1. Home Management Plan of Care

2. The 2012 Joint Commission requirements for Asthma Education and Documentation  A Home Management plan of care (HMPC) will be filled out and sent home with patients with Asthma or Reactive Airway Disease (RAD)  Patients will receive this if Asthma is listed as one of their top 3 diagnosis  Proper Documentation of the receipt of the HMPC is required

3. The HMPC includes:  Follow up physician, phone # and next appointment  A list of common triggers to avoid  Keys to recognizing symptoms  Actions and medications to take when a patient is having asthma symptoms or asthma attack  When to use Controller medications and when to use Quick-Relief medications

4. HMPC Procedure  After filling out the discharge summary form, fill out the HMPC with the Asthma medications.  Record the Controller medications, dose, and frequency in the green zone  Record the Quick-Relief medications in the yellow zone  Record medications and instructions for emergency situations in the red zone.  The top copy (color copy) will be given to the caregivers  The carbon copy will go into the chart  Document the Asthma Education provided  Handouts, GWN….

5. Fill this form out for patients with a diagnosis of Asthma or Reactive Airway Disease Patients with Asthma and their families should know their symptoms and how they are feeling. This form will help them know what medications to take and when. Patients with Asthma and their families should know their symptoms and how they are feeling. This form will help them know what medications to take and when. Patients with Asthma should be aware of and avoid these common triggers Write in the ordered medications, dose, and frequency. (ex. Quick-Relief medicines are listed here) Write in the ordered medications, dose, and frequency. (ex. Quick-Relief medicines are listed here) Refer the caregiver to the Nursing Discharge Summary sheet for their follow-up appointment.

6. Controller medicines (ex. Corticosteroids) These medications should be taken every day even when the patient is not having symptoms. Controller medicines (ex. Corticosteroids) These medications should be taken every day even when the patient is not having symptoms. Quick-Relief (ex. Bronchodilators ) These should be taken when the child is having symptoms. They should also continue to take their controller medicines. Quick-Relief (ex. Bronchodilators ) These should be taken when the child is having symptoms. They should also continue to take their controller medicines. List emergency medications and instructions here. Instruct caregivers to call their doctor or go to the nearest emergency room List emergency medications and instructions here. Instruct caregivers to call their doctor or go to the nearest emergency room

8. IMPORTANT  All patients with asthma as one of their top three diagnoses must be discharged with a home management plan of care.  Education must be documented in Meditech just as usual. This includes GetWell Network videos, verbal instruction, handouts, and other types of instruction.