Department of Emergency Medicine, Georgetown Public Hospital, Georgetown, Guyana.
Department of Emergency Medicine, Georgetown Public Hospital, Georgetown, Guyana; Department of Emergency Medicine, The University of Arizona, Tucson, Arizona.
J Emerg Med. 2020 Apr;58(4):667-672. doi: 10.1016/j.jemermed.2020.02.011. Epub 2020 Mar 31.
Inhaled β-agonists are the cornerstone of acute treatment for asthma and chronic lung disease. Upon emergency department (ED) discharge, patients optimally receive prescriptions for metered-dose inhalers (MDIs) with instructions on their proper use. Yet prior studies suggest that ED personnel have limited knowledge of proper MDI techniques. It is unclear how effectively brief education will improve this knowledge to enable them to provide adequate patient instructions.
Our aim was to evaluate ED medical personnel's baseline knowledge of MDI use and the utility of brief education on their ability to use MDIs.
After providing written consent, a spirometry nurse evaluated emergency physicians and nurses on their ability to properly perform three (open-mouth/two-finger, spacer, and closed-mouth) MDI techniques. The same spirometry nurse then gave a short educational session demonstrating the proper MDI techniques. Two weeks later, the nurse re-evaluated the same personnel on their MDI techniques.
All emergency medical personnel initially performed poorly in demonstrating proper MDI technique, averaging 29.8% steps done correctly. Two weeks after their educational session, they improved greatly, averaging 89.4% steps done correctly.
This study demonstrated both that ED personnel had poor initial knowledge about MDI techniques and that a brief educational intervention improved most people's ability to use, and presumably to instruct patients/parents in proper use of, MDIs.
吸入β-激动剂是急性治疗哮喘和慢性肺部疾病的基石。在急诊科(ED)出院时,患者最好能拿到定量吸入器(MDI)的处方,并附有正确使用说明。然而,先前的研究表明,ED 人员对正确的 MDI 技术知之甚少。目前尚不清楚简短的教育在提高他们的知识方面能起到多大的作用,以使其能够为患者提供适当的指导。
我们旨在评估 ED 医务人员使用 MDI 的基本知识,并评估简短教育对他们使用 MDI 能力的效用。
在提供书面同意后,一位肺量计护士评估了急诊医生和护士正确执行三种(张口/两指、带空间器和闭口)MDI 技术的能力。然后,同一位肺量计护士进行了简短的教育课程,演示了正确的 MDI 技术。两周后,护士重新评估了同一批人员的 MDI 技术。
所有急诊医务人员在演示正确的 MDI 技术方面最初表现不佳,正确完成的步骤平均为 29.8%。在教育课程两周后,他们的表现有了很大的提高,正确完成的步骤平均达到了 89.4%。
这项研究表明,ED 人员对 MDI 技术的初始知识水平较差,而简短的教育干预可以提高大多数人使用 MDI 的能力,并可能指导患者/家长正确使用 MDI。