337 - Linking school and health systems: Healthcare provider notification following stock albuterol events at school

Publication Number: 2326.337

Alexandra Knitter, University of Chicago, Chicago, IL, United States; Lynn B. Gerald, University of Illinois Chicago, Chicago, IL, United States; Paige L. Hardy, University of Illinois Chicago, Chicago Il, IL, United States; Andrea A. Pappalardo, University of Illinois Chicago, Chicago, IL, United States; Erica Salem, Respiratory Health Association, Chicago, IL, United States; Anna Volerman, University of Chicago Division of the Biological Sciences The Pritzker School of Medicine, Chicago, IL, United States

Background: Research shows few children with asthma have quick-acting inhalers at school. A statewide program (RESCUE) was implemented to provide undesignated quick-acting inhalers to Illinois public schools for use in case of respiratory distress. State legislation and program protocols specify school personnel should notify healthcare providers after an event to support optimal care.

Objective: To evaluate healthcare provider notification after stock inhaler use at school and analyze reasons cited by school personnel for non-notification.

Design/Methods: Albuterol metered dose inhalers were provided to participating Illinois public schools. School nurses/staff registered online and reported each use of RESCUE-provided undesignated albuterol (event). This report collected individual characteristics, event specifics, outcomes, and provider notification. Analyses included descriptive statistics, content analysis, and thematic analysis via inductive coding.

Results: In 2023-24 school year, 656 events occurred requiring stock inhaler use among students across RESCUE Illinois schools (n=2171). In 63% of events, the student had an asthma diagnosis on file at school, and among them, 42% had an asthma action plan on file. For disposition, most students returned to class after stock inhaler use (76%). Fewer left with a parent/guardian (21%) or required EMS transport (1.7%).

Providers were notified in 11% of stock inhaler events. Of 581 events where providers were not notified, 88% specified a reason. Reporting staff provided varied information about event conditions (i.e., severity, medication availability), documentation on file at school (i.e., provider information, asthma diagnosis), notification attempted or occurred (to parent or provider), and known or anticipated next steps (i.e., scheduled appointment). School personnel cited several reasons for not notifying providers: school notified parent (50%), provider could not be reached (34%), and perception that event did not warrant notification (4.4%). While the presence or absence of documentation was noted across responses, 12% of staff cited existing asthma treatment, asthma documentation, or other established care as the reason for non-notification.

Conclusion(s): Despite legislation and protocols requiring notification, few school personnel contacted a healthcare provider after a student used a stock inhaler for respiratory distress in school over one academic year. Efforts to ensure communication and collaboration between school and health systems can help optimize care for students experiencing respiratory events.

Quotations from school nurses and staff citing reasons that healthcare provider not notified after use of undesignated albuterol for respiratory distress in school