The Assessment of the effects of verbal and performance education on nurse's skill in the use of metered dose inhaler

Background and Inhaled drugs increase the effect of medications prescribed in the treatment of chronic airways diseases with fewer side effects compared to other methods. There are many users of metered dose inhaler (MDI), but the rate of improper use in patients, nurses and general practitioners is high. The purpose of this study was a) to assess the rate of MDI misuse in patients compared to nurses and b) to evaluate the effect of verbal and practical education in the use of MDI in nurses. Following ethical approval from Medical Ethics Board of the Mazandaran University of Medical Sciences, the present study was carried out in two separate stages. In the first stage which was a cross-sectional study, 110 subjects (55 nurses and 55 patients) were recruited from Mazandaran University Hospitals through a non-randomly and purposeful sampling method. A 0 -100 scale check list was used to measure the skill of nurses and patients in the use of MDI. In the second stage, a randomized clinical trial was designed to assess the effect of verbal and practical education in the use of MDI on 55 nurses (experimental group=25, control group=30). Nurses in the experimental group only, received the education and they were then asked to administer MDI after three weeks. The mean score for patient's skill was 63+37 which was not significantly correlated with age. The two lowest scores were related to slow inspiration (52.7%) and coordination between inspiration and using MDI (52.8%). The mean score for nurse's skill was 51±21/2. The lowest score was related to performance of a deep exhalation and holding the spray at 2.5-5cm distance (21.8%). Data analysis indicated that there was a significant difference between pre and post education score in the experimental group using paired t-test (P=0.0001, T=16.26). There was also a significant difference between the experimental and control group on MDI skill using t-test (p=0.0001, T=-8.19). The results of this study demonstrate that patients had higher score compared with nurses in the use of MDI. It is also shown that educational program may have an important role in improving nurse's skill in the administration of MDI.