Capstone Project – Asthma in Children
Improving the Management and Control of Asthma in Children within the Community
Asthma is usually identified across several and various communities and environments such as schools, primary care clinics, urgent care centers, home, and hospitals. Weather changes trigger asthma episodes characterized by cough, wheezing, chest tightness, and difficulty breathing. Some other common triggers can be smoke exposure, allergens, sports, and pollen. For pediatrics and adolescents, schools are key settings where asthma control issues become apparent. The goal of this proposed change is to bring awareness and to help with the control and management of Asthma in the community through community education. The purpose of this initiative is to focus on creating a better understanding of the seriousness of the disease among parents, patients, and caregivers, promote early detection, symptom identification, and trigger identification, and prevention to decrease the asthma-related complications, emergencies, hospital visits, and admissions among pediatric patients. It best aligns with the community category, considering its focus on empowering patients, caregivers, and parents in the identification and management of asthma in pediatric populations.
Schools are a key setting where asthma control issues become apparent. A child may become exposed to asthma triggers and develop symptoms requiring intervention from school nurses. Issues can arise with asthma control through mismanagement of medications at home, not enough education about the disease, or poor access to medications and medical services. The population most affected by these issues is school-aged children ages 5-14. Research shows that this age group experiences a proportionately high rate of incidence and prevalence of asthma and asthma exacerbations (Pate et al., 2023). Children in low-income households are disproportionately affected because these kids often live in homes that have poor ventilation, smoke exposure, pest infestations, and poor housing conditions. Children in Rural communities are at risk due to insufficient asthma education, a shortage of physicians and pediatric specialists, and limited access to preventative care services (Pate et al., 2023). The school settings help access children and adolescents from multiple backgrounds, allowing reach to a wider and more diverse population.
The ongoing challenge that Asthma in Children poses is that it requires ongoing and continuous management of the disease. It is a chronic and expensive illness whose management is crucial in the pediatric population. Primary care through education and early intervention is key to the prevention of complications and effective management. A majority of these roles fall under the nursing profession, making the issue crucial to the profession. Since children depend on their parents or caregivers, the effectiveness of education is very important, and making them fully understand what is directly involved in treatment and prevention can be daunting. When education is not clearly understood or reinforced, the ones who suffer and are at greater risk are the children in this situation. So, when educating parents and caregivers, nurses should avoid using medical jargon and use simple language and directions that can be easily followed, and techniques such as teach-back to confirm that information has been well received and understood.
Another implication is time management and recognition of the onset of symptoms. Acting early with asthma patients can prevent the situation from escalating to status asthmaticus, which is a medical emergency. Adequate assessment is required, and strong clinical decision-making is needed to make the best preventative choices. Asthma significantly impacts the livelihood of a child because it affects the activity of daily living, academic performance, and the overall functioning of the child. When this happens, it increases the clinic workload due to increased requests for visits, which strains the available medical resources (Averell et al., 2022). Health disparities also play a role in asthma cases. Many of the patients and their families that are seen in community clinics face limited access to medications, which leads to inadequate treatment and an increase in complications.
Cook Children’s Health Care System is a non-profit pediatric healthcare organization. A board of directors heads the hospital. The management structure also includes the executive leadership, doctors, managers, nursing, and all other administrative staff. The nursing department is headed by the chief of nursing, nurse directors, nurse managers, charge nurses, and staff nurses. This structure works well because there is communication, support, accountability, and quality patient care across the different nursing departments and units. Cook Children’s vision is to be recognized as the leading pediatric healthcare system, dedicated to achieving the best possible outcomes for children. The hospital’s mission is to improve the well-being of every child in its care by providing high-quality, family-centered healthcare. An internal problem that might affect this mission and vision is short staffing, incomplete documentation, and poor reports between departments, leading to gaps in asthma care and other diseases of condition (Sun et al., 2023). Some external factors that might exacerbate these issues can be access to primary care physicians and pulmonologists, lack of insurance coverage, social detriments to health, poor housing, exposure to allergens, and difficulty following up with family living in rural or underserved communities (Global Initiative for Asthma, 2025). Financial limitations can also impact reach and efficacy, considering the organization is non-profit and requires resources to run the initiative.
Cook Children’s Hospital has helped with managing Asthma in children through its referral program for pediatric patients who come from out of state or come from rural communities. Cooks also works with the CHIP and Medicaid. These services allow for medical treatment and improvements, eliminating delays in care access and utilization. Cooks offers a Home health department that takes care of several specialties. Respiratory equipment and medication are delivered to the homes of patients needing help with the continuation of treatment without creating gaps. Care access outside health facilities helps reduce the frequency of hospital and emergency visits, keeping patients safe and lowering the cost of healthcare on hospitals and facilities.
Overall, Asthma in children requires nurses to identify symptoms early and implementing life-saving measures immediately by relieving difficulty breathing. Before patients are discharged from healthcare centers, hospitals, or doctors’ offices, discharge education should be given. Information about triggers, symptoms, medications, and action plans should be covered in great detail so caregivers and family understand the importance of this condition. Nurses should also conduct follow-up meetings with patients to assess how the patient is doing.
References
Averell, C. M., Laliberté, F., Germain, G., Slade, D. J., Duh, M. S., & Spahn, J. (2022). Disease burden and treatment adherence among children and adolescent patients with asthma. Journal of Asthma, 59(8), 1687-1696. https://doi.org/10.1080/02770903.2021.1955377
Global Initiative for Asthma. (2025). Global strategy for asthma management and prevention. Accessed April 16th 2026 from https://ginasthma.org
Pate, C. A., Qin, X., Johnson, C., & Zahran, H. S. (2023). Asthma disparities among US children and adults. Journal of Asthma, 60(12), 2214-2223. https://doi.org/10.1080/02770903.2023.2228915
Sun, D., Sun, P., & Wang, Z. (2023). Assessment and therapeutic management of acute asthma: The approaches of nursing staff in patient care. Advances in Clinical and Experimental Medicine, 32(10), 1167-1178. https://doi.org/10.17219/acem/161156
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Write a 750-1000-word description of your proposed capstone project topic. Include the following:
- Describe the problem or issue that will be the focus of the change proposal. Explain with which category (leadership or community) the selected topic would best align.
- Discuss the setting or context in which the problem or issue can be observed and describe the population affected by this problem or issue.
- Discuss the implications this clinical practice problem or issue has on nursing practice.
- Based on your need’s assessment in Topic 1, describe why this is a priority for the community/clinical site or affected clinical population.
- Briefly describe the organizational structure (mission, vision, values, leadership structure, etc.) of the practicum site. What internal and external processes will impact care coordination for the selected population or community?
- How effective has the organization been in addressing the identified problem or issue?