scholarly journals Hospital staff practical skills and theoretical knowledge in inhaled aerosol therapy: a single centre cross-sectional observational study

2021 ◽  
Vol 91 (1) ◽  
Author(s):  
Martina Santambrogio ◽  
Marta Lazzeri ◽  
Gianluca Bonitta ◽  
Riccardo Guarise ◽  
Edoardo Simonetta ◽  
...  
Keyword(s):  
Hospital Staff ◽  
University Hospital ◽  
Inhalation Technique ◽  
Theoretical Knowledge ◽  
Practical Skills ◽  
Aerosol Therapy ◽  
Cross Sectional ◽  
Inhaled Therapy ◽  
Metered Dose ◽  
Inhaler Devices

Inhaled therapy is widely used for treatment of many respiratory disorders. Drug delivery in lungs is dependent on the correct use of aerosol devices and patients’ training is vital for a correct therapy administration. Therefore, is very important to assess the skills of professionals involved in training patients to the correct use of inhaler devices. The aim of this study was to check the practical skills and the theoretical knowledge of health care personnel in our University Hospital in using aerosol therapy and to determine differences among professional figures in the management of inhaler devices. Three hundred and fifteen (315) volunteers including physicians, residents, nurses and respiratory physiotherapists were enrolled; an independent professional, not working in our University Hospital, assessed their theoretical knowledge related to aerosol throughout a questionnaire. Practical skills were assessed through placebo simulation with the devices that participants declared to use frequently with patients. None of the respondents correctly answered all questions evaluating theoretical knowledge on the proper use of aerosol therapy. Respiratory physiotherapists obtained significantly better results with 17.2 (1.3) average points compared to 10.3 (3.7) obtained by doctors, 9.0 (3.0) by nurses and 9.1 (4.5) by residents. Analysing in detail physicians’ results, pneumologists showed better theoretical knowledge than other specialists. Concerning the practical skills, about 80% of those stating they knew how to use metered dose inhalers, made mistakes in the basic steps for proper inhalation technique and over 50% of respondents were unable to properly simulate placebo administration of dry powder inhalers. Also here, respiratory physiotherapists and pneumologists had significant better performances, when compared to other health professionals. Our data are in line with those published in the literature in other international clinical settings, noting inadequate practical and theoretical knowledge of the available devices for aerosol therapy.

scholarly journals The Challenge of Delivering Therapeutic Aerosols to Asthma Patients

ISRN Allergy ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-17 ◽  
Author(s):  
Federico Lavorini
Keyword(s):  
Asthma Management ◽  
Dose Inhaler ◽  
Inhalation Technique ◽  
Management Guidelines ◽  
Inhaler Device ◽  
Peripheral Airways ◽  
Metered Dose ◽  
Asthma Patients ◽  
Patient Noncompliance ◽  
Inhaler Devices

The number of people with asthma continues to grow around the world, and asthma remains a poorly controlled disease despite the availability of management guidelines and highly effective medication. Patient noncompliance with therapy is a major reason for poor asthma control. Patients fail to comply with their asthma regimen for a wide variety of reasons, but incorrect use of inhaler devices is amongst the most common. The pressurised metered-dose inhaler (pMDI) is still the most frequently used device worldwide, but many patients fail to use it correctly, even after repeated tuition. Breath-actuated inhalers are easier to use than pMDIs. The rationale behind inhaler choice should be evidence based rather than empirical. When choosing an inhaler device, it is essential that it is easy to use correctly, dosing is consistent, adequate drug is deposited in both central and peripheral airways, and that drug deposition is independent of airflow. Regular checking of inhalation technique is crucial, as correct inhalation is one of the cornerstones of successful asthma management.

scholarly journals Acquisition of Knowledge and Practical Skills after a Brief Course of BLS-AED in First-Year Students in Nursing and Physiotherapy at a Spanish University

