title: Knowledge and Attitudes of Nurses in Spain about Inhaled Therapy: Results of a National Survey.
abstract: BACKGROUND
  The main problem with inhalation therapy is incorrect use of inhalers. Nurses' limited knowledge may contribute to this situation. This study aimed to assess the level of knowledge and attitudes of respiratory nurses about inhaled therapy.
  
  
  METHODS
  A 12-item multiple-choice questionnaire was sent to members in the Nursing Area of the Spanish Society of Pneumology and Thorax Surgery and to nurses working with respiratory patients using inhalers devices. The survey was voluntary, self-administered, and anonymous. It collected demographic characteristics, preferences, and knowledge and education about devices and inhalation technique.
  
  
  RESULTS
  A total of 1496 nurses completed the questionnaire correctly. Results showed 65.4% preferred dry powder inhalers (DPI), 8.7% were familiar with all 12 devices listed, 59.6% identified "firing the device after beginning inspiration" as the most important step when using the pressurized metered dose inhaler (pMDI), 53.5% identified ''inhale deeply and forcefully'' as the most significant step using DPI, and 20.4% "always checked a patient's inhalation technique when a new inhaler was prescribed." A composite, variable, general inhaled therapy knowledge pooled the correct answers related to knowledge and showed only 14% of nurses had adequate knowledge of inhaled therapy.
  
  
  CONCLUSIONS
  In spite of recent training activities, knowledge concerning use of inhaler devices among Spanish nurses managing patients with respiratory diseases continues to be poor. Improvements are also needed in patient education and follow-up of inhalation techniques. Undergraduate and postgraduate educational programs need to be further developed.
authors.affiliation: 1 Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau , Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Department of Medicine, Barcelona, Spain .
authors.forename: Jordi
authors.initials: J
authors.lastname: Giner
authors.affiliation: 2 Service of Clinical Epidemiology, Hospital General de Vic , Barcelona, Spain .
authors.forename: Pere
authors.initials: P
authors.lastname: Roura
authors.affiliation: 3 Integrated Care Unit, Medical and Nursing Direction, Hospital Clínic , IDIBAPS, CIBER de Enfermedades Respiratorias (CIBERES), Universitat de Barcelona, Spain .
authors.forename: Carme
authors.initials: C
authors.lastname: Hernández
authors.affiliation: 1 Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau , Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Department of Medicine, Barcelona, Spain .
authors.forename: Montserrat
authors.initials: M
authors.lastname: Torrejón
authors.affiliation: 1 Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau , Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Department of Medicine, Barcelona, Spain .
authors.forename: Meritxell
authors.initials: M
authors.lastname: Peiró
authors.affiliation: 4 Lung Management Area, Central University Hospital of Asturias , Oviedo, Spain .
authors.forename: Ma Jesús
authors.initials: MJ
authors.lastname: Fernández
authors.affiliation: 5 Pneumology Department, Hospital Universitario Cruces , Barakaldo, Basque Country, Spain .
authors.forename: Elena López
authors.initials: EL
authors.lastname: de Santa María
authors.affiliation: 6 Service of Pneumology, Hospital de Palamós , Palamós, Girona, Spain .
authors.forename: Ma Angeles
authors.initials: MA
authors.lastname: Gimeno
authors.affiliation: 7 Service of Pneumology, Hospital Arnau de Vilanova , Valencia, Spain .
authors.forename: Vicente
authors.initials: V
authors.lastname: Macian
authors.affiliation: 8 Medical Advisor of Medical Department Chiesi, L'Hospitalet del Llobregat , Barcelona, Spain .
authors.forename: Eduard
authors.initials: E
authors.lastname: Tarragona
authors.affiliation: 1 Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau , Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Department of Medicine, Barcelona, Spain .
authors.forename: Vicente
authors.initials: V
authors.lastname: Plaza
keywords: DPI; inhalation devices; inhalation technique; inhaled therapy; misuse of pMDI; nurse; pMDI