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Stanislo KJ, Neumann LS. Introducing NASN's School Nursing Evidence-Based Clinical Practice Guideline: Allergy and Anaphylaxis CPG and Implementation Toolkit. NASN Sch Nurse 2024:1942602X241271276. [PMID: 39215595 DOI: 10.1177/1942602x241271276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Clinical Practice Guidelines (CPGs) are statements informed by a systematic review of research/evidence and provide recommendations for clinical practice to improve healthcare quality and patient outcomes. The National Association of School Nurses (NASN) released School Nursing Evidence-Based Clinical Practice Guideline: Students with Allergies and Risk for Anaphylaxis, in 2023, to provide evidence-based recommendations specific to school nursing practice and support the role of the school nurse in providing high-quality care for school-age children with allergies and risk for anaphylaxis. This article will provide an overview of the CPG and Implementation Toolkit. The implementation toolkit is designed to provide school nurses with tools and resources to implement the recommendations into practice. These tools and resources include school policies; nursing assessments and intake; planning, training, implementing, and evaluating care; and data collection. Examples are discussed, including how to customize the toolkit resources to your current practice needs.
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Affiliation(s)
- Kimberly J Stanislo
- Research Education Practice Director National Association of School Nurses Silver Spring, MD
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Huntley AP, Verdi M, Conway AE, Sharma H, Stukus D, Nanda A, Shaker M, Herbert L. Growing up with allergies: Transitioning from adolescence to adulthood. Ann Allergy Asthma Immunol 2024; 132:572-578. [PMID: 37984706 DOI: 10.1016/j.anai.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023]
Abstract
Allergic disease management for adolescents and young adults requires consideration of unique psychosocial challenges and opportunities. Erik Erikson's model for the Stages of Psychosocial Development is a useful lens through which we can understand adolescent and young adult experiences with allergic and immunologic disease, particularly with regard to identity and relationship development. It is important to provide anticipatory guidance for patients who are transitioning environments (eg, home to college), with attention to the anxiety-provoking demands for increased responsibility on top of new stressors such as academic and vocational demands. It is critical that health care professionals use an empathetic, shared decision-making approach regarding the emotional impact of allergy on a patient's social engagement. A patient's ability to develop positive lifelong habits is also shaped by their environment's "culture of wellness," and clinicians can encourage habits to promote healthy choices and effective disease management. Social media provides opportunities and challenges as a conduit for both social connection and possible misinformation. Overall, allergic disease management in adolescents and young adults is a "high-risk, high-reward" period of time-and with awareness, anticipation, and proactive action, health care professionals can better serve patients by leveraging this transitional period to promote positive approaches to management of allergies and asthma, trusting relationships, and personal responsibility.
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Affiliation(s)
| | - Marylee Verdi
- Dartmouth College Student Health, Hanover, New Hampshire
| | | | - Hemant Sharma
- Division of Allergy and Immunology, Children's National Hospital and Department of Pediatrics, George Washington University School of Medicine, Washington, District of Columbia
| | - David Stukus
- Division of Allergy and Immunology, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio
| | - Anil Nanda
- Asthma & Allergy Center, Lewisville and Flower Mound, Texas; Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Marcus Shaker
- Dartmouth Geisel School of Medicine, Hanover, New Hampshire; Department of Medicine and Pediatrics, Section of Allergy, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
| | - Linda Herbert
- Division of Allergy and Immunology, Children's National Hospital and Department of Pediatrics, George Washington University School of Medicine, Washington, District of Columbia
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Bingemann TA, LeBovidge J, Bartnikas L, Protudjer JLP, Herbert LJ. Psychosocial Impact of Food Allergy on Children and Adults and Practical Interventions. Curr Allergy Asthma Rep 2024; 24:107-119. [PMID: 38261244 PMCID: PMC11340266 DOI: 10.1007/s11882-023-01121-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE OF REVIEW IgE- and non-IgE-mediated food allergies are increasing in prevalence in children and adults worldwide. A food allergy diagnosis can be associated with a sense of overwhelm and stress and commonly has a negative impact on quality of life. RECENT FINDINGS While there is an increased recognition of the psychosocial effects of food allergy, the current research reflects the experience of mostly White, well-educated wealthier populations. Some studies have now explored the psychosocial impact among other populations; however, further study is needed. It is important that physicians and allied health professionals screen for the potentially negative psychosocial effects of food allergy and provide education to promote safety and self-efficacy at each visit; however, time may be a limiting factor. Numerous validated questionnaires are now available to help assess the psychosocial impact of food allergies. Allergy-friendly foods are typically more expensive, and thus, it is imperative that physicians screen for food insecurity as well. Educational resources should be offered regarding living well with food allergies at each visit. For patients and families experiencing anxiety or food allergy burden that is difficult to manage, referral to a mental health provider should be considered. Resources regarding programs to help accessing safe foods should also be available. Further research is needed among diverse populations focusing on interventions to best support patients and families with food allergy.
