Online Education Improves Confidence in Mechanical Insufflation-Exsufflation.

Autor:	Lambrinos E; Respiratory Support Service, Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia. elizabeth.lambrinos@health.nsw.gov.au., Elkins MR; Centre for Education and Workforce Development, Sydney Local Health District, Sydney, New South Wales, Australia.; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia., Menadue C; Respiratory Support Service, Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia., McGuiness OA; Respiratory Support Service, Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia., Melehan KL; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.; Department of Sleep and Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia., Piper AJ; Respiratory Support Service, Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia.
Jazyk:	angličtina
Zdroj:	Respiratory care [Respir Care] 2023 Jul 11. Date of Electronic Publication: 2023 Jul 11.
DOI:	10.4187/respcare.11031
Abstrakt:	Background: Mechanical insufflation-exsufflation (MI-E) is a cough augmentation technique used to support people with an ineffective cough. MI-E can be complex due to the number of different pressure, flow, and temporal setting adjustments needed to optimize cough efficacy. Many clinicians identify inadequate training, limited experience, and low confidence as barriers to MI-E use. The purpose of this study was to determine if an online education course could improve confidence and competence in the delivery of MI-E. Methods: An e-mail invitation to participate was disseminated to physiotherapists with a caseload that involved airway clearance for adults. The exclusion criteria were self-reported confidence and clinical expertise in MI-E. The education was created by physiotherapists with extensive experience in the provision of MI-E. The education material reviewed theoretical and practical components and was designed to take 6 h to complete. Physiotherapists were randomized to either the intervention group, who had 3 weeks of access to the education or the control group who received no intervention. Respondents in both groups completed a baseline and a post-intervention questionnaire by using visual analog scales, 0 to 10, with the primary outcomes being confidence in the prescription and confidence in the application of MI-E. Ten multiple-choice questions that covered key components of MI-E fundamentals were also completed at baseline and post-intervention. Results: The intervention group had a significant improvement in the visual analog scale after the education period with a between-group difference of mean 3.6 (95% CI 4.5 to 2.7) for prescription confidence and mean 2.9 (95% CI 3.9 to 1.9) for application confidence. There was also an improvement in the multiple-choice questions with a between-group difference of mean 3.2 (95% CI 4.3 to 2). Conclusions: Access to an evidence-based online education course improved confidence in the prescription and application of MI-E, and may be a valuable tool for training clinicians in the application of MI-E. (Copyright © 2023 by Daedalus Enterprises.)
Databáze:	MEDLINE
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