The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

REDUCTION OF NEBULIZATION TIME, NUMBER OF TREATMENTS, AND LENGTH OF STAY CAN BE ACHIEVED WITH A BREATH-ACTUATED NEBULIZER

K. Thigpen1, L. Simmons1

Background: Patient response to therapy is affected by many factors including nebulizer design, particle size, patient technique, nebulization time, et. al. Since its inception, a predominant goal in aerosol therapy has revolved around maximizing efficacy while delivering the medication in a reasonable manner. Therapists are currently under a higher degree of scrutiny to accomplish this than ever before. We report our findings on nebulization time, average number of treatments per admission and length of stay based on our experience utilizing an updraft nebulizer (UDN) and since our conversion to a breath-actuated nebulizer (BAN - Monaghan AeroEclipse) in October, 2003.

Methods: We performed a retrospective study on nebulization time and average number of treatments administered to a randomized sample of 50 adult patients who had been placed on our COPD Clinical Path using the UDN and BAN. We also performed a separate, retrospective study on the average length of stay (ALOS) on patients receiving aerosol therapy with UDN and BAN both with a primary diagnosis of COPD (51 cases) as well as a secondary diagnosis (2375 cases) in 2003 and 2006.

Results: Treatment times were significantly reduced from an average of approximately 10 minutes with the UDN to 5 minutes or less with the BAN. This reduction in time was based on a policy established after a review of superior deposition results cited in a 2004 bench study [1]. Treatments administered during hospitalization decreased from 24.5 using the UDN to 20.45 using the BAN. The other study demonstrated a reduction in ALOS for those patients with a primary diagnosis of COPD from 4.81 days with UDN to 4.41 days with BAN, a decrease of 0.4 days or 9%. There was also a reduction in ALOS for those patients with a secondary diagnosis of COPD from 7.76 days with UDN to 7.18 days with BAN, a decrease of 0.58 days or 8%.

Conclusion: The BAN had a desirable impact on decreasing the time required for nebulization while reducing the number of treatments required for our patients. The ALOS required for hospitalization was decreased as well.

[1] - Rau JL,  Ari A, Restrepo RD. Performance comparison of nebulizer designs: Constant-output, breath-enhanced, and dosimetric. Respir Care 2004;49(2):174-179.

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