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

Clinical Pediatrics
Marina ReznikJudith Wylie-Rosett

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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Citations

Sep 15, 2015·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Dayna S AlexanderDelesha M Carpenter
Sep 17, 2014·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Wesam G AmmariHenry Chrystyn
Apr 21, 2020·Expert Review of Respiratory Medicine·Anna VolermanValerie Press
Jun 1, 2016·The Canadian Journal of Nursing Research = Revue Canadienne De Recherche En Sciences Infirmières·Mahmoud Al-KalaldehAmal El-Ata
Jul 14, 2020·Frontiers in Pediatrics·Robert W MortonLesley Kennedy
Nov 6, 2020·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Jennifer A JonasMarina Reznik

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