National Association of Pediatric Nurse Practitioners
"The NACI [National Asthma Control Initiative]…is meant to help get the six GIP messages out to health care providers as well as to patients and families …and to help the health care providers implement the asthma guidelines..."
Heather Keesing, M.S.N., R.N., A.P.R.N., Program Manager, National Association of Pediatric Nurse Practitioners (Cherry Hill, NJ)
Laura Nelsen of the National Association of Pediatric Nurse Practitioners (NAPNAP) discusses how NAPNAP has tapped trainers from medically underserved areas in order to get the GIP messages out to those who need it the most.
The National Association of Pediatric Nurse Practitioners (NAPNAP) established a Pediatric Asthma Education Train-the-Trainer Program to strengthen the ability of primary care providers to improve the health outcomes of children who have asthma. NAPNAP designed the program to educate, prepare, and support a core group of trainers that had committed to disseminating the National Asthma Education and Prevention Program's (NAEPP) Expert Panel Report 3—Guidelines for the Diagnosis and Management of Asthma (EPR-3) recommendations to providers in clinical practice settings, local colleges of nursing, regional professional conferences, and other forums.
NAPNAP's 46 national pediatric asthma trainers come from 18 states. Many of them serve asthma disparity populations in areas where access to health care providers is limited.
NAPNAP trained 46 national pediatric asthma trainers (NPATs) in a two-day conference conducted in Dallas, Texas. The NPATs were competitively selected from applicants throughout the country. NAPNAP made a particular effort to recruit pediatric nurse practitioners, school nurses, physician assistants, nurses, and physicians from medically underserved areas and areas with high asthma prevalence.
NAPNAP developed the train-the-trainer curriculum in collaboration with a group of pediatric asthma experts from NAPNAP, the NAEPP, and other professional organizations. The group also evaluated the qualifications of 40 applicants before selecting three faculty members to present the train-the-trainer curriculum. Divided into six learning modules, the curriculum emphasized the NAEPP Guidelines Implementation Panel's six priority messages for achieving and maintaining asthma control. The program also featured strategies for primary care providers who work with rural, school, and adolescent populations.
As part of the program, NPATs conducted training sessions with 1,333 health care providers from a variety of disciplines. In addition to the availability of continuing education credit through NAPNAP, the American Academy of Physician Assistants (AAPA) also approved NPAT-conducted trainings for continuing education credit. Moreover, NAPNAP successfully created a community of NPATs who frequently exchange tips and share successes in a private discussion forum on the NAPNAP Web site.
Develop and implement a comprehensive pediatric asthma education core curriculum that will serve as a guide for providing essential content on pediatric asthma.
Increase the number of pediatric nurse practitioners, school nurses, and other pediatric health care providers in primary care settings who have completed the national curriculum training on pediatric asthma.
Increase the number of pediatric nurse practitioners, school nurses, and other pediatric health care providers who have the knowledge and skills to assess, manage, and educate about the EPR-3 evidence-based practice strategies regarding asthma care in their practice settings.
Conduct an outcomes evaluation to determine the impact of the pediatric asthma education training program within two years of its implementation.
Challenges & Solutions
Challenge: Find more opportunities for NPATs to train providers. NAPNAP had an active network of NPATs ready to educate providers about guidelines-based care. However, some NPATs, particularly those in rural areas, experienced challenges in finding an audience for this program.
Solution: Support local NPAT recruitment efforts with national outreach. NAPNAP developed a centralized NPAT speaker request form and sent a message to its members encouraging them to make training requests. This creative marketing strategy resulted in several inquiries. NAPNAP also used its biweekly member news publication to promote the NPATs and commemorate the 1,000th person trained through the program. NAPNAP also highlighted the program at its annual conference, where one of the national pediatric asthma trainers based in Texas presented a session using the program's asthma pharmacology module.
NAPNAP recruited and trained 46 NPATs from 18 states and issued continuing education credits to nearly 1,200 health care professionals who subsequently completed NPAT-led trainings.
NAPNAP turned the asthma pharmacology module from its pediatric asthma education program into a free online continuing education program. Three hundred and forty-eight (348) pediatric health care professionals completed this online activity, and 90% indicated that they were confident of their ability to integrate concepts and information learned through this continuing education activity into their practice.
NAPNAP established an active online discussion and information-exchange forum for its NPATs.
NAPNAP's article on the development of the NPAT program, titled "The Need for Asthma Educators: Designing a Pediatric Asthma Train-the-Trainer Program," was published in the Journal of Asthma & Allergy Educators.
Laura Nelson, E-Learning and Continuing Education Manager, NAPNAP, and colleagues at a NACI meeting in Baltimore, MD.
NAPNAP shared and collaborated with other NACI-funded projects to advance asthma care best practices. For example:
NAPNAP partnered with the National Environmental Education Foundation, a NACI Strategic Partner, and other key stakeholder organizations, including the National Association of School Nurses, National Assembly on School-Based Health Care, Society of Pediatric Nurses, and American Academy of Physician Assistants, in the development, implementation, and evaluation of the pediatric asthma education program.
Education for Health, a NACI Demonstration Project, presented its NACI-funded training program at a 2011 NAPNAP annual meeting.
NAPNAP joined in discussions convened by the American School Health Association, a NACI Strategic Partner, on addressing asthma disparities in the Central Appalachian region.
NAPNAP focused on evidence-based provider education and a train-the-trainer approach to help meet its project goals.
Other NACI-funded projects that used NAPNAP-type approaches are: