Discrepancies in Nurses’ Knowledge and Ability to Use MDIs with and without Spacers: Practice Implications

2.50
Hdl Handle:
http://hdl.handle.net/10755/151789
Type:
Presentation
Title:
Discrepancies in Nurses’ Knowledge and Ability to Use MDIs with and without Spacers: Practice Implications
Abstract:
Discrepancies in Nurses’ Knowledge and Ability to Use MDIs with and without Spacers: Practice Implications
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:June, 2001
Author:Brenner, Phyllis, PhD
P.I. Institution Name:Madonna University
Title:Assistant Professor
Objective: To examine the knowledge and ability of nurses (RNs) related to the use of metered dose inhalation (MDI) devices with and without spacers. Design: Comparative, descriptive. Sample/Setting: A purposive sample of 241 RNs from a variety of private offices and 5 different organizational systems, including a health maintenance organization (HMO), a managed care organization (MCO), and other settings in a Midwestern city and the mid-Atlantic region of the USA. RNs employed in 5 different primary care areas including internal medicine, family practice, pediatrics, emergency rooms/urgent care centers (ERs/UCCs), and the specialty area of pulmonary/respiratory were included. The RNs were categorized as either non-nurse practitioners (non-NPs) or NPs. Outcome Variables: A 16-item knowledge test based on the National Heart, Lung, and Blood Institutes' 1997 guidelines was used to evaluate knowledge of asthma and MDI techniques. Demonstration checklists, also based on these guidelines, were developed to evaluate skill in the use of MDIs with or without spacers. Methods: The PI and 5 research assistants collected all data over a period of 4 months following the necessary IRB approvals and establishment of acceptable intra-rater and inter-rater reliability. One half of the sample completed the written questionnaire followed by the demonstration while the other half completed the study instruments in the reverse order. Findings: In addition to extensive descriptive analyses, three research hypotheses were tested. There were no significant differences in knowledge or demonstration scores between non-NPs and NPs. There were significant differences in knowledge and demonstration scores between the RNs in the specialty area and those in the ER/UCCs. There were also differences in knowledge and demonstration scores between RNs in HMO/MCO settings and RNs in non-HMO/MCO settings. Appropriate validity and reliability analyses were done for all instruments. Another noteworthy finding was that for the total sample and for each of the settings and practice areas, there were consistent differences in mean percent correct scores with ability/skill lagging behind knowledge scores. Additionally, analyses were done to verify that the order of testing (questionnaire followed by demonstration vs. demonstration followed by questionnaire) had no effect on knowledge or demonstration scores. Conclusions: The hypothesis and finding that RNs in the specialty area score higher in both knowledge and skill than other RNs is consistent with previous studies primarily of physician cohort groups with specialty physicians scoring higher than other cohort groups. The hypothesis that nurses in HMO/MCO settings would score higher than RNs in other settings was also supported. Additionally, the hypothesis that NPs would not score differently than non-NP RNs was supported. The discrepancy between knowledge and demonstration of skills has implication for education of RNs. Implications: Over half of the subjects (57%) reported that the RN was the primary educator and 42% reported that they did client teaching at least weekly. This discrepancy between a fair level of knowledge and lower demonstration scores suggests the need for concerted efforts to include skill competency in the initial and on-going education of RNs. This is an area needing careful attention, as the ability of clients who have asthma to engage in self-care is dependent upon their skills in the administration of inhaled medications. The need for rigorous translational research (Titler, 2000) is evident as it is imperative to determine the best methods to move the knowledge and skill competencies contained within national guidelines and standards into the practice of both health care providers and their clients.
Repository Posting Date:
26-Oct-2011
Date of Publication:
Jun-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDiscrepancies in Nurses’ Knowledge and Ability to Use MDIs with and without Spacers: Practice Implicationsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151789-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Discrepancies in Nurses&rsquo; Knowledge and Ability to Use MDIs with and without Spacers: Practice Implications</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">June, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Brenner, Phyllis, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Madonna University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">psbrenner@msn.com</td></tr><tr><td colspan="2" class="item-abstract">Objective: To examine the knowledge and ability of nurses (RNs) related to the use of metered dose inhalation (MDI) devices with and without spacers. Design: Comparative, descriptive. Sample/Setting: A purposive sample of 241 RNs from a variety of private offices and 5 different organizational systems, including a health maintenance organization (HMO), a managed care organization (MCO), and other settings in a Midwestern city and the mid-Atlantic region of the USA. RNs employed in 5 different primary care areas including internal medicine, family practice, pediatrics, emergency rooms/urgent care centers (ERs/UCCs), and the specialty area of pulmonary/respiratory were included. The RNs were categorized as either non-nurse practitioners (non-NPs) or NPs. Outcome Variables: A 16-item knowledge test based on the National Heart, Lung, and Blood Institutes' 1997 guidelines was used to evaluate knowledge of asthma and MDI techniques. Demonstration checklists, also based on these guidelines, were developed to evaluate skill in the use of MDIs with or without spacers. Methods: The PI and 5 research assistants collected all data over a period of 4 months following the necessary IRB approvals and establishment of acceptable intra-rater and inter-rater reliability. One half of the sample completed the written questionnaire followed by the demonstration while the other half completed the study instruments in the reverse order. Findings: In addition to extensive descriptive analyses, three research hypotheses were tested. There were no significant differences in knowledge or demonstration scores between non-NPs and NPs. There were significant differences in knowledge and demonstration scores between the RNs in the specialty area and those in the ER/UCCs. There were also differences in knowledge and demonstration scores between RNs in HMO/MCO settings and RNs in non-HMO/MCO settings. Appropriate validity and reliability analyses were done for all instruments. Another noteworthy finding was that for the total sample and for each of the settings and practice areas, there were consistent differences in mean percent correct scores with ability/skill lagging behind knowledge scores. Additionally, analyses were done to verify that the order of testing (questionnaire followed by demonstration vs. demonstration followed by questionnaire) had no effect on knowledge or demonstration scores. Conclusions: The hypothesis and finding that RNs in the specialty area score higher in both knowledge and skill than other RNs is consistent with previous studies primarily of physician cohort groups with specialty physicians scoring higher than other cohort groups. The hypothesis that nurses in HMO/MCO settings would score higher than RNs in other settings was also supported. Additionally, the hypothesis that NPs would not score differently than non-NP RNs was supported. The discrepancy between knowledge and demonstration of skills has implication for education of RNs. Implications: Over half of the subjects (57%) reported that the RN was the primary educator and 42% reported that they did client teaching at least weekly. This discrepancy between a fair level of knowledge and lower demonstration scores suggests the need for concerted efforts to include skill competency in the initial and on-going education of RNs. This is an area needing careful attention, as the ability of clients who have asthma to engage in self-care is dependent upon their skills in the administration of inhaled medications. The need for rigorous translational research (Titler, 2000) is evident as it is imperative to determine the best methods to move the knowledge and skill competencies contained within national guidelines and standards into the practice of both health care providers and their clients.</td></tr></table>en_GB
dc.date.available2011-10-26T11:13:45Z-
dc.date.issued2001-06en_GB
dc.date.accessioned2011-10-26T11:13:45Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.