Registered Nurses' Association of Ontario

Purpose & Scope

  • The purpose of this Guideline is to provide nurses and other health-care providers with evidence-based recommendations of foundational asthma care for adults (≥ 18 years of age) with a diagnosis of asthma to promote asthma control.
  • The expert panel adopted the diagnostic and control criteria for asthma in adults outlined in the Canadian Thoracic Society 2012 Guideline Update: Diagnosis and Management of Asthma in Preschoolers, Children and Adults. 
  • The recommendations in this Guideline apply to adults who have received an established or confirmed diagnosis of asthma from an appropriate health-care provider, as defined by the Canadian Thoracic Society  Click here to view the Diagnosis of Asthma: Pulmonary Function Criteria. 
  • Practice recommendations are directed primarily at nurses who provide direct care to persons with asthma across the spectrum of care, including (but not limited to): primary care, acute care, home-care settings, alternative levels of care/complex continuing care, and long-term care. The secondary audience of the practice recommendations includes other members of the interprofessional health-care team who collaborate with nurses to provide comprehensive care.
  • Several populations and conditions are beyond the scope of this Guideline. These include:
    • Assessment and management recommendations specific to children. These are covered in the RNAO BPG Promoting Asthma Control in Children(2004) and its supplement(2008). 
    • Asthma–COPD overlap syndrome. Asthma and chronic obstructive pulmonary disease (COPD) can co-exist, in a condition known as (Global Initiative for Asthma.. However, due to the complexities involved in working with this population, the expert panel decided that this clinical issue was beyond the scope of this Guideline. Assessment and management interventions specific to COPD are covered in the RNAO BPG Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease (2005) and its supplement.
    • Assessment and management recommendations specific to asthma in pregnancy.
    • Pharmacological management of asthma. While pharmacological interventions are essential to achieving asthma control, they are outside the scope of this Guideline. Pharmacological management is comprehensively addressed in the CTS 2012 Guideline Update.
    • Work-related asthma. While it is acknowledged that work-related asthma (WRA) affect many adults with asthma, recommendation statements specific to WRA have not been developed. However, many of the recommendations are relevant for health-care professionals, including occupational health nurses, who practise with individuals in this population.
  • It is acknowledged that achieving control of asthma requires coordination and communication between health-care providers, as well as a partnership between the person with asthma and the health-care team.
  • In this Guideline, the terms “person,” “persons,” and “people” are used to refer to adults with an asthma diagnosis with whom a health-care provider is engaged in a therapeutic relationship.
  • In this Guideline, the term “at every encounter” is used to refer to any interaction between a health-care provider and the person with asthma within community care, home care, and ambulatory-care settings (e.g., primary care clinics, emergency departments). In institutionalized-care settings (e.g., hospitals, long-term care), the term may refer to interactions that occur on admission, or when the person experiences a change in health status, care needs, or location (either within, between, or across settings). With regard to the assessment recommendations, in institutional settings an assessment of the person’s asthma symptoms should be completed at every interaction (e.g., at the start of each shift) at a minimum. A complete assessment of the person’s asthma control and future risk should be based on clinical context and professional judgment.
  • This Guideline adopted the control criteria for asthma outlined in the CTS 2012 Guideline Update; which characterizes a person’s asthma as being either controlled or uncontrolled. Therefore, throughout this Guideline, asthma is referred to as being either controlled or uncontrolled.
Chronic Disease
Adult Asthma Care Guidelines for Nurses: Promoting Control of Asthma
Background Information