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Research Letter
September 23, 2013

“Nebs No More After 24”: A Pilot Program to Improve the Use of Appropriate Respiratory Therapies

Author Affiliations
  • 1Department of Medicine, University of California, San Francisco, San Francisco
JAMA Intern Med. 2013;173(17):1647-1648. doi:10.1001/jamainternmed.2013.9002

Nebulized bronchodilator therapies (“nebs”) are commonly used in the inpatient setting for the treatment of obstructive pulmonary symptoms. Nebs have equal efficacy when compared with metered-dose inhalers (MDIs) for patients with obstructive pulmonary symptoms1-3 but are significantly more costly because they need to be directly administered by a respiratory therapist (RT). Unnecessary neb administration in the hospital also represents a missed opportunity to educate inpatients on proper use of their MDIs. Press et al4 found that while 86% of patients incorrectly administered their prescribed MDI, all were able to achieve mastery following instruction.

We created a program to decrease inappropriate neb administration, improve inpatient MDI teaching, and increase resident physician knowledge of appropriate respiratory therapies.