showed that there is a need for further follow-up with schools, data collection, and opportunities to assess barriers to compliance with a decision support tool with individual school districts.