Knowledge of inhaler technique and performing peak expiratory flow rate among healthcare professionals

Abstract

BACKGROUND: Healthcare professionals should ensure that patients carry out an adequate inhaler technique. The aim of this audit was to assess the knowledge of healthcare professionals in performing a correct technique with two very commonly encountered devices, that is the metered dose inhaler (with spacer) and the turbohaler. Assessment of peak expiratory flow rate (PEFR) measurement technique was also done, since healthcare professionals should be able to monitor this parameter to aid detection of clinical improvement or deterioration.

METHODS: The healthcare professionals involved equal numbers (25 of each group) of nursing staff, foundation trainees and medical basic specialist trainees. Assessment was performed by two observers with the use of a checklist for each technique.

RESULTS: The turbohaler technique scored lower than the metered dose inhalers across all three groups, however there was no statistical significance when comparing the results of the three groups for the turbohaler technique. The highest scores were obtained in the medical specialist trainee group; results being statistically significant (p= <0.001) between the three groups with regards to metered dose inhalers and PEFR. The lowest scores were obtained in the nursing staff group.

DISCUSSION: Education regarding inhaler techniques and PEFR should be a priority. Lack of knowledge from healthcare professionals would reflect on patients and this would lead to deterioration of disease control. Measures such as having printed guidelines in the ward for ease of reference, information leaflets and placebo inhalers can help improve education. If available, designated specialised respiratory nurses can also help in education for both healthcare professionals and patients.