Rationale: For children with asthma, access to quick-relief medications is critical to minimizing morbidity and mortality. An innovative and practical approach to ensure access at school is to maintain a supply of stock albuterol that can be used by any student who experiences respiratory distress. To make this possible, state laws allowing for stock albuterol are needed to improve medication access.Objectives: To provide policy recommendations and outline steps for passing and implementing stock albuterol laws.Methods: We assembled a diverse stakeholder group and reviewed guidelines, literature, statutes, regulations, and implementation documents related to school-based medication access. Stakeholders were divided into two groups-legislation and implementation-on the basis of expertise. Each group met virtually to review documents and draft recommendations. Recommendations were compiled and revised in iterative remote meetings with all stakeholders.Main Results: We offer several recommendations for crafting state legislation and facilitating program implementation. 1) Create a coalition of stakeholders to champion legislation and implement stock albuterol programs. The coalition should include school administrators, school nurses and health personnel, parents, or caregivers of children with asthma, pediatric primary care and subspecialty providers (e.g., pulmonologists/allergists), pharmacists, health department staff, and local/regional/national advocacy organizations. 2) Legislative components critical for effective implementation of stock albuterol programs include specifying that medication can be administered in good faith to any child in respiratory distress, establishing training requirements for school staff, providing immunity from civil liability for staff and prescribers, ensuring pharmacy laws allow prescriptions to be dispensed to schools, and suggesting inhalers with valved holding chambers/spacers for administration. 3) Select an experienced and committed legislator to sponsor legislation and guide revisions as needed during passage and implementation. This person should be from the majority party and serve on the legislature's health or education committee. 4) Develop plans to disseminate legislation and regulations/policies to affected groups, including school administrators, school nurses, pharmacists, emergency responders, and primary/subspecialty clinicians. Periodically evaluate implementation effectiveness and need for adjustments.Conclusions: Stock albuterol in schools is a safe, practical, and potentially life-saving option for children with asthma, whether asthma is diagnosed or undiagnosed, who lack access to their personal quick-relief medication. Legislation is imperative for aiding in the adoption and implementation of school stock albuterol policies, and key policy inclusions can lay the groundwork for success. Future work should focus on passing legislation in all states, implementing policy in schools, and evaluating the impact of such programs on academic and health outcomes.

中文翻译：

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确保学校获得沙丁胺醇：从政策到实施。官方 ATS/AANMA/ALA/NASN 政策声明。


理由：对于患有哮喘的儿童来说，获得快速缓解药物对于最大限度地降低发病率和死亡率至关重要。确保学校入学的一种创新且实用的方法是维持沙丁胺醇库存供应，供任何出现呼吸窘迫的学生使用。为了实现这一目标，需要允许沙丁胺醇库存的州法律来改善药物获取。目标：提供政策建议并概述通过和实施沙丁胺醇库存法律的步骤。方法：我们组建了一个多元化的利益相关者团体，并审查了指南、文献、法规与校内药品获取相关的法规和实施文件。利益相关者根据专业知识分为立法组和实施组两类。每个小组都以虚拟方式召开会议，审查文件并起草建议。在与所有利益相关者举行的反复远程会议中汇编和修订了建议。主要结果：我们为制定州立法和促进计划实施提供了几项建议。 1) 创建利益相关者联盟来支持立法并实施沙丁胺醇库存计划。该联盟应包括学校管理人员、学校护士和卫生人员、哮喘儿童的家长或照顾者、儿科初级保健和亚专科提供者（例如肺病专家/过敏专家）、药剂师、卫生部门工作人员以及当地/区域/国家倡导组织。 2) 对于有效实施沙丁胺醇库存计划至关重要的立法内容包括规定可以善意地对任何患有呼吸窘迫的儿童进行药物治疗、为学校工作人员制定培训要求、为工作人员和处方者提供民事责任豁免权、确保药房法允许向学校发放处方，并建议使用带阀门的储存室/间隔器的吸入器进行管理。 3) 选择一位经验丰富、忠诚的立法者来支持立法并在通过和实施过程中根据需要指导修订。此人应来自多数党并在立法机关的健康或教育委员会任职。 4) 制定计划，向受影响群体（包括学校管理人员、学校护士、药剂师、急救人员和初级/专科临床医生）传播立法和法规/政策。定期评估实施效果和调整需求。结论：对于患有哮喘的儿童来说，学校库存沙丁胺醇是一种安全、实用且可能挽救生命的选择，无论哮喘是否已确诊，也无法获得个人快速缓解药物。立法对于帮助采用和实施学校库存沙丁胺醇政策势在必行，关键政策的纳入可以为成功奠定基础。未来的工作应侧重于在所有州通过立法、在学校实施政策以及评估此类计划对学业和健康结果的影响。