2019 ◽  
Vol 16 (5) ◽  
pp. 766 ◽  
Author(s):  
Carlos Méndez-Martínez ◽  
Santiago Martínez-Isasi ◽  
Mario García-Suárez ◽  
Medea Aglaya De La Peña-Rodríguez ◽  
Juan Gómez-Salgado ◽  
...  
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Quality Criteria ◽  
Western World ◽  
First Year ◽  
Practical Training ◽  
Theoretical Knowledge ◽  
Training Methods ◽  
Practical Skills ◽  
Cross Sectional

Out-of-hospital cardiorespiratory arrest is one of the leading causes of death in the Western world. Early assistance with quality Cardiopulmonary Resuscitation (CPR) and the use of a defibrillator may increase the percentage of survival after this process. The objective of this study was to evaluate the effect of CPR training and the management of an Automatic External Defibrillator (AED). A descriptive, cross-sectional, observational study was carried out among students in the first year of a Nursing and Physiotherapy degree of the University of León. To achieve this goal, a theoretical-practical educational intervention of four hours’ duration which included training on CPR, AED and Basic Life Support (BLS) was carried out. A total of 112 students were included. The results showed an increase in theoretical knowledge on BLS as well as on CPR and AED, and practical skills in CPR and AED management. A theoretical exposition of fifteen minutes and the practical training of CPR wasenough for the students to acquire the necessary theoretical knowledge, although the participants failed to reach quality criteria in CPR. Only 35.6% of students reached the right depth in compressions. Also, ventilation was not performed properly. Based on the results, we cannot determine that the percentage of overall quality of CPR was appropriate, since 57.6% was obtained in this respect and experts establish a value higher than 70% for quality CPR. There was a clear relationship between sex, weight, height and body max index (BMI), and quality CPR performance, being determinant variables to achieve quality parameters. Currently, Basic Life Support training in most universities is based on training methods similar to those used in the action described. The results obtained suggest implementing other training methods that favour the acquisition of quality CPR skills.

scholarly journals Strategies for infection control and prevalence of anti-SARS-CoV-2 IgG in 4,554 employees of a university hospital in Munich, Germany

2020 ◽  
Author(s):  
Johanna Erber ◽  
Verena Kappler ◽  
Bernhard Haller ◽  
Hrvoje Mijočević ◽  
Ana Galhoz ◽  
...  
Keyword(s):  
Virus Transmission ◽  
Healthcare Facility ◽  
Hospital Staff ◽  
University Hospital ◽  
Individual Risk ◽  
Igg Antibody ◽  
Cross Sectional ◽  
Hygiene Measures ◽  
Antibody Titres ◽  
Spatio Temporal

AbstractBackgroundHospital staff are at high risk of infection during the coronavirus disease (COVID-19) pandemic. We analysed the exposure characteristics, efficacy of protective measures, and transmission dynamics in this hospital-wide prospective seroprevalence study.Methods and FindingsOverall, 4554 individuals were tested for anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibodies using a chemiluminescent immunoassay. Individual risk factors, use of personal protective equipment (PPE), occupational exposure, previous SARS-CoV-2 infection, and symptoms were assessed using a questionnaire and correlated to anti-SARS-CoV-2 IgG antibody titres and PCR testing results. Odds ratios with corresponding exact 95% confidence intervals were used to evaluate associations between individual factors and seropositivity. Spatio-temporal trajectories of SARS-CoV-2-infected patients and staff mobility within the hospital were visualised to identify local hotspots of virus transmission.The overall seroprevalence of anti-SARS-CoV-2-IgG antibody was 2.4% [95% CI 1.9–2.9]. Patient-facing staff, including those working in COVID-19 areas, had a similar probability of being seropositive as non-patient-facing staff. Prior interaction with SARS-CoV-2-infected co-workers or private contacts and unprotected exposure to COVID-19 patients increased the probability of seropositivity. Loss of smell and taste had the highest positive predictive value for seropositivity. The rate of asymptomatic SARS-CoV-2 infections was 25.9%, and higher anti-SARS-CoV-2 IgG antibody titres were observed in symptomatic individuals. Spatio-temporal hotspots of SARS-CoV-2-positive staff and patients only showed partial overlap.ConclusionsPatient-facing work in a healthcare facility during the SARS-CoV-2 pandemic may be safe if adequate PPE and hygiene measures are applied. The high numbers of asymptomatic SARS-CoV-2 infections that escaped detection by symptomatic testing underline the value of cross-sectional seroprevalence studies. Unprotected contact is a major risk factor for infection and argues for the rigorous implementation of hygiene measures.

