by Jo Massey and Jakki Sutherland (also known as CHAH Asthma)
We are the Children’s Asthma Service in Croydon, part of the Children’s Hospital at Home Team at Croydon Health Services NHS Trust. There are two of us in our team, and we are both full time Children’s Asthma Nurse Specialists. We have a real passion for improving long term health outcomes for children and young people with asthma. Over the past 18 months we have been working hard to develop our service in order to meet the needs of our patients, and provide the best asthma care possible.
Croydon has one of the highest number of emergency asthma admissions in London and with only two of us, there is a lot of work for us to do! Luckily, our general paediatric consultants see children with asthma in their outpatient clinics, and we have monthly clinical supervision with a paediatric consultant who has a special interest in asthma and allergy.
Promoting the importance of safe asthma care has been challenging at times, but we like a challenge, and the idea behind setting up a Croydon Asthma Champion Programme was one way to help achieve this. Recruiting motivated and enthusiastic champions with a passion for asthma seemed like a new and innovative way to share key asthma messages, such as the importance of taking a daily preventer inhaler, using an inhaler and spacer correctly, and having a personalized asthma action plan.
So how did we get started? Our first step was to identify whether anyone would be keen to take on the Asthma Champion role. We had already established strong working relationships with the Children’s ED and inpatient ward (having both worked there in the past), so we had a fair idea of who would be interested in signing up. We also asked our Trust Communications department to share an Asthma Champion sign-up poster on our Trust intranet page, during the #AskAboutAsthma campaign in 2019.
We were pleased to receive a lot of interest in the role, so the next step was to organize a full-day study day, which we held at our Trusts’ hospital to make it easier for staff to attend. Nine children’s nurses attended, coming from A&E, inpatients, community nursing, day surgery and special schools. The study day consisted of looking at asthma guidelines, medication, asthma action plans, inhaler technique and peak flow measuring. We discussed case studies in groups to make it more relatable, and this generated some brilliant discussions. It also helped us identify our champion’s strengths, knowledge and areas for development.
Our Asthma Champions were also signposted to the Healthy London Partnership’s London Asthma Standards and the London Asthma Toolkit, as well as Asthma UK.
Learning about peak flow and discussing case studies
At the end of a fun and productive day, the newly recruited Asthma Champions decided what they would like their role to look like. We had some fantastic ideas and suggestions, some of which we had never really considered!
Deciding on our asthma champion role
Our Asthma Champions were provided with placebo inhalers and spacers, thanks to our local reps and clinical areas, so that they could teach and support children and families with inhaler technique. This is a fundamental component of successful asthma management.
At the end of the day, we formulated 10 key roles for our champions:
- Educator & Resource; for children, their families and health care professionals. To provide consistent asthma messages across health care settings in Croydon
- Inhaler Technique Checks; making sure spacer devices are appropriate and that the inhaler/device is right for the child. Making sure inhaler technique is correct
- Spacer Care; looking after spacer devices and how to wash them
- Asthma Action Plans; ensuring every child is given an asthma action plan before discharge
- Peak Flow Teaching; teaching correct peak flow technique,
- Making Referrals; identifying children who require asthma support and education
- Education Boards; in clinical areas for patients and other staff
- Smoking Cessation; taking the opportunity to give brief cessation advice
- Signposting; children, families and health professionals to high quality, evidence-based information
- Recruitment; of other Asthma Champions in a variety of settings
So how is it going? Well, since then great things have been happening! We have trained up three more Asthma Champions, meaning we now have twelve Croydon Asthma Champions in total, which is amazing! Our champions have been busy identifying children that need referring to our service, as well as designing educational boards in clinical areas. We have also set up an Asthma Champion WhatsApp group, so that we can keep in regular contact with each other, and so that they can easily contact us for advice. Our champions are also starting to help us spread “Week 38 and Asthma” information in the areas that they work in, and will provide valuable support during the #AskAboutAsthma campaign in September. Most of our champions also now feel comfortable developing asthma action plans for children prior to discharge from hospital.
An asthma education board in the community setting
And the future? There is still a lot of work to do; we are planning to train five more champions within the hospital during the #AskAboutAsthma campaign. We also want to develop and nurture our existing champions, so we are holding a development day to reinforce key messages. We are both really looking forward to finding out more about what they have been up to.
Moving forward, every new member of nursing staff is automatically asked if they would like to become a Croydon Asthma Champion and training for this can be provided during their induction. We would also like to eventually recruit Asthma Champions for primary care settings, such health visiting, school nursing and local GP surgeries.
The COVID 19 pandemic has been a challenging time for all of us, and we are very grateful to our Asthma Champions for their support. We would highly recommend other teams rolling this initiative out in their own Trusts, as working together in this way definitely leads to improved outcomes for children and young people with asthma.
For further information and advice on this programme, you can contact the Children’s Asthma Service on mhn-tr.CHAHAsthma@nhs.net