Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Assessment of Asthma Control

Recommendation 1.0:
All individuals identified as having asthma, or suspected of having asthma, will have their level of asthma control determined by the nurse.

Recommendation 1.1:
Every client should be screened to identify those most likely to be affected by asthma. As part of the basic respiratory assessment, nurses should ask every client two questions:

  • Have you ever been told by a physician that you have asthma?
  • Have you ever used a puffer/inhaler or asthma medication for breathing problems?

Recommendation 1.2:
For individuals identified as having asthma or suspected of having asthma, the level of asthma control should be assessed by the nurse. Nurses should be knowledgeable about the acceptable parameters of asthma control, which are:

  • use of inhaled short-acting ß2 agonist < 4 times/week (unless for exercise);
  • experience of daytime asthma symptoms < 4 times/week;
  • experience of night time asthma symptoms < 1 time/week;
  • normal physical activity levels;
  • no absence from work or school; and
  • infrequent and mild exacerbations.

Recommendation 1.3: For individuals identified as potentially having uncontrolled asthma, the level of acuity needs to be assessed by the nurse and an appropriate medical referral provided, i.e., urgent care or follow-up appointment.