Primary Health Care Pediatricians’ Self-Perception of Theoretical Knowledge and Practical Skills in Life-Threatening Emergencies: A Cross-Sectional Study

2020 ◽  
Vol 35 (2) ◽  
pp. 152-159
Author(s):  
José Antonio Cernuda Martínez ◽  
Rafael Castro Delgado ◽  
Pedro Arcos González
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Theoretical Knowledge ◽  
Practical Skills ◽  
Self Perception ◽  
Cross Sectional ◽  
Emergency Procedures ◽  
Primary Health ◽  
Life Threatening

AbstractIntroduction:Within out-of-hospital emergencies, Primary Health Care (PHC) pediatricians will likely be the first to provide health care at the scene of a life-threatening emergency (LTE) in children. Pediatricians should be trained to initially intervene, safely and effectively the LTEs, including the activation of Emergency Medical Systems (EMS), an adequate stabilization of patients and transport to the hospital.Study Objectives:The aims of this study are to know the training received for out-of-hospital LTEs by PHC pediatricians of the Principality of Asturias (Spain) and the perception they have about their own theoretical knowledge and practical skills in a series of emergency procedures used in LTEs; also, to analyze the differences according to the geographical context of their work.Methods:This was a cross-sectional, descriptive, and observational study of a sample of 27 PHC pediatricians from PHC Service of Asturias, Spain, from among the total of 88 pediatricians who make up the staff of pediatricians, conducted from April through May 2019. The survey was designed ad hoc using the Curriculum in Primary Care Pediatrics (CPCP) proposed by the European Confederation of Primary Care Pediatricians (ECPCP; Europe), which indicates the theoretical and practical procedures that must be acquired by the PHC pediatricians. It is composed of 30 procedures or techniques employed in LTEs using a 11-point Likert scale rating to detect their self-perception about theoretical knowledge and practical skills from zero (“Minimum”) to 10 (“Maximum”).Results:There are significant differences in the mean of theoretical knowledge and practical skills in many procedures or techniques studied, depending on the different areas of work.Conclusion:Asturian pediatricians are generally well-prepared to solve LTEs with a few exceptions. The degree of self-perception and acquisition of general theoretical knowledge and general practical skills in LTEs is heterogeneous, with differences according to the scope of work.

scholarly journals Errors in Aerosol Inhaler Use and Their Effects on Maternal and Fetal Outcomes among Pregnant Asthmatic Women (Subanalysis from QAKCOP Study)

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Wanis H. Ibrahim ◽  
Fatima Rasul ◽  
Mushtaq Ahmad ◽  
Abeer S. Bajwa ◽  
Laith I. Alamlih ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Asthma Control ◽  
Primary Objective ◽  
Inhalation Technique ◽  
Breath Hold ◽  
Inhaler Technique ◽  
Fetal Outcomes ◽  
Cross Sectional ◽  
Metered Dose ◽  
Aerosol Inhaler

