Abstract
Most respiratory patients are prescribed inhaled medication. During a hospital admission, in Ireland, these inhalers are often left with the patient at their bedside for self-administration. We have no idea of how many doses the patient has taken, or even if the medication was taken properly.
A novel acoustic inhaler tracking device was used to assess when and how an individual took their inhaler, INhaler Compliance Assessment (INCA). An initial audit of inhaler use in hospital was done.
A quality improvement program (inhaler policy) occurred in our hospital, which involved inhalers being stored in individually labelled 'inhaler bags' in the drug trolley and administered only as prescribed and supervised for technique errors by nursing staff. A follow-up audit of inhaler use was done with the INCA device.
Fifty-one in-patients on a salmeterol/fluticosone Diskus inhaler were randomly selected. Errors were divided in to timing and technique. Errors in timing were noted in 37% of patients, with 16% having significant overdosing. Technique errors were high, with 40% of patients having problems with inhaler technique.
Fifty-nine patients were randomly selected post policy. Errors in timing reduced to 11%, and technique errors also reduced to 19%.
A change of inhaler policy, recorded by a novel inhaler tracker device showed a satisfactory improvement in patient timing and technique errors. We have proposed this new 'inhaler policy' to become a national hospital policy.
- © 2014 ERS