Effectiveness of a nursing training intervention in complex chronic patients

Efficacy of an educational intervention in the management of an inhalation device among nursing professionals of an emergency department

OBJECTIVE

To explore the most frequent errors of the inhalation technique (main topic for the pharmacological treatment of exacerbations of asthma and/or chronic obstructive pulmonary disease) in the nursing staff of an emergency department, and to evaluate the efficacy of an educational intervention.

METHODS

Prospective quasi-experimental study, carried out in a hospital in Argentina during 2019. For the evaluation of the nursing staff, the steps of the Separ-Alat Consensus were used. The educational intervention consisted of oral explanation and visual demonstration of the inhalation technique. Paired data analysis was performed, and absolute and relative frequencies were calculated with their respective 95% confidence intervals.

RESULTS

A consecutive sample of 72 nurses was included, of which 95.83% (95%CI 88.30-99.13) made at least one error in the baseline assessment. The most frequent errors were the lack of indication to the patient to exhale prior to inhalation (83.72%), forgetting to remove the air chamber and repeat the steps before the second dose (81.40%). After immediate evaluation after receiving the educational intervention, 74.42% (95%CI 58.83-86.49) corrected the technique. However, at one month, 53.49% (23/43; 95%CI 37.66-68.86) performed the technique correctly.

CONCLUSIONS

The educational intervention could be effective in correcting errors in this practice, although its effects tend to fade over time. Therefore, we consider periodic and systematic education relevant to maintain a correct inhalation technique among professionals.