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Affiliation(s)
- Theresa A Bingemann
- Departments of Allergy, Immunology and Rheumatology and Pediatric Allergy and Immunology, University of Rochester School of Medicine, 601 Elmwood Ave, Box 695, Rochester, NY, 14642, USA.
| | - Jennifer LeBovidge
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lisa Bartnikas
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, MA, USA
| | - Jennifer L P Protudjer
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, Canada
- George Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Linda J Herbert
- Division of Psychology &, Behavioral Health, Children's National Hospital, Washington, DC, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA
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LeBovidge J, Elverson W, Esty B, Maciag MC, Syverson EP, Grossman M, Crestani E, Queheillalt D, Okazaki Y, Perez O, Hait EJ, Bartnikas LM. Piloting a multidisciplinary group education session to support caregivers of children with food protein-induced enterocolitis syndrome (FPIES). THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3260-3262.e1. [PMID: 37406809 DOI: 10.1016/j.jaip.2023.06.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/30/2023] [Accepted: 06/24/2023] [Indexed: 07/07/2023]
Affiliation(s)
- Jennifer LeBovidge
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
| | - Wendy Elverson
- Department of Clinical Nutrition, Boston Children's Hospital, Boston, Mass
| | - Brittany Esty
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Michelle C Maciag
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass; Asthma and Allergy Affiliates, Salem, Mass
| | - Erin Phillips Syverson
- Harvard Medical School, Boston, Mass; Department of Medicine, Division of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Mass
| | - Mia Grossman
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Mass
| | - Elena Crestani
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Dianna Queheillalt
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, Mass
| | - Yoshiko Okazaki
- Department of Medicine, Division of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Mass; Department of Social Work, Boston Children's Hospital, Boston, Mass
| | - Olga Perez
- Department of Social Work, Boston Children's Hospital, Boston, Mass
| | - Elizabeth J Hait
- Harvard Medical School, Boston, Mass; Department of Medicine, Division of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, Mass
| | - Lisa M Bartnikas
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
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Ruran HB, Dupuis R, Herbert LJ, D'Anna RK, Dahlberg SE, Young MC, Sicherer SH, Bartnikas LM. Parental awareness and management of bullying in children with food allergies. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3257-3259.e2. [PMID: 37406807 PMCID: PMC10592494 DOI: 10.1016/j.jaip.2023.06.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023]
Affiliation(s)
- Hana B Ruran
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass; Case Western Reserve University, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Roxanne Dupuis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Linda J Herbert
- Division of Psychology and Behavioral Health, Children's National Hospital, Washington, DC; Department of Pediatrics, George Washington University School of Medicine, Washington, DC
| | - Rachel K D'Anna
- Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Mass
| | - Suzanne E Dahlberg
- Harvard Medical School, Boston, Mass; Department of Pediatrics, Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Mass
| | - Michael C Young
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Scott H Sicherer
- Department of Pediatrics, Division of Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lisa M Bartnikas
- Department of Medicine, Division of Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
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Evaluating the Food Allergy Passport: A Novel Food Allergy Clinical Support Tool. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:1162-1168.e7. [PMID: 36716996 DOI: 10.1016/j.jaip.2023.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND The prevalence of pediatric food allergy (FA) has increased in the past 2 decades. The previous literature suggests that FA presents burdens, both economically and psychosocially, to children and their caregivers, especially families in lower-income strata. Using data from a previously published needs assessment, the Food Allergy Management in Low-Income Youth study, the FA Passport and Workbook tools were developed to address identified needs. OBJECTIVE This study evaluated the utility of the FA Passport in helping families insured by Medicaid to manage FA better and improve quality of life. METHODS Families insured through Illinois Medicaid were recruited from two Chicago-based allergy clinics. Caregivers of children with FA completed a pretest evaluating knowledge, attitudes, beliefs, and practices regarding FA management. A clinician guided caregivers through the FA Passport. The caregivers then completed a posttest immediately afterward and again 3 months later. Changes were evaluated from baseline responses and direct feedback was elicited about the tool. RESULTS The FA Passport successfully improved caregiver-reported confidence with epinephrine autoinjector use (from 69% to 93%), caregiver anaphylaxis recognition (from 66% to 73%), and reported quality of life, and it nearly doubled caregiver comfort regarding leaving the child in the care of others (from 40% to 75.7%). Caregivers rated the FA Passport tool as extremely helpful overall (9.4 out of 10). CONCLUSIONS The FA Passport is a novel FA clinical support tool that addresses barriers to proper FA management described in previous studies. It proved effective at improving caregiver comfort with regarding leaving the food-allergic children with other caregivers, increasing FA knowledge, and improving the quality of life in families affected by FA.
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