(a) Adequate preparation of the inhaler by shaking the canister and removing the mouthpiece cap;
(b) Adequate expiration accomplished with the head in the correct position;
(c) Adequate slow inspiration to total lung capacity; and
(d) Breath held subsequent to inspiration. Implicit in this audit is coordination of canister actuation with the beginning of inspiration. (Buckner, 2005)
What follows is a brief overview of the planned education program:
Accurate diagnosis of the patient’s asthmatic condition and initial treatment plans with a short explanation of prescribed medicines as well a demonstration of the correct inhaler technique is scheduled for the very first visit. A more detailed diagnosis as well as a more comprehensive education session can be slated for later visits.
One of the basic objectives for the education program includes facilitating asthma patients to keep their condition under control under any circumstance. Also, the program will aim to use the available resources efficiently, to help patients regain and maintain their independence, and to keep them motivated for further learning. The program tries to achieve these essentials by adhering to sound educational principles. These education principles include “providing information in small bites, using simple terms, encouraging the use of resources, being flexible, relevant, optimistic, and sensitive”. The instructor makes sure that the information given is comprehended, and also encourages queries from participating patients (Hume, 2002).
The management and training of Asthma will be made compatible with the existing primary care pattern of small but frequent sessions. For example, the sessions might last approximately ten minutes. Since most patients do not retain most of what they learnt in the therapist’s office, their methods and techniques of using the inhaler might be incorrect. This is where the ten minute sessions come very handy, as the amount of information passed on to the patient is quite small and easy to assimilate and remember. To back this up a written version of the instructions are also handed to the patients. The following is an overview of what’s been planned for their subsequent visits:
“Subsequent visits are used to check what has or should have been learned, to correct misunderstandings, and to impart new knowledge. New patients, if stable, need to be seen at least every 2 weeks. Patients who are unstable or who present in a more acute stage must be followed up more frequently, as their condition dictates. As patient knowledge and asthma control improves, the frequency of visits may be decreased. At the stage of apparent stability, it is important to review, at each visit, some aspect of the patient’s asthma education, including the action plan and inhaler technique” (Hume, 2002).
The importance of follow-up visits is not lost while drawing up the plan of action. These subsequent visits are great opportunities for identifying patient misunderstandings with respect to asthma control practices. In addition to serving as opportunities for patient education, these sessions help make an assessment whether to increase or taper off the maintenance therapy. This is a crucial decision, as the lowering of treatment to minimum effective drug treatment at the correct time is equally important as increasing the intensity of treatment (Slutsky, 2001).