Asthma Forms and Resources

Nursing Forms

• 2018 Colorado Asthma Care Plan (PDF)
  • Asthma Care Plan Instructions (2010 - DOC)
  • Asthma Care Plan Supplement – Training Handout (2010 - DOC)
• Parent Asthma Intake - English and Spanish (Word - September 2016)
• Asthma Intake Form with highlights - English and Spanish (fillable PDF 2019)
• Asthma Training and Delegation Record (DOC) - inhaled medication
• Asthma/Allergy Self Carry Contract - English and Spanish (DOC)
• Is the Asthma Action Plan Working? (Exiting CDE - PDF)
• How Asthma Friendly Is Your School? (Exiting CDE - PDF)
• Management of Asthma if Student Does Not Have an Action Plan (Exiting CDE - PDF)
• Asthma Episode When a Nurse is Not Available (Exiting CDE - PDF)
• Assessing Student Readiness to Self Carry (PDF)

Guidelines

• Colorado Childhood Asthma Guidelines (2008-PDF)

Medications and Devices

• Asthma Medications
• Asthma Inhalers (PDF)
• Inhaler Technique Assessment Tool (2011 PDF)
• Priming and Care Guide for Inhalers (PDF)
• AeroChamber (large) (PDF)
• AeroChamber (small) (PDF)

Asthma Trainings

Applying Best Practice Asthma Care in Schools: A Standardized Statewide Approach
(Online 4 hour training for school nurses)

Objectives of the course:

• Describe the role and responsibilities of the school nurse to provide comprehensive care of students with asthma
• Apply Colorado best practice approaches to providing quality asthma care in school settings
• Impact student asthma care and management within the school setting

To enroll, email Pam Hitt

Asthma Training for Unlicensed Assistive Personnel (UAP)
(Online 2 hour training for UAPs)

Objectives of the course:

• Encourage parents/guardians to complete the Asthma Intake Form and communicate its completion to the school nurse
• Implement the green (required pretreatment), yellow and red zones of the Colorado Asthma Care Plan.
• Administer and coach accurate technique for administration of a quick relief medication using a MDI plus spacer

This free, 2 hour training program is aligned with the Moodle course for School Nurses Applying Best Practice Asthma Care in Schools: A Standardized Statewide Approach. 
Each individual completing the course will have access to a certificate.

To enroll your UAP, email Pam Hitt with the name of the course, and include the UAP’s first and last name, email address and school district. 
Pam will email each individual a log in, a password, and the link to access the training.

View the Asthma and Allergy Foundation of America Asthma Management Education Course
(7 credit hours)
 

Student and Family Education

• Quest for the CODE (PDF)
• Asthma Basics (PDF)
• Clear Your Home of Asthma Triggers (EPA) (PDF)
• Overview of Asthma Student Education Programs
• Kids Asthma Fast Facts (PDF)

Resources

• American Lung Association (Exiting CDE)
• Colorado Asthma Coalition (Exiting CDE)
• EPA - Indoor Air Quality in Schools (Exiting CDE)
• Health Team Works (CCGC) (Exiting CDE)
• National Jewish Hospital (Exiting CDE)