Inhaler technique in a pediatric emergency department: Impact of an education intervention among healthcare professionals

Pediatr Pulmonol. 2023 Feb;58(2):441-448. doi: 10.1002/ppul.26205. Epub 2022 Oct 25.

Abstract

Background: Inhaler technique (IT) knowledge among healthcare providers is poor. The aim was to improve Pediatric Emergency Department (PED) healthcare providers' IT technique by carrying out an education intervention and sustain it for 6 months.

Methods: Open-label, quasi-experimental, prospective, and unicentric study. Healthcare professionals working at the PED were enrolled. The study was developed in three phases: baseline evaluation and education intervention (P1) and reevaluation 1 month (P2) and 6 months (P3) after the education intervention. Participants fulfilled an eight-question theoretical test. Practical skills were evaluated by demonstrating IT in all three phases. The education intervention consisted in a verbal explanation of IT followed by a demonstration of IT with metered-dose inhaler using a mannequin.

Results: A total of 84 healthcare providers (medical residents, nurses, and nursing assistants) were involved. In the theoretical questionnaire, the mean score at baseline was 4.4/8 (SD 1.7) improving to 6.3/8 (SD 1.2) in P2 and 6.47/8 (SD 1.1) in P3. In the IT evaluation for children <7 years old, the score improved from 5.7/7 (SD 1.3) to 6.5/7 in P2 and 6.7/7 in P3 (p < 0.001). For children >7 years old, the mean score of IT at baseline was 3.1/10 (SD 4), which improved to 7.4/10 (SD 3) and 8.2/10 in P2 and P3, respectively (p < 0.001). Only professional category influenced results at baseline.

Conclusion: Healthcare providers' theoretical knowledge and practical skills on IT are low. The education intervention performed is a useful strategy to ameliorate IT among healthcare providers.

Keywords: asthma; emergency service; metered-dose inhalers; nebulizers and vaporizers; quality of healthcare; teacher training.

MeSH terms

  • Administration, Inhalation
  • Child
  • Delivery of Health Care
  • Emergency Service, Hospital
  • Health Personnel
  • Humans
  • Metered Dose Inhalers*
  • Nebulizers and Vaporizers*
  • Prospective Studies