Theme | Description of step performed incorrectly | N (50) |
---|---|---|
Assembling and operating | Failure 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 fluid | Failure to store the nebuliser fluid correctly | 0 |
Failure to use the nebuliser fluid at room temperature | 0 | |
Failure to prepare the nebuliser fluid immediately prior to use | 3 | |
Failure to dilute the nebuliser fluid* | 0 | |
Failure to mix the drug formulations | 0 | |
Failure to fill the medication tank with the drug fluid* | 6 | |
Compatibility | Failure 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 interface | Failure to fit the facemask/holds the mouthpiece* | 6 |
Inhalation technique | Failure to sit in an upright position* | 2 |
Failure to inhale from the mouth* | 17 | |
Breathing pattern | Failure to inhale slowly* | 23 |
Failure to inhale as deeply as possible* | 28 | |
Failure to hold breath for few seconds before exhaling* | 39 | |
End point | Failure to define an end point to stop nebulisation | 5 |
Dismantling | Failure to switch off the compressor | 0 |
Failure to detach the nebuliser from the tubing | 9 | |
Failure to dismantle the nebuliser (cap/medication tank/vaporiser head) | 14 | |
Cleaning | Failure to wash hands before handling the drug | 45 |
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 cloth | 34 | |
Failure to discard the remaining drug fluid* | 16 | |
Failure to reassemble and place the nebuliser in a clean bag/tubing placed inside compartment | 28 | |
Failure to close the lid when not in use | 15 | |
Drying | Failure to leave the parts to dry on a clean tissue | 20 |
Failure to run the machine until no moisture remains in the tubing | 42 | |
Failure to hang the tubing to dry | 32 | |
Equipment misuse | Failure to place the equipment on a flat surface | 16 |
Failure to place the equipment at least 4 inches away from any other equipment | 27 | |
Maintenance | Failure 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.