TableĀ 1

Problems encountered by patients using nebuliser therapy in the management of chronic obstructive pulmonary disease

ThemeDescription of step performed incorrectlyN (50)
Assembling and operatingFailure to remove the nebuliser cap from the medication tank*11
Failure to ensure the vaporiser head is freely moving prior to filling the drug fluid*22
Failure to reinsert the vaporiser head in the medication tank**3
Failure to reconnect the nebuliser cap to the medication tank*1
Failure to fit the facemask/mouthpiece on the nebuliser cap*4
Failure to connect the tubing to the medication tank from one end and to the compressor from the other*6
Failure to switch on the compressor**0
Filling drug fluidFailure to store the nebuliser fluid correctly0
Failure to use the nebuliser fluid at room temperature0
Failure to prepare the nebuliser fluid immediately prior to use3
Failure to dilute the nebuliser fluid*0
Failure to mix the drug formulations0
Failure to fill the medication tank with the drug fluid*6
CompatibilityFailure to use the correct nebuliser for the drug*0
Failure to use the correct nebuliser for the compressor?25
Failure to use compatible drug formulations*
Patient/device interfaceFailure to fit the facemask/holds the mouthpiece*6
Inhalation techniqueFailure to sit in an upright position*2
Failure to inhale from the mouth*17
Breathing patternFailure to inhale slowly*23
Failure to inhale as deeply as possible*28
Failure to hold breath for few seconds before exhaling*39
End pointFailure to define an end point to stop nebulisation5
DismantlingFailure to switch off the compressor0
Failure to detach the nebuliser from the tubing9
Failure to dismantle the nebuliser (cap/medication tank/vaporiser head)14
CleaningFailure to wash hands before handling the drug45
Failure to run the machine for some time with saline/empty*44
Failure to rinse the parts (except the tubing) under hot water after use*31
Failure to disinfect the parts (except the tubing) with a suitable disinfectant once a day*46
Failure to wipe the compressor and tubing at least once a day with a damp cloth34
Failure to discard the remaining drug fluid*16
Failure to reassemble and place the nebuliser in a clean bag/tubing placed inside compartment28
Failure to close the lid when not in use15
DryingFailure to leave the parts to dry on a clean tissue20
Failure to run the machine until no moisture remains in the tubing42
Failure to hang the tubing to dry32
Equipment misuseFailure to place the equipment on a flat surface16
Failure to place the equipment at least 4 inches away from any other equipment27
MaintenanceFailure to replace the tubing according to manufacturer's recommendations*36
Failure to replace the nebuliser according to manufacturer's recommendations*37
Failure to replace the facemask/mouthpiece according to manufacturer's recommendations*36
Failure to check the filter monthly and to replace it according to manufacturer's recommendations*37
Failure to service the equipment annually and to check it for any electrical fault*39
  • Steps highlighted in bold are likely to result in either a reduced drug output (*), no drug output (**) or an unknown drug output (?), if performed incorrectly by the patient.