703 Audit of the Use of a Written Asthma Action Plan in a Busy Pediatric Unit

Abstract

Background and aims: A written action plan (WAP) is recommended for all patients with asthma, particularly those who have moderate or severe exacerbations, frequent or poorly controlled asthma.Our hospital introduced a new WAP 1 year ago, which we are now auditing. The WAP should be provided to all pediatric asthma patients on discharge.Methods: A retrospective audit was carried out identifying all asthmatic patients admitted to the pediatric ward during November 2009. Patient's notes were pulled and checked for the presence of a WAP. When a WAP was present it was assessed for completeness using a questionnaire.Results: 29 asthmatic patients were discharged from the pediatric ward from 1st through 30th November. 20 of these admissions were with asthma, 1 patient was admitted twice. A WAP was identified in 3 of the patients' charts. The WAP was complete in 1 case and incomplete in 2 cases. In an additional 3 cases the nursing staff documented that the patient was discharged home with a WAP, although a copy of the WAP was not found in the notes.Conclusions: The BTS guidelines for the management of asthma, including provision of a WAP for all patients with moderate to severe asthma, should be reviewed with each new group of doctors biannually. The WAP, the patient's notes and the kardex should state which asthma medications the patient is taking and their doses. The dose of rescue steroids for home use should be stated on the WAP if prescribed.