Data on inhaler technique and its effects on maternal and fetal outcomes during pregnancy are seldom reported. The primary objective of this study was to evaluate inhaler technique and identify errors in inhaler use among pregnant women with asthma. Secondary objectives were to identify factors associated with poor inhaler technique and study the association between inhaler technique and maternal and fetal outcomes. This was a cross-sectional, face-to-face, prospective study of 80 pregnant women with physician-diagnosed asthma. Seventy-three and 41 asthmatic pregnant women reported using pressurized metered dose inhalers (pMDIs) and dry powder inhalers (DPIs), respectively. Overall, wrong inhaler technique was observed in 47 (64.4%) subjects. Among pMDI users, correct inhaler use was observed in only 26/73 (35.6%) of the patients, with lack of coordination between inhalation and generation of the aerosol and failure to breathe out gently before using the inhaler, being the most common errors. Among DPI users, 21 (51.2%) demonstrated correct inhaler use, with failure to perform a breath-hold for 10 seconds after inhaling the powder and to exhale gently before using the inhaler being the most common errors. Significant associations between inhaler technique and patient’s understanding of asthma medications and the kind of follow-up clinic (respiratory versus nonrespiratory clinic) were found. No significant associations between inhaler technique and various maternal and fetal outcomes or asthma control were found. In conclusion, improper inhalation technique is significantly prevalent in pregnant asthmatic women, particularly among those being followed in nonspecialized respiratory clinics. The lack of significant association between the inhaler technique and asthma control (and hence maternal and fetal outcomes) may simply reflect the high prevalence of uncontrolled asthma and significant contribution of other barriers to poor asthma control in the current patient’s cohort. Multidisciplinary management of asthma during pregnancy with particular emphasis on patient’s education is imperative.

scholarly journals Determinants of Obtaining COVID-19 Vaccination among Health Care Workers with Access to Free COVID-19 Vaccination: A Cross-Sectional Study

Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 39
Author(s):  
Mariam R. Elkhayat ◽  
Maiada K. Hashem ◽  
Ahmed T. Helal ◽  
Omar M. Shaaban ◽  
Ahmed K. Ibrahim ◽  
...  
Keyword(s):  
Vaccine Development ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Vulnerable Groups ◽  
Sources Of Information ◽  
University Hospitals ◽  
Cross Sectional ◽  
Job Category ◽  
To Receive

Introduction: Despite global efforts to contain the illness, COVID-19 continues to have severe health, life, and economic repercussions; thus, maintaining vaccine development is mandatory. Different directions concerning COVID-19 vaccines have emerged as a result of the vaccine’s unpredictability. Aims: To study the determinants of the attitudes of healthcare workers (HCWs) to receiving or refusing to receive the vaccine. Methods: The current study adopted an interviewed questionnaire between June and August 2021. A total of 341 HCWs currently working at Assiut University hospitals offered to receive the vaccine were included. Results: Only half of the HCWs (42%) accepted the COVID-19 vaccine. The most common reason that motivated the HCWs was being more susceptible than others to infection (71.8%). On other hand, the common reasons for refusing included: previously contracted the virus (64.8%); did not have time (58.8%); warned by a doctor not to take it (53.8%). Nearly one-third of nonaccepting HCWs depended on television, the Internet, and friends who refused the vaccine for information (p < 0.05). In the final multivariate regression model, there were six significant predictors: sex, job category, chronic disease, being vaccinated for influenza, and using Assiut University hospital staff and the Ministry of Health as sources of information (p < 0.05). Conclusion: Misinformation and negative conceptions are still barriers against achieving the desired rate of vaccination, especially for vulnerable groups such as HCWs.

Primary Health Care Nurses’ Self-Perception of Theoretical Knowledges and Practical Skills in Life-Threatening Emergencies: A Cross-Sectional Study

2019 ◽  
Vol 34 (04) ◽  
pp. 376-384 ◽  
Author(s):  
José Antonio Cernuda Martínez ◽  
Rafael Castro Delgado ◽  
Tatiana Cuartas Álvarez ◽  
Pedro Arcos González
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Geographical Area ◽  
Theoretical Knowledge ◽  
Practical Skills ◽  
Self Perception ◽  
Cross Sectional ◽  
Emergency Procedures ◽  
Primary Health ◽  
Life Threatening

