Running Head: CAPSTONE PART I PICOT ASSIGNMENT
Capstone Part I PICOT Assignment
NGR6970 MSN Capstone Project
Florida National University
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Capstone Part I PICOT Assignment
Asthma occurs in the airways, and the breathing tubes that move air to the lungs thereby tightening muscles in the tubes and narrowing the tubes to become hence making it hard for the child to breathe. Children who experience asthmatic attacks may experience coughing, wheezing, shortness of breath, and chest tightness. Asthma is a common health problem in children, affecting more than 6 million children in the United States (Pate, 2021). According to Johnson et al., (2021), asthma frequently occurs in boys before puberty and more than 8% of children in the U.S. have been hospitalized due to asthma and the rates increase to around 40 % among populations in urban centers.
Asthma patterns vary in every child. Some children experience asthma once after a while or after exercise, others experience the problem more often. In this proposed program, a combination program comprising nursing education in the primary care setting plus normal medication shall be adopted to reduce asthma-related health problems among children aged between 5 and 19 years. It is hoped that this proposed program will reduce/ control the
symptoms and reduce the frequency and severity of exacerbations among this age group within
one year of its implementation.
PICOT Question: In children with asthma between the ages of 5 and 19 (P), does a
combination program comprising of nursing education in the primary care setting plus the
normal medication (I) compared to only using medication (C) moderate asthma exacerbations
(O) over one year (T)?
P (Patient, population, or problem)
The program will focus on children with asthma and aged 5 to 19. As argued by
Pijnenburg, M. W., & Fleming, L. (2020), the common asthma symptoms in children aged five
years and above include coughing at night, and a high-pitched whistling sound made while
breathing out. Experiencing trouble while breathing, chest pains, and discomfort. Even though
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asthma cant be treated, its conditions can be reduced by adhering to an action plan that tracks
symptoms and adjusts treatment when needed.
I (Intervention)
This program proposes an intervention that focuses on a combination program
comprising of nursing education in the primary care setting plus normal medication. Martin
and Brodie (2022) observe that nursing education is key to the management of asthma in
children..Nursing education shall entail empowering nurses and healthcare professionals with
information on the management of a child’s asthma. This will entail steps to take on a daily,
weekly, monthly, and yearly basis, and the need for each step in the management of a child’s
asthma. In addition, nursing education shall involve an action plan that will help in tracking a
child’s asthma in terms of how well the treatment plan is working based on a child’s symptoms
and an analysis of how much the child’s symptoms affect daily activities such as sleep, play,
and learning. Nursing education shall involve programs aimed at tracking how often the child
has asthma exacerbations, side effects of the medications, and learning the danger signs that
need a referral to an asthma specialist.
C (Comparison or control)
The use of maintenance medication has been the long-standing method of managing
asthma. The medications are usually taken daily on a long-term basis to control asthma and
may include inhaled corticosteroids that are breathed in to treat airway inflammation that leads
to asthma, leukotriene modifiers taken by mouth to block the effects of immune chemicals that
lead to asthma, biologics that target part of the immune system to moderate asthma and
combination inhalers that are breathed in to relax muscles in the airways. Quick relief
medicines relieve asthma symptoms right away but do not keep the child’s asthmatic symptoms
from occurring.
O (Outcome or objective)
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The desired outcome of this program is a reduction in asthma exacerbations. It is hoped
that the program will lead to better management of the asthma symptoms thereby leading to a
step down treatment that will involve reducing the child’s medication.
T (Time frame)
The program shall be implemented for one year
Although asthma can occur at any age, children above five years old are the most
vulnerable population when it comes to asthma attacks. Risk factors that make this population
vulnerable include, having an asthmatic family member, food and other allergies, exposure to
tobacco smoke, being around air pollution, and having other health problems such as being
overweight (Reyes-Angel et al., 2022)..
Theoretical Framework/Nursing Theory
This project shall be based on the psychosomatic asthma theory, that forms the basis of
controlling the development of asthma symptoms. This theory is based on clinical and
psychiatric observation of the client and after undergoing testing using psychological and
physiological methods, the theory regards asthmatic conditions as a reaction of predisposed
personality features, heredity factors, and environmental factors leading to a frustration that is
not acted upon but inhibited hence leading to respiratory behavior patterns such as blockage of
the airways, and wheezing.
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References
Johnson, C. C., Havstad, S. L., Ownby, D. R., Joseph, C. L., Sitarik, A. R., Myers, J. B., … &
Gern, J. E. (2021). Pediatric asthma incidence rates in the United States from 1980 to
2017. Journal of Allergy and Clinical Immunology, 148(5), 1270-1280.
Martin, J., Townshend, J., & Brodlie, M. (2022). Diagnosis and management of asthma in
children. BMJ Paediatrics Open, 6(1).
Pate, C. A. (2021). Asthma surveillanceUnited States, 20062018. MMWR. Surveillance
Summaries, 70.
Pijnenburg, M. W., & Fleming, L. (2020). Advances in understanding and reducing the
burden of severe asthma in children. The Lancet Respiratory Medicine, 8(10), 10321044.
Reyes-Angel, J., Kaviany, P., Rastogi, D., & Forno, E. (2022). Obesity-related asthma in
children and adolescents. The Lancet Child & Adolescent Health, 6(10), 713-724.
