Managing COPD in LTC: focusing on administration of inhaled medications.

Abstract

In summary, all three types of aerosol therapy have a place in patient care. While MDI and DPI use is more efficient, less costly, and less time consuming, nebulization is still indicated under certain circumstances. As the length of hospitalization for COPD patients decreases and the cost burden shifts, nurses in the LTC setting are caring for more acute COPD residents. Prevention of exacerbations is an important focus of care in the LTC setting. With a good understanding of aerosol devices, the nurse can greatly impact the goals of respiratory disorder management. It is important for the nurse to be well versed in the use of aerosol therapies to provide adequate instruction to residents. Many nurses and other staff in the long-term care facility are unaware of proper inhalation technique with MDI use, and staff education is essential. Accurate care and use of aerosol medications will prevent medication errors and help the LTC facility comply with CMS regulations. The nurse can use resident teaching time to assess the resident's condition and capabilities with the device. If a resident is having difficulty with a device for any reason, the efficacy of the device may be greatly impacted. In such cases, the nurse can provide reinforcement teaching or recommend a change in the type of aerosol therapy. Not only must the nurse teach and continually evaluate the appropriateness of the therapy and its use, but also assess the resident for any side effects. Through continual assessment, implementation, and evaluation, the nurse has the opportunity to affect the resident's condition, and quality of life. [table: see text]