Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Debra Anderson

Clinical Mentor

Dr. Pamela Johnson

Committee Member

Dr. Debra Hampton


In this retrospective cohort study a screening tool aimed at identification of pediatric asthma based on patients’ symptoms and directions for referral for PFT testing was placed in a Pediatric Practice site EMR in template form as a movement towards Accountable Patient Care. Twenty-eight pre-intervention patients and 5 post-intervention patients met criteria based on symptoms for referral to perform PFT testing to evaluate asthma as a diagnosis. These records were evaluated to see if PFT testing was performed, and if performed how it correlated with an asthma diagnosis. The screening tool had 100% identification of asthma as a diagnosis for those referred to PFT testing; however there were only 2 patients referred for this testing in the post-intervention cohort. There were no patients sent for PFT testing in the pre-intervention cohort.

Limitations to this study included no pre-intervention PFT testing for comparison and the small number of patients in the post-intervention cohort. Implications for practice are that structured guidelines within practice site EMRs have been shown according to evidence based literature to improve outcomes of quality which will be very important to the upcoming Accountable Care Models and hold promise to assist with meeting quality guidelines. More work should be performed to evaluate the effects of structured templates for diagnosing and treatment of chronic conditions such as asthma to assist with meeting guidelines and improving patient outcomes in the Accountable Patient Care Models.