Abstract
An audit using an adherence monitor device (adherence = time and technique) of hospitalised patients identified that 16% of patients overused on their inhalers, 21% of doses were not administered and 40% of doses were taken incorrectly.
Hence a need to change practice to improve patient safety as well as patient and staff awareness regarding inhaler administration and technique was identified. A practice change with the introduction of a new Inhaler Management Policy was developed. This included inhaler education for all staff involved in inhaler administration, supervision of inhaler technique and administration for all patients, a change in the storage of inhalers and updated nursing documentation.
A prospective, observational study was performed following the implementation of this policy. Four key components of the policy were monitored; inhaler storage, patient knowledge, nursing knowledge, and nursing documentation. An audit tool based on the NHS Metrics Assurance framework was devised to monitor the impact of the new policy.
Seventeen wards were included in the study. Monthly audits were performed and results relayed back to the wards with appropriate action plans. Six months after implementation there was a 90-100% improvement in inhaler storage on 15 wards as well as a 90-100% improvement in patients and nurses knowledge regarding inhaler technique on all 17 wards and 7 wards demonstrated a 90-100% improvement in nursing documentation.
In conclusion, a change in practice regarding inhaler management with the introduction of a new inhaler management policy for patients whilst in hospital has improved the safety of inhaler administration and knowledge of inhaler technique for both patients and staff.
- © 2014 ERS