AbstractBackground:Within out-of-hospital emergencies, primary health care (PHC) nurses must face life-threatening emergencies (LTEs), which are defined as “a situation associated with an imminent life risk that entails the start-up of resources and special means to resolve the situation.”Objectives:The objectives of this study were to know the training received for out-of-hospital LTEs by PHC nurses of Asturias, Spain and the perception they have about their theoretical knowledge and practical skills in a series of emergency procedures or techniques used in LTE emergencies; as well as to analyze the differences according to the geographical area of their work.Design:Cross-sectional, descriptive, and observational study was conducted in 2018 of a sample of PHC service nurses of Asturias, Spain.Methods:A total of 236 nurses from PHC service centers of Asturias, Spain, from among the total of 730 nurses who make up the staff of nurses of the PHC service of Asturias, between April and May 2018, were surveyed. The survey was designed ad hoc using the Doctrinal Body of Emergency Nursing (DBEN) proposed by the Spanish Society of Emergency Medicine (SEMES; Madrid, Spain), which indicates the theoretical and practical procedures that must be acquired by the PHC nurses. It is composed of 37 procedures or techniques employed in LTEs using an 11-point Likert scale rating to detect their self-perception about theoretical knowledge and practical skills from zero (“Minimum”) to ten (“Maximum”).Results:There were significant differences in the mean of theoretical knowledge and practical skills in many procedures or techniques studied, depending on the different areas of work.Conclusions:All PHC nurses must be perfectly trained to provide initial quality assistance to the LTE, with both theoretical and practical knowledge of the different techniques, so that it can continue to be attended by the corresponding Emergency Service.

scholarly journals LIMITAÇÃO DA UTILIZAÇÃO DO ACESSO INTRAÓSSEO: ASPECTOS DA ENFERMAGEM E DA INSTITUIÇÃO DE SAÚDE

2018 ◽  
Vol 9 (2) ◽  
Author(s):  
Mayara Larissa Nilsen Schumaher ◽  
Carlos Poblete Jara ◽  
Vanessa Cristina Dias Bóbbo ◽  
Cristiane Helena Gallasch ◽  
Luciane Ruiz Carmona Ferreira
Keyword(s):  
Analytical Study ◽  
Technical Support ◽  
Theoretical Knowledge ◽  
Practical Skills ◽  
Intraosseous Access ◽  
Cross Sectional

Objetivo: Verificar a realização do acesso intraósseo por enfermeiros. Método: Estudo analítico transversal, realizado por meio da aplicação de um questionário. Resultados: Demonstrou-se que 97,0% dos profissionais nunca realizaram o acesso (p<0,001), e 48,5% tiveram um treinamento adequado. Apenas 9,1% relatou se sentir seguro para executar a técnica (p<0,001) e 69,7% responderam que não possuem apoio técnico, e não possuem material apropriado. Conclusão: Demonstrou-se que existe uma limitação do uso do acesso intraósseo. A falta de autonomia para realizar a técnica pode se explicar pela falta de habilidade prática e conhecimento teórico dos enfermeiros, e pela falta de protocolos e acesso à informações institucionais, treinamentos e insumos.Descritores: Infusões Intraósseas; Enfermagem; Desenvolvimento de pessoal.LIMITATION OF THE USE OF INTRAÓSSEO ACCESS: ASPECTS OF NURSING AND HEALTH INSTITUTIONAim: To verify the achievement of intraosseous access by nurses. Method: Cross-sectional analytical study, carried out through the application of a questionnaire. Results: It was demonstrated that 97,0% of the professionals never performed access (p <0.001), and 48,5% had adequate training. Only 9,1% reported feeling safe to perform the technique (p <0.001) and 69,7% answered that they do not have technical support, and do not have appropriate material. Conclusion: It has been demonstrated that there is a limitation of the use of intraosseous access. The lack of autonomy to perform the technique can be explained by the lack of practical skills and theoretical knowledge of nurses, and the lack of protocols and access to institutional information, training and inputs.Descriptors: Intraosseous infusions; Nursing; Development of personnel.ACCESO LIMITACIÓN DE USO INTRAÓSEA: ASPECTOS DE LA ENFERMERÍA Y INSTITUCIÓN DE SALUD.Objetivo: Verificar la realización del acceso intraóseo para las enfermeras. Método: Estudio transversal analítico realizado mediante la aplicación de un cuestionario. Resultados: Se demostró que 97,0% de los encuestados nunca hizo de acceso (p <0,001), y 48,5% tenía una formación adecuada. Sólo 9.1% reportó sentirse seguro para llevar a cabo la técnica (p <0,001) y 69,7% dijeron que no tienen soporte, y no tienen ningún material adecuado. Conclusión: Se ha demostrado que existe una limitación del uso de la vía intraósea. La falta de autonomía para llevar a cabo la técnica puede explicarse por la falta de habilidades prácticas y conocimientos teóricos de las enfermeras, y la falta de protocolos y el acceso a la información institucional, la capacitación y los insumos.Descriptores: Infusiones intraóseas; enfermería; desarrollo del personal.

