Utilidad de la enseñanza del manejo del cartucho presurizado y el sistema Turbuhaler® en los pacientes hospitalizados
Usefulness of teaching how to manag the pressurized canister and the Turbuhaler®system in hospitalized patients
M. Haro Estarriola,
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mip.mharo@htrueta.scs.es
Correspondencia: Dr. M. Haro Estarriol. Sección de Neumología (Planta 4.B). Hospital Universitario de Girona Doctor Josep Trueta. Avda. de Francia, s/n. 17007 Girona
Correspondencia: Dr. M. Haro Estarriol. Sección de Neumología (Planta 4.B). Hospital Universitario de Girona Doctor Josep Trueta. Avda. de Francia, s/n. 17007 Girona
a Hospital Universitario de Girona Doctor Josep Trueta
C. Lázaro Castañer, C. Marín-Barnuevo, M.J. Andicoberry Martínez, M.D. Martínez Puerta
Grupo de Enfermería y Sección de Neumología. Hospital General de Albacete
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"apellidos" => "Haro Estarriol" "email" => array:1 [ 0 => "mip.mharo@htrueta.scs.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Hospital Universitario de Girona Doctor Josep Trueta" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Dr. M. Haro Estarriol. Sección de Neumología (Planta 4.B). Hospital Universitario de Girona Doctor Josep Trueta. Avda. de Francia, s/n. 17007 Girona" ] ] ] 1 => array:3 [ "autoresLista" => "C. Lázaro Castañer, C. Marín-Barnuevo, M.J. Andicoberry Martínez, M.D. Martínez Puerta" "autores" => array:4 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Lázaro Castañer" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Marín-Barnuevo" ] 2 => array:2 [ "nombre" => "M.J." "apellidos" => "Andicoberry Martínez" ] 3 => array:2 [ "nombre" => "M.D." "apellidos" => "Martínez Puerta" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Grupo de Enfermería y Sección de Neumología. Hospital General de Albacete" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Usefulness of teaching how to manag the pressurized canister and the Turbuhaler®system in hospitalized patients" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec190568" "palabras" => array:4 [ 0 => "Inhaladores" 1 => "Cartucho presurizado (CP)" 2 => "Tur-buhaler<span class="elsevierStyleSup">®</span> (TB)" 3 => "Educación" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec190567" "palabras" => array:4 [ 0 => "Inhalers" 1 => "Pressurized cannister" 2 => "Turbuhaler<span class="elsevierStyleSup">®</span>" 3 => "Edu-cation" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Valorar el conocimiento del manejo del cartu-cho presurizado (CP) o el sistema Turbuhaler ® (TB) y la utilidad de su enseñanza en los pacientes hospitalizados, considerando especialmente a los diagnosticados de una enfermedad pulmonar obstructiva crónica (EPOC) según el grado de obstrucción</p> <span class="elsevierStyleSectionTitle">Método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Evaluar el manejo y la utilidad de la enseñanza del CP en 107 pacientes consecutivos y del sistema TB en 79 a partir de la normativa de la SEPAR cuando fueron ingresados en una sección de neumología. Se valoraron la edad, el sexo, la enfermedad respiratoria de base, la opinión del paciente y los años previos de realización del sistema, el valor del volumen espiratorio forzado en el primer segundo (FEV<span class="elsevierStyleInf">1</span>), y la técnica realizada en una primera valoración y después de su educación en ambos sistemas durante el ingreso</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Inicialmente sólo realizó correctamente la técnica inhalatoria el 19% de los pacientes con CP y el 32% con el TB, y estos porcentajes mejoraron después de su educación el 42% y el 70%, respectivamente, durante un tiempo aproximado de 4 días, y considerando que el 77% de los pacientes con CP pensaban que ya lo hacían correctamente. Todos los pasos de ambos sistemas mejoraron reduciendo el número de errores iniciales sobre todo en los considerados de mayor relevancia (coordinación del disparo y la inspiración en el CP o la espiración completa y la apnea final de ambos sistemas), aumentando el número de técnicas correctas al final del estudio de forma similar a los pacientes con EPOC, divididos por su grado de obstrucción, y especialmente cuando se utilizaba el sistema TB</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La mayoría de los pacientes ingresados en nuestra sección no era capaz de realizar correctamente los sistemas analizados, especialmente el CP, aunque es posible mejorar su realización si nos preocupamos de su enseñanza con un tiempo limitado de dedicación en todos los casos y en los pacientes con EPOC con independencia de su grado de obstrucción. Nuestros resultados demostraron que es posible e importante llevar a cabo un programa para la enseñanza del manejo de estos sistemas durante la hospitalización</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To assess knowledge of how to use a pressurized canister (PC) or Turbuhaler ® (TB) systems and to evaluate the usefulness of giving technical instruction to hospitalized patients, analyzing chronic obstructive pulmonary disease (COPD) patients according to degree of obstruction</p> <span class="elsevierStyleSectionTitle">Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We evaluated the use of the PC by 107 consecutive patients and the TB by 79 patients upon their admission to the respiratory medicine ward, with reference to the guidelines of the Spanish Society of Respiratory Medicine and Thoracic Surgery. We then evaluated the usefulness of instruction PC or TB technique. We recorded age, sex, underlying respiratory disease, the patient's opinion and time in years the patient had been using the inhaler, FEV1, and technique upon admission and after instruction during the hospital stay</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Only 19% of the patients used the PC and 32% of the TB patients used their inhaler correctly at first. After instruction, the rates of correct use improved to 42% and 70% for the PC and TB, respectively, over the course of an approximately 4-day hospital stay. Among the PC users, 77% believed they were performing the maneuver correctly. All steps for both inhalers improved, as the number of errors decreased, particularly errors considered most rele-vant (coordination of the trigger and inspiration from the PC or full expiration and breath holding with both systems). The number of correct techniques at the end of the study was similar for all levels of COPD obstruction, and particularly for those using the TB</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Most patients admitted to our wardwere unable to use either inhaler correctly, with incorrect use of the PC being particularly evident. It is possible to improve performance, however, if we take care to teach patients in short instruction sessions. This is true for all COPD patients, regardless of level of obstruction. Our results demonstrate that a program of instruction during a patient's hospital stay is both feasible and important</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 3 | 5 |
| 2024 October | 38 | 32 | 70 |
| 2024 September | 45 | 38 | 83 |
| 2024 August | 54 | 64 | 118 |
| 2024 July | 40 | 27 | 67 |
| 2024 June | 44 | 28 | 72 |
| 2024 May | 45 | 27 | 72 |
| 2024 April | 36 | 32 | 68 |
| 2024 March | 38 | 45 | 83 |
| 2024 February | 24 | 36 | 60 |
| 2024 January | 0 | 2 | 2 |
| 2023 December | 0 | 4 | 4 |
| 2023 November | 0 | 6 | 6 |
| 2023 October | 0 | 6 | 6 |
