Page 1 of 2
Procedures

The following are sample instructions for procedures to be followed related to aerosol applications:

Procedure for Aerosol Medication Delivery

The following procedure is provided for use when delivering medications by means of an aerosol generator:

A. Check Order. Verify the physician's order as follows:

  1. Compare the requisition with the physicians order to ensure that no discrepancies exist
  2. Review the order to ensure that the following are prescribed:
    • FI02
    • Medication to be used
    • Frequency of therapy
    • Duration of therapy
  3. If any part of the order is unfamiliar, question its accuracy.

B. Review Chart. Use the following procedure to review the patient's chart:

  1. On the patient's chart, identify all pertinent data in the following areas:
    • History and physical
    • Admitting diagnosis
    • Progress notes
    • Blood gas analysis
    • Chest x-rays
  2. Based on the patient data, identify the following:
    • Conditions that indicate the need for aerosol medication delivery
    • Potential hazards of aerosol medication delivery for the patient

C. Maintain Asepsis. While performing the remainder of this procedure, you are expected to maintain aseptic conditions. This includes following universal precautions and washing your hands:

    1. Before obtaining equipment
    2. Following performance of step K. Conclude Procedure
    3. Anytime during the procedure that contamination is suspected

D. Obtain Equipment Collect the following equipment and supplies:

    • Flowmeter or air compressor
    • Miniature nebulizer
    • Supply tubing
    • Prescribed medication
    • Stethoscope

E. Assemble Equipment. Prepare the equipment for use as follows:

    1. Connect the supply tubing to the nebulizer.
    2. Attach the other end of the supply tubing to the flowmeter.
    3. Insert the prescribed medication into the nebulizer.

F. Test Equipment. Test the aerosol medication delivery equipment as follows:

    1. Connect the flowmeter to the correct gas source.
    2. Turn on the flowmeter.
    3. If a fine mist is absent, tighten all connections and adjust the jets, if applicable.
    4. If a fine mist is still absent:
      1. Label the nebulizer as defective and replace it
      2. Reassemble and retest the new equipment

G. Confirm Patient. Ensure that the procedure is performed with the correct patient as follows:

    1. Match the information on the order with the following:
      • Room number
      • Name on the door or bed
      • Name on the wristband
    2. Greet the patient by name (in a questioning manner if unknown).
    3. Resolve any discrepancies in the patient identification information by conferring with the nursing staff.
H. Inform Patient Interact with the patient as follows:
    1. Introduce yourself by name and department (if not already acquainted).
    2. Tell the patient what procedure is to be performed.
    3. Explain the procedure by describing:
      • Why it is to be performed
      • How it will be performed
      • What the patient is expected to do
      • What you will be doing
      • How frequently it will be performed

I. Implement Procedure. Perform the following tasks:

    1. Position the patient in an upright position (45 to 9O° angle).
    2. Administer the aerosol medication as follows:
      1. a. Turn on the flow meter.
      2. b. Attach the aerosol medication delivery device to the patient
      3. c. Ensure that the delivery device fits comfortably.
    3. Coach the patient to breathe in the following manner:
      • Diaphragmatically
      • Through the mouth
      • Slowly and deeply
      • Pause at end-inspiration, maintaining an I:E ratio of at least 1:2

J. Monitor Patient. Determine the patient's response to therapy as follows:

    1. Determine the pulse rate. (Count for at least one minute.)
    2. Determine the respiratory rate. (Count for at least one minute.)
    3. Observe respiration to identify any abnormalities in the breathing pattern.
    4. Auscultate the patient's chest
    5. Note any abnormalities in the patient's appearance or behavior.

K. Conclude Procedure. Complete the following tasks:

    1. Place the patient in a comfortable position.
    2. Assure that the call bell and bedside table are within the patient's reach.
    3. Ask if the patient has any needs.
    4. Answer any questions as effectively as possible.
    5. Unplug and cover all equipment and move it away from the patient's bed (or remove it from the room).

L. Record Results. Document the therapy as follows:

    1. Record the following data on the patient's chart:
      • Aerosol medication administered
      • Pulse rate
      • Respiratory rate
      • Volume, color, and consistency of sputum
      • Abnormal patient characteristics
      • Therapy-related patient complaints
    2. Sign the patient's chart (first initial and full last name).

M. Report Observations. Report the following information:

    1. Report any significant adverse changes in the patients condition to the nurse or physician whenever observed.
    2. Following the procedure, inform the appropriate personnel of:
      • Patient requests
      • Patient complaints
      • Unexpressed patient needs
    3. Following the procedure, report to the nurse or physician:
      • Any non-critical adverse reactions to the therapy
      • Other pertinent observations of the patients condition
· Previous · Next ·
· Learning Objectives · Bibliography ·