Online intervention improves pediatric food allergy knowledge among school nurses

Key takeaways:

• An intervention improved food allergy knowledge among school nurses, particularly among those with prior education.
• However, 21% of nurses wrongly chose the front of the thigh for epinephrine injection.

WASHINGTON — A nurse-led intervention improved pediatric food allergy knowledge, although it also revealed “concerning” shortcomings in certain areas of identification and management, research showed.

According to Elizabeth S. Burke-Roberts, RN, MSN, CPNP, a pediatric nurse practitioner at Boston’s Children’s Hospital, nonspecialist clinicians overtest for allergies and underuse epinephrine when indicated.

The goal of the study “was to improve knowledge and confidence in the identification and management of pediatric food allergy through an online education session for nurses,” she said at the American Academy of Allergy, Asthma & Immunology Annual Meeting.

Changes in knowledge were measured through Food Allergy Knowledge Test (FAKT) scores at baseline and then after the intervention.

The final cohort consisted of 25 participants, most of whom were school nurses and had prior food allergy education.

Overall, the intervention improved knowledge compared with baseline. Burkes-Roberts and colleagues also found that the mean baseline FAKT scores of participants with prior food allergy education were 6 points higher than those without education, which “indicates that knowledge persists.”

However, Burke-Roberts highlighted several knowledge deficits. For example, 41% of “these very seasoned nurses” said that hair loss was a symptom of an immunoglobulin E-mediated reaction, and 66% of nurses said “hyperactivity was a sign or symptom of an IgE-mediated reaction,” she noted.

Burke-Roberts also pointed out that 79% of nurses chose the outer thigh as the site to administer epinephrine — the standard of care — compared with 21% who chose the front of the thigh. She said that finding “is just concerning,” especially because 68% of school nurses “are responsible for training the rest of the school in how to give epinephrine.”

There were some limitations in the study, which included the small sample size, the high attrition rate and the fact that surveys were completed in a manner that did not allow for data matching.