Demonstrating and assessing metered-dose inhaler-spacer technique: Pediatric care providers' self-reported practices and perceived barriers

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Abstract

The National Asthma Education and Prevention Program recommends that providers demonstrate and assess metered-dose inhaler-spacer (MDI-S) technique at each medical visit. To examine practice behaviors and perceived barriers to demonstrating and assessing MDI-S technique, we surveyed pediatric providers (n = 114) at an inner-city academic medical center. While 82% of providers demonstrated MDI-S technique, only 5% of providers demonstrate the technique at every visit. Although 67% of providers assessed MDI-S technique, only 13% assess the technique at every visit. None of the providers used MDI-S checklist for assessment. Attendings were more likely than residents to demonstrate with illustrations (24% vs 6%, P =.01) and when patient's asthma was not well controlled (68% vs 47%, P =.05). Provider-identified barriers included limited access to MDI-S device, lack of time, and inadequate knowledge. Suggestions to address barriers include in-service training, device access, and nurse/health educators to alleviate the time constraints. Clinic modifications and education are needed.

Original languageEnglish (US)
Pages (from-to)270-276
Number of pages7
JournalClinical Pediatrics
Volume53
Issue number3
DOIs
StatePublished - Mar 2014

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Metered Dose Inhalers
Self Care
Pediatrics
Asthma
Health Educators
Education
Equipment and Supplies
Checklist
Nurses

Keywords

  • asthma
  • barriers
  • MDI-spacer technique
  • pediatric care provider

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

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abstract = "The National Asthma Education and Prevention Program recommends that providers demonstrate and assess metered-dose inhaler-spacer (MDI-S) technique at each medical visit. To examine practice behaviors and perceived barriers to demonstrating and assessing MDI-S technique, we surveyed pediatric providers (n = 114) at an inner-city academic medical center. While 82{\%} of providers demonstrated MDI-S technique, only 5{\%} of providers demonstrate the technique at every visit. Although 67{\%} of providers assessed MDI-S technique, only 13{\%} assess the technique at every visit. None of the providers used MDI-S checklist for assessment. Attendings were more likely than residents to demonstrate with illustrations (24{\%} vs 6{\%}, P =.01) and when patient's asthma was not well controlled (68{\%} vs 47{\%}, P =.05). Provider-identified barriers included limited access to MDI-S device, lack of time, and inadequate knowledge. Suggestions to address barriers include in-service training, device access, and nurse/health educators to alleviate the time constraints. Clinic modifications and education are needed.",
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