effect of training inhalation technique with or without spacer on maximum expiratory flow rate and inhaler usage skills in asthmatic patients: a randomized controlled trial

The most common treatment for asthma is transferring the drug into the lungs by inhaler devices. Besides, correct use of inhaled medication is required for effectiveness of pharmacotherapy. Thus, it is necessary to train the patients how to use Metered Dose Inhaler [MDI]. This study aimed to determine the effect of training about MDI usage with or without spacer on maximum expiratory flow rate and inhaler usage skills in asthmatic patients. This randomized clinical trial was conducted on 90 asthmatic patients who were randomly divided into inhalation technique group with spacer, inhalation technique group without spacer, and a control group. Then, the Peak Expiratory Flow Rate [PEFR] was measured using a peak flow meter, as a basic test. In addition, the patients' functional skills of inhalation technique were assessed using two checklists. Afterwards, 3 sessions of training were arranged for both groups. PEFR and the ability to use the MDI were evaluated immediately and 1 month after the intervention. Finally, the data were entered into the SPSS statistical software [v. 18] and analyzed using independent t-test and repeated measures ANOVA. After the intervention, MDI usage skills improved in the two intervention groups compared to the control group [P<0.001]. In addition, a significant difference was found between the intervention groups and the control group regarding the mean of PEFR after the intervention [P<0.001]. However, no significant difference was observed between the two intervention groups [P=0.556]. According to the results, providing appropriate training for asthmatic patients increased MDI usage skills, and both methods of inhalation [with or without spacer] could improve the PEFR among the patients

Effects of triage education on knowledge, practice and qualitative index of emergency room staff: a quasi-interventional study

Objective: To determine the effects of triage education based on emergency severity index [ESI] on promoting the knowledge and performance of nurses and qualitative indices of emergency department

Methods: This study was a quasi-interventional study being performed in Vali Asr Hospital of Fasa University of Medical Sciences during 2012. For this purpose, 50 members of staff including nurses and technicians of emergency medicine in the Emergency department with the inclusion criteria for participation were selected. Data collection instruments included a questionnaire consisting of two parts, [personal characteristics, and knowledge] and the performance assessment checklist was prepared. Content validity was used to determine the validity. The test-retest method and quder-Richardson 20 were applied to determine the reliability of the questionnaire. Interobserver reliability and the correlation between the two observers and imaging modalities were measured to determine the reliability of the performance checklist. The questionnaires and checklist were completed by the participants before, 2 days and 6 weeks after completion of the training. Workshop in two 9-hour sessions was provided which consisted of lectures, questions and answers

Results: The triage scores were 10.7+/-3.1, 17.8+/- 1.6 and 16.1+/-2.3 before, 2 days and 6 weeks after training, respectively. Triage performance score increased from 48.9 +/- 9.9 before training to 59.8 +/- 7.6, two days after training and to 59.7 +/-8.1 six weeks later [p=0.001]. In addition to triage training of the nurses the emergency department qualitative indices were impressively upgraded. Other results showed that there was no significant correlation between individual characteristics and personal knowledge of triage score 6-week after training [r=0.018, p=0.126]. However, significant positive correlation was found between nursing work experience, work experience in emergency ward and type of employment and performance scores 6 weeks after training [r=0.258, p=0.032]

Conclusion: The results of the present study showed that triage education influences the practice and knowledge of nurses and improves the qualitative indices of emergency department. Therefore, it is recommended to include theoretical and practical training of triage for nurses in hospitals

[ effectiveness of a multimedia training program on incidence of occupational exposure to contaminated sharp tools among nurses]

Health workers are threatened by injuries caused by the insertion of sharp medical devices [Needle Stick Injury] contaminated with patients'? blood and body fluids. The purpose of this study was to explore the effect of a multimedia training program on the incidence of occupational exposure of nurses to contaminated sharp tools in a university hospital in 2009. In an experimental study, 120 volunteer nurses, working in a university hospital was randomly assigned to either experimental group or control group. The experimental group received a multimedia training program for prevention of exposure during two weeks but the control group did not receive any training. All subjects completed the occupational exposure and knowledge questionnaires during 4 months before and 4 months after intervention. After data collection, mean standard deviation, paired t-test and chi-square were used for data analysis. Significant level of P< 0.05 was accepted. in the experimental group, the incidence of occupational exposure to contaminated sharp tools decreased [p<0.05] but in the control group, this change was not significant [p>0.05]. Also the mean score for knowledge in the experimental group improved significantly from 8.05 to 14.1[p<0.05] but the increase in the mean score of knowledge in control group from 8.30 to 8.98 [p=0.33] was not significant. The knowledge and performance of the experimental group regarding occupational exposure to contaminated sharp tools improved. Continuous education is recommended