school grantees and were changes in the way students with asthma are assessed and/or monitored. Examples of these policy changes included:
1. A policy now documented in the health policy manual that describes the procedure for assessing
children with asthma at regular intervals, based on illness severity. Students assessed to have poorly
controlled asthma are monitored at the beginning of each school day, while students with better asthma control are monitored on a weekly basis.
2. A policy included in the school nurse manual regarding the use of metered dose inhaler technique
check with In-Check Dial—a tool to assess and coach inhalation technique—when assessing
children with asthma. Proper inhalation technique is critical to assure inhaled medication is deposited in the lungs.
3. A policy outlining the use of a new asthma assessment form, which is documented in the
school nurse procedure manual. The new form promotes EPR-3 guidelines and standardizes care
across nurses in the school district.
4. A policy regarding a new communication tool used by the school nurses when communicating
assessment findings with primary care physicians of children with asthma, which is outlined in the
school nurse handbook. The tool encourages care based on EPR-3 guidelines, and provides for more consistent care across providers.