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Inhalation technique practical skills and knowledge among physicians and nurses in two pediatric emergency settings.

Abstract
Introduction: Correct technique with a pressurized metered-dose inhaler (pMDI) equipped with a valved holding chamber (VHC) or spacer provides an important advantage for adequate control of asthma and virus-induced wheezing in young children. The aim of this study was to assess the ability and knowledge of physicians and nurses to use a pMDI with a masked VHC in two pediatric emergency units.Methods: Study design: Two-center observational study. Inhaler use technique was assessed in 50 physicians and 50 nurses using a child mannequin and a validated videotaped nine-step scoring method. The participants' knowledge was evaluated by a questionnaire.Results: The inhalation technique was perfectly mastered by 49% of the study participants and almost perfectly mastered by another 34% (mean score 8.3 ± 0.7; range 5-9). Nurses were more likely than doctors to demonstrate the technique perfectly (66% vs. 32%, p < 0.05). The two most common errors were forgetting to shake the pMDI between two consecutive puffs (38% of the participants) and putting the patient in an incorrect position (11%). About half of the participants reported that they checked each patient's inhalation technique at every opportunity and knew how to clean the VHC. A large majority did not employ a reliable method to determine the amount of medication remaining in pMDIs without a counter.Conclusion: Healthcare professionals' practical skills and knowledge on inhalation therapy were not completely mastered and could be improved with a mandatory training program.
AuthorsStéphanie Spaggiari, Mario Gehri, Laurence Di Benedetto, Gaudenz M Hafen, Jean-Yves Pauchard, Alain Gervaix, André Pannatier, Farshid Sadeghipour, Ermindo R Di Paolo
JournalThe Journal of asthma : official journal of the Association for the Care of Asthma (J Asthma) Vol. 58 Issue 2 Pg. 190-196 (02 2021) ISSN: 1532-4303 [Electronic] England
PMID31566459 (Publication Type: Journal Article, Multicenter Study, Observational Study)
Topics
  • Administration, Inhalation
  • Adult
  • Asthma (drug therapy)
  • Emergency Service, Hospital
  • Female
  • Health Knowledge, Attitudes, Practice
  • Hospitals, Pediatric
  • Humans
  • Inhalation Spacers
  • Male
  • Manikins
  • Metered Dose Inhalers
  • Middle Aged
  • Nurses (standards)
  • Physicians (standards)

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