Hospital staff practical skills and theoretical knowledge in inhaled aerosol therapy: a single centre cross-sectional observational study

Abstract

Inhaled therapy is widely used for treatment of many respiratory disorders. Drug delivery in lungs is dependent on the correct use of aerosol devices and patients’ training is vital for a correct therapy administration. Therefore, is very important to assess the skills of professionals involved in training patients to the correct use of inhaler devices. The aim of this study was to check the practical skills and the theoretical knowledge of health care personnel in our University Hospital in using aerosol therapy and to determine differences among professional figures in the management of inhaler devices. Three hundred and fifteen (315) volunteers including physicians, residents, nurses and respiratory physiotherapists were enrolled; an independent professional, not working in our University Hospital, assessed their theoretical knowledge related to aerosol throughout a questionnaire. Practical skills were assessed through placebo simulation with the devices that participants declared to use frequently with patients. None of the respondents correctly answered all questions evaluating theoretical knowledge on the proper use of aerosol therapy. Respiratory physiotherapists obtained significantly better results with 17.2 (1.3) average points compared to 10.3 (3.7) obtained by doctors, 9.0 (3.0) by nurses and 9.1 (4.5) by residents. Analysing in detail physicians’ results, pneumologists showed better theoretical knowledge than other specialists. Concerning the practical skills, about 80% of those stating they knew how to use metered dose inhalers, made mistakes in the basic steps for proper inhalation technique and over 50% of respondents were unable to properly simulate placebo administration of dry powder inhalers. Also here, respiratory physiotherapists and pneumologists had significant better performances, when compared to other health professionals. Our data are in line with those published in the literature in other international clinical settings, noting inadequate practical and theoretical knowledge of the available devices for aerosol therapy.

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Author Biographies

Martina Santambrogio, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan

Department of Pathophysiology and Transplantation, University of Milan

Edoardo Simonetta, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan

Department of Pathophysiology and Transplantation, University of Milan

Francesco Blasi, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan

Department of Pathophysiology and Transplantation, University of Milan

Emilia Privitera, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan

Health Professions Department Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan

References

References

Global Initiative for Asthma. Pocket guide for asthma management and prevention (for adults and children older than 5 years). 2020. Available from: https://ginasthma.org/pocket-guide-for-asthma-management-and-prevention/

Global Initiative for Chronic Obstructive Lung Disease. Gold Pocket Guide 2019.

Sanchis J, Gich I, Pedersen S, Aerosol Drug Management Improvement Team. Systematic review of errors in inhaler use: Has patient technique improved over time? Chest 2016;150:394-406.

Capanoglu M, Dibek Misirlioglu E, Toyran M, et al. Evaluation of inhaler technique, adherence to therapy and their effect on disease control among children with asthma using metered dose or dry powder inhalers. J Asthma 2015;52:838-45.

Momeni S, Nokhodchi A, Ghanbarzadeh S, Hamishehkar H. The effect of spacer morphology on the aerosolization performance of metered-dose inhalers. Adv Pharm Bull 2016;6:257-60.

Westerik JA, Carter V, Chrystyn H, Burden A, et al. Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting. J Asthma 2016;53:321-9.

Plaza V, Lopez-Vina A, Entrenas LM, et al. Differences in adherence and non-adherence behaviour patterns to inhaler devices between COPD and asthma patients. COPD 2016;13:547-54.

Plaza V, Giner J, Rodrigo GJ, et al. Errors in the use of inhalers by health care professionals: A systematic review. J Allergy Clin Immunol Pract 2018;6:987-95.

Melani AS. Inhalatory therapy training: a priority challenge for the physician. Acta Biomed 2007;78:233-45.

Chopra N, Oprescu N, Fask A, Oppenheimer J. Does introduction of new "easy to use" inhalational devices improve medical personnel's knowledge of their proper use? Ann Allergy Asthma Immun 2002;88:395-400.

Alismail A, Song CA, Terry MH, et al. Diverse inhaler devices: A big challenge for health-care professionals. Respir Care 2016;61:593-9.

Esposito S, Brivio A, Tagliabue C, et al. Knowledge of oxygen administration, aerosol medicine, and chest physiotherapy among pediatric healthcare workers in Italy. J Aerosol Med Pulm Drug Deliv 2011;24:149-56.

Douglas S, Gardenhire DB, Shawna Strickland, et al. A guide to aerosol delivery devices for respiratory therapists. American Association for Respiratory Care; 2017.

Fink JB, Rubin BK. Problems with inhaler use: a call for improved clinician and patient education. Respir Care 2005;50:1360-74; discussion 74-5.

Team RDC. A language and environment for statistical computing. R Foundation for Statistical Computing. 2015.

Rau JL. Practical problems with aerosol therapy in COPD. Respir Care 2006;51:158-72.

Sestini P, Cappiello V, Aliani M, et al. Prescription bias and factors associated with improper use of inhalers. J Aerosol Med 2006;19:127-36.

De Blaquiere P, Christensen DB, Carter WB, Martin TR. Use and misuse of metered-dose inhalers by patients with chronic lung disease. A controlled, randomized trial of two instruction methods. Am Rev Respir Dis1989;140:910-6.

Gambazza S, Carta F, Brivio A, Colombo C. Aerosol delivery practice in Italian Cystic Fibrosis centres: a national survey. Arch Physiother 2016;6:1.

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Published
2021-01-25
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Section
Physiotherapy - Original Articles
Keywords:
Aerosol, inhaler technique, practical skills, health care personnel
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How to Cite
Santambrogio, M., Lazzeri, M., Bonitta, G., Guarise, R., Simonetta, E., Blasi, F., & Privitera, E. (2021). Hospital staff practical skills and theoretical knowledge in inhaled aerosol therapy: a single centre cross-sectional observational study. Monaldi Archives for Chest Disease, 91(1). https://doi.org/10.4081/monaldi.2021.1532