Open Airways for Schools (OAS)

A program of the American Lung Association, implemented in Office of School Health, Department of Health Anne Arundel County, Maryland.

Strengths/Challenges: Replicated Program

In Anne Arundel County, success for OAS is defined as (1) fewer student visits to the nurse or health room, (2) an increase in students’ recognition of asthma symptoms and their levels of severity, and (3) increased use of inhalers and spacers. Although a formal evaluation has not been conducted, respondents identified several key strengths of the program that contribute to its perceived success.

Strengths

Pre-Packaged Open Airways for Schools Kit
Using the OAS Kit enables session leaders to follow a previously evaluated format for teaching asthma self-management. This practice is especially beneficial for the nurses who do not have a teaching background. Nurses report that the prepared seminars and curriculum provide them a kind of “safety net” and an opportunity to focus on teaching the children instead of having to focus on developing teaching tools and activities.

Solid School Foundation
OAS operates in a county with solid experience with school health programs. The county has both a framework for school health and a network of people interested in its success.

Part of a Larger Initiative
In Anne Arundel County, OAS operates within the context of AMP and the school nursing program. In this way the program has a “home” and can flourish. AMP offers school nurses a set of guidelines and resources to facilitate monitoring students with asthma, while OAS offers nurses the tools to educate elementary schools students about how to manage their asthma. Not only does AMP result in improved coordination of services but it also promotes consistency in asthma management in the county school system.

Flexibility
Nurses in Anne Arundel County have indicated how important it is that instructors have the flexibility to alter the delivery of the OAS program to either better meet the needs of students with different learning styles or maximize limited resources. However, in the absence of a formal evaluation, it is unclear how altering the format and/or delivery of the program affects its effectiveness.

Challenges

Time missed from regularly scheduled class: Students participate in educational sessions during school hours. As a result, they often have to miss a regularly scheduled class. Nurses report that some parents and teachers are reluctant to have a child miss classroom instruction and possibly fall behind his or her peers. In addition, OAS is one of many activities in the schools with which teachers have to compete with for their students’ time. Nurses report that, whenever possible, they try to hold class during the lunch break to avoid causing the student to miss class. When students must miss class, nurses communicate with both parents and teachers to explain how teaching children with asthma to better manage their disease results in benefits not only for students but for parents and teachers as well. In fact, the amount of time that a child spends out of class is less than or equal to one school day missed due to asthma, which he or she will easily make up for in learned asthma management skills. Healthier students learn better and have lower rates of absenteeism.

Community Outreach
Although OAS in Anne Arundel County is part of a larger county-wide initiative, neither AMP nor OAS partners with other sectors of the community besides the Department of Health. As a result, very little advertisement exists of the program’s availability or success. Staff members report that greater visibility would facilitate efforts to raise funds to purchase “extras” the program needs, such as peak flow meters and nebulizers. It is important to note that the State Department of Health and Mental Hygiene now has an asthma coordinator responsible for building community partnerships.

Staff Turnover
Currently, the annual turnover rate among school nurses in Anne Arundel County is 30%. In addition, the county and state experienced a general nursing shortage last year that led to staff shortages for OAS as well.