scholarly journals Changing attitudes towards annual influenza vaccination amongst staff in a Tertiary Care Irish University Hospital

2021 ◽  
Author(s):  
Emma C. Kearns ◽  
Ian Callanan ◽  
Ann O’Reilly ◽  
Aisling Purcell ◽  
Niamh Tuohy ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Online Survey ◽  
Tertiary Care ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Flu Vaccination ◽  
Data Collection And Analysis ◽  
Changing Attitudes

Abstract Background Healthcare workers are encouraged annually to get vaccinated against influenza. This year in view of COVID-19 pandemic, attitudes of HCWs towards vaccination are particularly important. A cross-sectional study was completed to understand how to best encourage and facilitate the vaccination of HCWs based on the previous years’ findings. Methods An online survey was disseminated to all hospital staff via electronic channels. The clinical audit sphinx software was used for data collection and analysis. Results The total number of responses was n = 728, almost double the rate from 2018 (N = 393). A total of 78% (N = 551) of participants were vaccinated last year. A total of 94% (N = 677) of participants reported their intention to be vaccinated this year. The main barriers listed were being unable to find time (32%, N = 36), side effects (30%, N = 33) and thinking that it does not work (21%, N = 23). The most popular suggestions for how to increase uptake were more mobile immunisation clinics (72%, N = 517) and more information on the vaccine (50%, N = 360). A total of 82% of participants (N = 590) agreed that healthcare workers should be vaccinated, with 56% (N = 405) agreeing that it should be mandatory. Of the participants who were not vaccinated last year (N = 159), 40% (N = 63) agreed that COVID-19 had changed their opinion on influenza immunisation with a further 11% (N = 18) strongly agreeing. Discussion In light of the increasing number of survey participants, more staff were interested in flu vaccination this year than ever before. The COVID-19 pandemic has had some influence on staff’s likelihood to be vaccinated. Feasibility of immunisation and education posed the largest barriers to HCW vaccination.

Nurses’ Performance of Inhalation Technique with Metered-Dose Inhaler plus Spacer Device

1993 ◽  
Vol 27 (2) ◽  
pp. 185-187 ◽  
Author(s):  
Timothy H. Self ◽  
Tiffany M. Kelso ◽  
Kristopher L. Arheart ◽  
Joyce H. Morgan ◽  
G. Umberto Meduri
Keyword(s):  
Outcome Measures ◽  
Educational Intervention ◽  
Clinical Pharmacist ◽  
Item Analysis ◽  
University Hospital ◽  
Dose Inhaler ◽  
Inhalation Technique ◽  
Metered Dose Inhaler ◽  
Metered Dose

Objective To determine if nurses could correctly use a metered-dose inhaler plus spacer (MDI–spacer) device after a brief description and demonstration of proper use by a clinical pharmacist. Design Pretest, educational intervention, posttest. Setting University hospital. Participants Twenty-three nurses. Interventions Nurses were asked to use the MDI-spacer (Aerochamber) and were scored using a nine-point checklist (pretest). Educational intervention by the clinical pharmacist consisted of a five-minute discussion and correct demonstration of the device. Nurses were then asked to use the device again (posttest). Main Outcome Measures Pre- and posttest scores. Results Total scores were improved after the educational intervention (66 percent pretest vs. 88 percent posttest, p=0.0001). In an item analysis, four of the nine steps had improved significantly. Conclusions A brief discussion and demonstration of correct use of MDI–spacers is effective in improving nurses’ skill in using the device.

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