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Handling Errors in the Use of Inhalation Devices: Inhalation Technique Skills and Knowledge in Pediatric Nurses
Martina Patrizia Neininger1, Almuth Kaune, Juliane Musiol
1Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University and Drug Safety Center, Leipzig University and University Hospital, Leipzig, Germany (Drs Neininger and T. Bertsche and Mss Kaune and Musiol); University Hospital for Children and Adolescents, Center for Pediatric Research, Leipzig, Germany (Drs Kiess, A. Bertsche, and Prenzel); and Neuropediatrics, University Hospital for Children and Adolescents, Rostock, Germany (Dr A. Bertsche).
Insights
Nurses require enhanced training in pediatric inhalation device use. Proper technique and knowledge are crucial for improving patient safety and ensuring effective medication delivery in children with bronchial diseases.
Area of Science:
- Pediatric Nursing
- Respiratory Care
- Medication Administration
Background:
- Children with bronchial diseases often require assistance with inhalation devices.
- Effective use of these devices is critical for managing pediatric respiratory conditions.
Purpose of the Study:
- To evaluate the proficiency of nurses in administering medications via inhalation devices to hospitalized children.
- To identify gaps in nurses' knowledge and skills related to pediatric inhalation therapy.
Main Methods:
- An expert panel identified common medication errors associated with pediatric inhaler use.
- Nurse skills were assessed through observation of 241 inhalation procedures.
- Nurse knowledge was evaluated using a questionnaire completed by 29 participants.
Main Results:
- A significant number of procedures (39%) had issues with airtight mask/mouthpiece fit.
- Post-inhalation mouth care was inadequate, particularly after glucocorticoid administration.
- Many nurses lacked knowledge regarding proper mask fit and post-inhalation cleaning protocols for medications like budesonide.
Conclusions:
- Current education on inhalation procedures for nurses is insufficient.
- Practical training and updated educational strategies are necessary to improve nurses' skills and patient safety.
- Enhanced training can lead to better outcomes for pediatric patients with respiratory illnesses.
Background:
Children suffering from bronchial diseases need assistance from nurses in the use of inhalation devices.
Purpose:
We aimed to assess nurses' skills and knowledge concerning drug administration with inhalation devices in hospitalized pediatric patients.
Methods:
An expert panel defined medication errors in drug administration with inhalation devices in children. We monitored 241 inhalation procedures to investigate nurses' inhalation technique skills. Twenty-nine nurses completed a questionnaire to assess nurses' knowledge.
Results:
Skills: In 93 of 241 (39%) inhalation procedures, the mask/mouthpiece did not fit airtight. In none of the 11 inhalations administering a glucocorticoid, the patient's mouth was thoroughly cleaned afterward. Knowledge: Ten of 29 nurses (34%) thought a distance between mask and the patient's face was acceptable. Only 16 of 29 (55%) knew that it is necessary to thoroughly clean the patient's mouth after the inhalation of budesonide.
Conclusions:
We found that education on inhalation procedures including practical training is required to increase patient safety.
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