4CPS-143 Treatment of asthma and chronic obstruction pulmonary disease: are our hospital nurses and physicians ready to treat and educate inpatients?

Background and importance In the treatment of asthma/chronic obstruction pulmonary disease (COPD), misuse of inhalation devices is common, with a higher risk of treatment inefficacy, side effects or acute exacerbations, leading to more hospitalisations. In hospital, nurses and doctors are expected to (re)assess patients’ knowledge/ability to use their treatments for those hospitalised with severe asthma/COPD, particularly among the elderly population. Aim and objectives Before implementing a procedure of patient assessment at admission, we conducted a hospital wide survey to appraise knowledge and current practices of nurses and doctors. Material and methods We conducted an observational study by interviewing nurses and doctors from 12 care units (adults/geriatric, without respiratory specialisation) in August 2019. Two distinct questionnaires based on a literature review were developed by a multidisciplinary group, including three similar parts: knowledge about physiopathology and treatments (1); practices and self-confidence to educate patients (2); and professional training needs (3). Nurses were individually interviewed by a pharmacy resident while doctors answered an individual online questionnaire. Results We interviewed 37 nurses, and 14/27 practitioners/interns responded to the questionnaire. The main results in part 1 were that 51.4% of nurses knew the characteristic symptoms of asthma, 45.9% considered budesonide a bronchodilator and 14.3% of doctors knew that there were non-validated combinations of nebulisation drugs. In part 2, 48.6% of nurses and 14.3% of doctors declared that a patient’s assessment is made at admission, partly due to the absence of a procedure and a lack of time, respectively; 60% of nurses told patients to rinse their mouth after inhalation of corticoids. In part 3, 78% of nurses were quite/totally confident about inhaler device use compared with 35.7% of doctors; doctors considered general practitioners and nurses the most appropriate professionals for patient education. We found that 84.1% of nurses and 92.9% of doctors were interested in specific training. Conclusion and relevance The results showed a lack of knowledge of nurses/prescribers about some aspects of asthma/COPD, despite nurses’ self-confidence. Among our patients, few were evaluated at admission on their ability to use their devices correctly, with the risk that their treatments may not be optimised. To improve knowledge of professionals and harmonise our practices, we aim to offer training and formalise a procedure for eligible patient evaluation/education at admission, thus ensuring better care. References and/or acknowledgements No conflict of interest.