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ASSESSMENT OF THE KNOWLEDGE, SKILLS, AND ABILITY TO USE INHALER DEVICES BY MEDICAL PERSONNEL

The Brooklyn Hospital Center, Brooklyn, NY

PURPOSE:To determine if medical personnel at different levels of training responsible for monitoring and instructing patients in optimal inhaler use have sufficient knowledge and ability to use inhaler devices. Does training medical personnel have an impact on their knowledge and ability to use these devices?.

METHODS:A trained pulmonary physician at our hospital assessed internal medicine interns and residents for their knowledge, skills and ability to use inhaler devices. Respiratory therapists (RT) were evaluated similarly as a control group. The devices included metered dose inhalers, spacing chamber, turbuhaler, handihaler and accuhaler. An objective scoring system was devised based on percentage of questions answered and percentage of steps performed correctly as per the manufacturers’ instruction booklet. Subjects were shown printed instructions and correct technique in inhaler use after the completion of the initial test. Subjects were reevaluated after one month by a repeat test. The study is ongoing.

RESULTS:Thirty-three subjects completed the initial test. Twenty-two subjects participated in the repeat test. The mean of the initial test scores of post graduate year (PGY) 1, PGY 2, PGY 3 and RT were 43.9 (Standard Deviation [SD] 42.2), 47.6 (SD 39), 54.6 (SD 40.3), and 87.3 (SD 24.4) respectively. On the initial test RT did significantly better (p<0.0001) than others as would be expected because of their experience in use of these devices. The repeat test scores for PGY 1, PGY 2, PGY 3 and RT were 90 (SD 17.5), 82.9 (SD 22.7), 85.4 (SD 26.0) and 96.3 (SD 8) respectively. All groups showed remarkable improvement in the scores after training; PGY 1 demonstrating the greatest improvement. There was no significant difference in the scores among the interns, residents and RT on the repeat test.

CONCLUSION:Residents knowledge and skills about inhaler use varied widely. Training residents in use of inhaler devices resulted in significant improvement in their knowledge and skills.

CLINICAL IMPLICATIONS:Medical personnel especially residents should be trained about correct use of inhalers.

DISCLOSURE:Mary-Kavitha Vangala, None.