Authors: (including presenting author): :
Ng SW(1), Choi MW(2), Lam CK(2), Lee SW(1), Lee KC(1), Kwok TYJ, Chan YM(1), Lai YKA (3)
Affiliation: :
(1) Nursing Services Division, United Christian Hospital (2) Department of Medicine and Geriatrics, United Christian Hospital (3) School of Nursing and Health Sciences, Hong Kong Metropolitan University
Keyword 1: :
Inhaler Use Training
Keyword 2: :
Nurses Competency
Introduction: :
Inhalation therapy is a cornerstone for the management of chronic obstructive airway diseases. Nurses are pivotal in assessing, educating, and reviewing patients’ inhaler techniques. However, persistent gaps in healthcare professionals' knowledge and frequent patient errors in inhaler device use are urged a critical need for improved training. Inadequate nurse competency directly hinders effective patient education, potentially impacting clinical outcomes.
Objectives: :
This study aimed to evaluate the effectiveness of a newly developed in-service training program on 1) nurses’ knowledge of different inhaler devices, 2) their practical skills in demonstrating correct inhaler technique, and 3) their self-reported confidence and perceived barriers in providing patient education.
Methodology: :
A pre-post intervention study was conducted at United Christian Hospital. The intervention was a mandatory, theory-based (informed by social learning theory) training workshop for newly employed Registered Nurses (n=147) held in August 2025. The face-to-face workshop included structured teaching, live demonstration, and hands-on return demonstration using a standardized algorithm for three inhaler types: pressurized metered-dose inhaler (pMDI), dry powder inhaler (DPI), and soft mist inhaler (SMI). Immediate corrective feedback was provided. Evaluation employed a multi-method approach: (1) A Pre-post training online survey measured knowledge on device-specific inhalation maneuvers was completed. (2) A subset of participants (n=36) underwent a direct, objective skills assessment conducted by three trained specialty nurses using a standardized checklist. (3) The post-training online survey measured also perceived confidence, barriers, resource sufficiency, and training satisfaction.
Result & Outcome: :
Results Among 147 attending nurses (72% female), 131 completed the knowledge tests and survey. Knowledge scores showed significant improvement: correct steps for pMDI increased from 28.2% to 71.6%, for DPI from 17.6% to 83.0%, and for SMI from 32.1% to 71.6%. In the practical skills assessment, the average score for correct procedural steps was 91% (range: 71-100%). The post-training survey revealed that 89% of respondents felt moderately to extremely confident in educating patients on inhaler use, a substantial increase from baseline perceptions. Conclusion The structured, hands-on training program was highly effective in significantly improving nurses’ theoretical knowledge and practical skills regarding inhaler techniques, while also boosting their professional confidence. The findings strongly support the integration of such competency-based, practical workshops into standard orientation and continuous professional development for nurses. This initiative has direct potential to enhance the quality of patient education, thereby reducing common inhaler errors and optimizing inhalation therapy outcomes in chronic airway disease management.
