Publication Date

Spring 2022

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Ruth Rosenblum


Asthma, exacerbation, evidenced-based training, inhaler, spacer, absenteeism, health office staff, prevalence, disparities, morbidity, health clerks, triggers, rules of two, asthma action plans, training, front office staff, credentialed school nurse, asthma control


This Quality Improvement project (QI) aims to improve the competence and confidence of unlicensed school health staff in identifying asthma symptoms, reading an asthma action plan, asthma care, emergency response, medication delivery tools, and trigger reduction in the school setting. The QI project transpired in an Elementary School District in Los Angeles County, CA. The Project Manager, an asthma instructor trained by the American Lung Association, provided evidence-based Asthma-Basics training for health clerks (HCs), substitute health clerks (SHCs), licensed vocational nurse health clerks (LVN HCs), school office coordinators (SOCs), school office attendance clerks (SOAs), and substitute school office staff (SDO). A descriptive quasi-experimental single group design was utilized with a quantitative pretest-posttest and follow-up test methodology. An online training module, pretest-posttest, and follow-up test were provided using the Google Classroom platform. In addition, participants received a Google Slide deck consisting of 5 slides (see Appendix B) outlining instructions for the training, a link/quick reference (QR) code for pretest-posttest, a follow-up test link, QR code, and an Asthma Basics Zoom presentation link. Tests were composed of 10 Asthma Basics questions and two 6-point Likert Scales for self-evaluation in confidence and competence. The results of the ANOVA were significant, F(2, 56) = 4.23, p = .019, indicating there were significant differences in Asthma Basics Training among the levels of Tests. In addition, the Asthma training data indicated that health office staff established increased competence in identifying asthma symptoms, identifying rules of two, implementing emergency asthma procedures, trigger reduction, establishing a support network, and increased competence and confidence in asthma care.


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