Open Airways for Schools (OAS)
A program of the American Lung Association, implemented in Office of School Health, Department of Health Anne Arundel County, Maryland.
Operation of Replicated Program
OAS operates in all of Anne Arundel County’s’s 77 elementary schools as part of the comprehensive Asthma Management Program described earlier. Nurses work in their assigned schools at least 3 days a week and lead all education sessions. Most nurses have a health assistant who assumes their nursing duties while they teach the session.
After parental consent is received, the school nurse coordinates the timing and delivery of the educational sessions. Upon completion of the program, each student receives a certificate of completion. Although no formal protocol exists for follow-up with students, some school nurses conduct refresher courses with students during the following semester or year depending on the student’s needs.
In Anne Arundel County elementary schools, OAS is usually offered as a series of six 40-minute group sessions. All classes are held during the school day; however, the timing, number, and format of the sessions vary depending on a number of factors, such as the school nurses’ perceptions of students’ cognitive abilities, willingness to let a child miss a scheduled class, or preference for the length of sessions. Classes are usually stratified by grade; however, nurses report that when only a few children sign up for the sessions, nurses mix grades as appropriate.
All nurses conducting the OAS program are trained by a health educator from the state ALA office. Although length of training may vary across the country, it is typically 1 full day. The ALA sends a certified educator to train the nurses at a location convenient to them. In Anne Arundel County, nurses meet with the trainer at a centrally located school. The ALA instructor describes the program and reviews the components of the OAS kit. Additionally, the instructor demonstrates the uses and functions of different types of asthma medical devices, such as peak flow meters and inhalers. In Anne Arundel County, the training occurs when a new group of nurses is hired.
OAS in the county is funded as a component of the AMP by the County Health Department as part of the county’s allocation for school health and nursing. This arrangement makes it difficult to identify funds used exclusively for the operation of OAS. An alternative way to gauge the resources required to operate OAS in Anne Arundel County is to estimate the labor involved with operating the program. The school nurses estimate that OAS requires 12 hours for each set of the OAS classes: 4 hours to conduct six 40-minute classes; 3 hours for planning and preparation; 2 hours for copying and sorting; 1 hour to write and distribute informational letters to parents; and 2 hours to communicate with parents, teachers, and principals.
While the School Health Services program pays for the nurses’ time, many school nurses indicated that additional funding is needed to cover such “extras” as pizza, other food and refreshments, prizes, and stickers. Often these items are purchased by the nurses themselves, or in some cases, by the Parent Teacher Association (PTA).
The implementation of OAS in Anne Arundel County has had no formal or structured evaluation. However, in December of 2000, the Anne Arundel County Department of Health applied for a grant from the Maryland Department of Health and Mental Hygiene, and was awarded $19,000 to begin analyzing outcome data for its Asthma Management Program, of which OAS is a part.