Statewide Implementation of Stock Inhaler Programming: Respiratory Distress De‐Escalation, Implementation and Utilization Experiences

INTRODUCTION: Asthma is common in children, but many do not have access to a personal inhaler at school. The Resources for Every School Confronting Unexpected Emergencies- Illinois (RESCUE-IL) program provided stock undesignated asthma medication for respiratory distress to 77% of Illinois schools over the first implementation year (2023-2024). A qualitative study was conducted to examine utilization experiences with emphasis on program benefits and barriers in the inaugural year of RESCUE-IL. METHODS: Interviews were conducted from March to May 2024. Primary data was collected from trained Illinois school health staff who had administered a stock inhaler in the 2023-2024 school year. Semi-structured interviews were transcribed, de-identified, and qualitatively coded in Dedoose. Thematic data analysis using a hybrid inductive and deductive approach based on grounded theory was performed by trained researchers. RESULTS: Out of 37 nurses interested, 24 participated. The first theme surrounding stock inhaler benefits included the program's ability to address asthma burden, health equity concerns, and improve student-level outcomes. Barriers included administrative support and non-health staff training, among others. Stock inhaler utilization experiences referred to events leading up to the respiratory event, its management, student disposition and follow-up demonstrating the program's effectiveness. The final theme-RESCUE-IL implementation and support-pertained to logistics regarding program startup, training, supplies, and event documentation. Overall, participants felt the program enhanced accessibility and ability to de-escalate events, but there were concerns regarding protocols and reporting. CONCLUSIONS: A statewide stock inhaler program allowed respiratory distress de-escalation in schools. These real-world experiences by nurses highlight the need for ongoing funding and expansion. Further research is needed to ensure comprehensive training is universally available.