Paper
Wednesday, 19 July 2006
This presentation is part of : Evidence-Based Practice Outcomes: Measuring and Monitoring Strategies
Development of Evaluation Measures: Promoting Asthma Control in Children
Barbara L. Davies, RN, PhD, Nursing/Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada, Evangeline Danseco, PhD, Research, Canadian Council on Health Services Accreditation, Ottawa, ON, Canada, Nancy Edwards, RN, PhD, Nursing/Health Sciences, University of Ottawa, Ottawa, ON, Canada, Kathryn Smith Higuchi, PhD, RN, School of Nursing, University of Ottawa, Ottawa, ON, Canada, Heather McConnell, RN, BScN, MA(Ed), Nursing Best Practice Guidelines Program, Registered Nurses’ Association of Ontario (RNAO), Toronto, ON, Canada, Debra Clarke, BScN, Paediatrics/Birthing Unit, Orillia Soldiers Memorial Hospital, Orillia, ON, Canada, and Ana MacPherson, RRT, CAE, MSc, Asthma Education Centre, The Credit Valley Hospital, Mississauga, ON, Canada.
Learning Objective #1: Increase their knowledge of the design of reliable and valid nursing outcomes to assess the implementation of evidence-based guidelines.
Learning Objective #2: Increase their knowledge about a training program that resulted in increased skills of nurses to observe children’s correct use of five inhaler/devices for asthma control.
The Registered Nurses Association of Ontario in Canada produced an evidence-based guideline recommending that children with asthma should have their inhaler/device technique assessed by the nurse at each visit to ensure accurate use. Incorrect technique among pediatric patients and by healthcare providers is common.
Objectives: 1) Develop and assess the content validity of a tool to assess skills on appropriate usage of inhalation devices for asthma control in children (IDAT-N); and 2) evaluate the acceptability, feasibility, and reliability of this tool.
Methods:  The tool incorporated common errors and coaching techniques. Content validity was assessed by five experts. Seventy nurses working on pediatric units and emergency units at two community hospitals were recruited. They completed a 14-item questionnaire on the tool’s usability.  A 3-phase study ensued with baseline assessment, training sessions and post-training assessment. Devices included placebo metered dose inhaler with and without spacer and mask, Diskus and Turbuhaler. Descriptive and bivariate statistics were used for analyses.
Results: The feasibility and acceptability of using the tool were good. Overall mean scores (sd) on 5- point rating scales about ease of use were 3.55 (0.92), time to administer 3.44 (1.02), clear instructions 3.67 (1.00).and likelihood of using checklist 4.01 (0.84). Inter-rater agreement of observations of nurse participants ranged from .70 to 100% with one exception. All 5 pre and post-comparisons of nurses training scores increased significantly with pre scores ranging from a mean of 1.96 (1.50) to 3.04 (1.02)  and post scores ranging from a mean of 4.92 (0.28) to 4.99 ( 0.12) p < .001.       
Conclusions: Results show that the IDAT –N tool is highly feasible, acceptable, valid and reliable tool for teaching nurses with pediatric patients in emergency departments and in-patient pediatric units on the use of 5 inhalation devices.  

See more of Evidence-Based Practice Outcomes: Measuring and Monitoring Strategies
See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)