| 2023 July | 0 | 8 | 8 |
| 2023 June | 0 | 15 | 15 |
| 2023 April | 0 | 4 | 4 |
| 2023 March | 4 | 4 | 8 |
| 2023 February | 22 | 19 | 41 |
| 2023 January | 26 | 33 | 59 |
| 2022 December | 37 | 31 | 68 |
| 2022 November | 43 | 24 | 67 |
| 2022 October | 26 | 47 | 73 |
| 2022 September | 39 | 47 | 86 |
| 2022 August | 36 | 46 | 82 |
| 2022 July | 24 | 41 | 65 |
| 2022 June | 41 | 48 | 89 |
| 2022 May | 76 | 38 | 114 |
| 2022 April | 81 | 44 | 125 |
| 2022 March | 72 | 45 | 117 |
| 2022 February | 38 | 37 | 75 |
| 2022 January | 29 | 38 | 67 |
| 2021 December | 27 | 48 | 75 |
| 2021 November | 26 | 39 | 65 |
| 2021 October | 28 | 49 | 77 |
| 2021 September | 39 | 41 | 80 |
| 2021 August | 15 | 35 | 50 |
| 2021 July | 16 | 15 | 31 |
| 2021 June | 27 | 35 | 62 |
| 2021 May | 49 | 64 | 113 |
| 2021 April | 56 | 72 | 128 |
| 2021 March | 36 | 16 | 52 |
| 2021 February | 30 | 14 | 44 |
| 2021 January | 22 | 23 | 45 |
| 2020 December | 31 | 25 | 56 |
| 2020 November | 25 | 35 | 60 |
| 2020 October | 32 | 9 | 41 |
| 2020 September | 21 | 12 | 33 |
| 2020 August | 23 | 10 | 33 |
| 2020 July | 32 | 26 | 58 |
| 2020 June | 33 | 16 | 49 |
| 2020 May | 38 | 11 | 49 |
| 2020 April | 36 | 9 | 45 |
| 2020 March | 20 | 19 | 39 |
| 2020 February | 34 | 19 | 53 |
| 2020 January | 62 | 25 | 87 |
| 2019 December | 34 | 31 | 65 |
| 2019 November | 18 | 8 | 26 |
| 2019 October | 12 | 14 | 26 |
| 2019 September | 26 | 11 | 37 |
| 2019 August | 21 | 10 | 31 |
| 2019 July | 29 | 26 | 55 |
| 2019 June | 17 | 10 | 27 |
| 2019 May | 40 | 42 | 82 |
| 2019 April | 22 | 13 | 35 |
| 2019 March | 22 | 15 | 37 |
| 2019 February | 21 | 14 | 35 |
| 2019 January | 13 | 7 | 20 |
| 2018 December | 29 | 18 | 47 |
| 2018 November | 38 | 18 | 56 |
| 2018 October | 48 | 12 | 60 |
| 2018 September | 34 | 12 | 46 |
| 2018 May | 18 | 2 | 20 |
| 2018 April | 9 | 5 | 14 |
| 2018 March | 15 | 9 | 24 |
| 2018 February | 7 | 10 | 17 |
| 2018 January | 9 | 9 | 18 |
| 2017 December | 14 | 17 | 31 |
| 2017 November | 6 | 15 | 21 |
| 2017 October | 10 | 12 | 22 |
| 2017 September | 6 | 18 | 24 |
| 2017 August | 17 | 15 | 32 |
| 2017 July | 19 | 12 | 31 |
| 2017 June | 21 | 39 | 60 |
| 2017 May | 12 | 19 | 31 |
| 2017 April | 10 | 7 | 17 |
| 2017 March | 13 | 16 | 29 |
| 2017 February | 8 | 12 | 20 |
| 2017 January | 9 | 12 | 21 |
| 2016 December | 51 | 20 | 71 |
| 2016 November | 66 | 26 | 92 |
| 2016 October | 67 | 29 | 96 |
| 2016 September | 66 | 19 | 85 |
| 2016 August | 47 | 7 | 54 |
| 2016 July | 44 | 6 | 50 |
| 2016 June | 45 | 13 | 58 |
| 2016 May | 33 | 6 | 39 |
| 2016 April | 37 | 1 | 38 |
| 2016 March | 15 | 4 | 19 |
| 2016 February | 28 | 0 | 28 |
| 2016 January | 39 | 14 | 53 |
| 2015 December | 40 | 18 | 58 |
| 2015 November | 39 | 5 | 44 |
| 2015 October | 75 | 1 | 76 |
| 2015 September | 61 | 0 | 61 |
| 2015 August | 71 | 0 | 71 |
| 2015 July | 54 | 0 | 54 |
| 2015 June | 68 | 0 | 68 |
| 2015 May | 71 | 0 | 71 |
| 2015 April | 60 | 0 | 60 |
| 2015 March | 81 | 0 | 81 |
| 2015 February | 47 | 0 | 47 |
| 2015 January | 47 | 0 | 47 |
| 2014 December | 42 | 0 | 42 |
| 2014 November | 56 | 0 | 56 |
| 2014 October | 81 | 0 | 81 |
| 2014 September | 38 | 0 | 38 |
| 2014 August | 38 | 0 | 38 |
| 2014 July | 43 | 0 | 43 |
| 2014 June | 49 | 0 | 49 |
| 2014 May | 69 | 0 | 69 |
| 2014 April | 65 | 0 | 65 |
| 2014 March | 89 | 0 | 89 |
| 2014 February | 65 | 0 | 65 |
| 2014 January | 65 | 0 | 65 |
| 2013 December | 56 | 0 | 56 |
| 2013 November | 48 | 0 | 48 |
| 2013 October | 58 | 0 | 58 |
| 2013 September | 55 | 0 | 55 |
| 2013 August | 52 | 0 | 52 |
| 2013 July | 64 | 0 | 64 |
| 2013 June | 44 | 0 | 44 |
| 2013 May | 29 | 0 | 29 |
| 2013 April | 35 | 0 | 35 |
| 2013 March | 11 | 0 | 11 |
| 2000 January | 2498 | 0 | 2498 |
Show all
