The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

PREDICTORS OF COMPETENCE IN METERED DOSE INHALER KNOWLEDGE AND TECHNIQUE IN FOUR HEALTH PROFESSIONS

Tammy K Sleeper BS RRT *, Jon Gietzen BS RRT, Darrin Beier BS RRT, *Arkansas Children's Hospital, Little Rock, AR, North Dakota State University/MeritCare Resp Care Program, Fargo, ND 58122

INTRODUCTION: Correct use of metered dose inhalers (MDI) is very technique and knowledge dependent. Given the diverse educational backgrounds of the four professions studied, we sought to determine whether demonstrable differences in MDI technique or knowledge in these care givers exist, and if we could predict competence based on training, frequency of MDI use and years experience. METHOD: We studied MDI technique and knowledge of randomly selected MD's (13), RN's (15), RPH's (14) and RT's (14) [56 subjects] from a 400+ bed regional teaching facility and local retail pharmacies. Consent was implied by participation. Each subject answered seven questions to determine their knowledge of common MDI facts. The subject, using a clean placebo inhaler, also demonstrated their MDI technique. Results: Data was analyzed, using one way ANOVA (p < .05) and Tukey (HSD) comparison of means (alpha < .05). All data reported as % correct Mean (sd).

MD RN RPH RT

KNOWLEDGE Know when MDI is empty .54 .47 .64 .93

Inhale with slow inspiration 1.0 .93 1.0 .79

Spacer effect on mouth deposits .77 1.0 .64 1.0

When to rinse mouth .85 .93 .79 1.0

First Beta2, Second steroid .69 .33 .57 .93

Effect of waiting between puffs .69 .67 .57 .93

% of aerosol deposited in lungs .15 .07 .00 .29

Mean % Correct Knowledge .67(.16).63(.14) .60(.10).84(.13)

TECHNIQUE Shake prior to use .85 .80 1.0 1.0

Exhale fully prior to actuate .23 .33 .29 .79

Hold MDI upright when using 1.0 1.0 .93 1.0

Use some type of spacer device 1.0 1.0 .93 1.0

Begin inspiring before actuate .77 .80 .29 1.0

Actuate MDI .92 1.0 1.0 1.0

Inspire with slow deep breath .92 .93 .50 1.0

Hold breath for > 3 seconds .46 .53 .57 1.0

Only inspire 1 Puff per time .92 1.0 .79 .93

Mean % Correct Technique .78(.11).82(.11).71(.13).97(.05)

PREDICTORS n Knowledge Technique

How Trained MDI pkg insert 14 .60(.09) .74(.16)

Formal education 26 .75(.17) p=.01 .87(.11) p=.01

Peer education 16 .65(.15) .81(.15)

MDI Frequency < 10X per week 35 .64(.14) .77(.15)

>10X per week 21 .75(.18) p=.09 .90(.09) p=.01

Experience < 15 years 26 .68(.17) .85(.12)

>15 years 30 .69(.15) p=.19 .79(.15) p=.15

CONCLUSION: There is a significant difference in the overall knowledge and technique (p=.0001) between professions, with RT scoring significantly higher. Formal education, and MDI frequency > 10 X per week predict greater competence in technique. Only formal education predicts increased knowledge. We conclude, in our facility, formal education is the best option for ensuring competence in both MDI knowledge and technique.

OF-97-011

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