ASSESSMENT OF KNOWLEDGE AND PRACTICE AMONG NURSES REGARDING NEBULIZATION THERAPY IN PUBLIC SECTOR HOSPITALS AT CHARSADDA, KHYBER- PAKHTUNKHWA PAKISTAN: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.71000/9v8rr114Keywords:
Aerosol Therapy, Knowledge, Nebulization, Nurses, Practice, Public Sector Hospitals, Respiratory CareAbstract
Background: Nebulization therapy is a vital mode of drug delivery for patients with acute and chronic respiratory disorders, as it allows medications to reach the lower airways directly. Nurses play a central role in administering this therapy and ensuring its effectiveness and safety. However, inadequate knowledge and improper practices among nursing staff can compromise treatment outcomes, increase infection risk, and reduce therapeutic efficiency. Limited evidence is available from public sector hospitals in Khyber Pakhtunkhwa, particularly Charsadda, highlighting the need for systematic evaluation of nurses’ competence in nebulization therapy.
Objective: To assess the level of knowledge and practice regarding nebulization therapy among nurses working in public sector hospitals of Charsadda, Khyber Pakhtunkhwa, Pakistan.
Methods: A descriptive cross-sectional study was conducted over four months in two public sector hospitals of Charsadda. A total of 106 registered nurses involved in direct patient care were enrolled using a convenience sampling technique. Data were collected using a standardized, self-administered questionnaire covering demographic characteristics, knowledge of nebulization therapy, and routine clinical practices. Descriptive statistics, including frequencies, percentages, means, and standard deviations, were analyzed using SPSS version 16.
Results: Among the participants, 93.4% were female and 6.6% were male. The mean knowledge score was 26.17 ± 4.34, with scores ranging from 20 to 43. A low level of knowledge was observed in 85.9% of nurses, while only 14.1% demonstrated high knowledge. Regarding practice, 52.8% of participants exhibited good nebulization practices, whereas 47.2% showed poor practice. Nebulization was used routinely, most commonly three to five times per day, indicating frequent clinical reliance despite knowledge gaps.
Conclusion: The study revealed a substantial gap between knowledge and practice of nebulization therapy among nurses in public sector hospitals of Charsadda. Although nebulization was routinely performed, insufficient theoretical understanding may limit safe and effective care. Targeted training programs, standardized protocols, and continuous professional education are essential to improve nursing competence and patient outcomes.
References
Sakrani NF, Hussein SE, Borg M, Konstantinopoulou S. Assessing and addressing barriers towards MDI use in acute asthma exacerbations at a tertiary pediatric ED in the United Arab Emirates. Int J Pediatr Adolesc Med. 2022;9(1):41-5.
Kimel LS. Assisting Students With Asthma Inhaler Technique and Knowledge. NASN Sch Nurse. 2022;37(3):127-31.
Hardy P, Gonzalez M, Volerman A, Salem E, Amerson N, Woolverton N, et al. Asthma policy in Illinois: A survey of school nursing and staff knowledge and implementation patterns. Public Health Nurs. 2024;41(4):704-8.
Ozoh OB, Akinbolagbe Y, Tekobo A, Dede SK, Dania MG, Adeyeye O. The feasibility and effect of a nurse-led, patient-centered asthma education program in a Nigerian context. J Asthma. 2022;59(8):1670-9.
Ongtengco A, Wilt E, Hardy P, Youssef C, Martin MA, Pappalardo AA. "Getting in and doing it personally": Engagement strategies for rural school asthma programs. Ann Allergy Asthma Immunol. 2025;135(6):668-75.
Neininger MP, Kaune A, Musiol J, Kiess W, Bertsche A, Prenzel F, et al. Handling Errors in the Use of Inhalation Devices: Inhalation Technique Skills and Knowledge in Pediatric Nurses. J Nurs Care Qual. 2022;37(2):180-7.
Santambrogio M, Lazzeri M, Bonitta G, Guarise R, Simonetta E, Blasi F, et al. Hospital staff practical skills and theoretical knowledge in inhaled aerosol therapy: a single centre cross-sectional observational study. Monaldi Arch Chest Dis. 2021;91(1).
Spaggiari S, Gehri M, Di Benedetto L, Hafen GM, Pauchard JY, Gervaix A, et al. Inhalation technique practical skills and knowledge among physicians and nurses in two pediatric emergency settings. J Asthma. 2021;58(2):190-6.
Jové-Blanco A, Toledano-Revenga J, Rivas-García A, Vazquez-López P, Lorente-Romero J, Marañón R. Inhaler technique in a pediatric emergency department: Impact of an education intervention among healthcare professionals. Pediatr Pulmonol. 2023;58(2):441-8.
Zhang C, Mi J, Wang X, Lv S, Zhang Z, Nie Z, et al. Knowledge and current practices of ICU nurses regarding aerosol therapy for patients treated with invasive mechanical ventilation: A nationwide cross-sectional study. J Clin Nurs. 2021;30(23-24):3429-38.
Mushkani EA, Hamidy F, Ahmad T, Adelyar MA. Misuse of Respiratory Inhalers Among Hospitalized Patients in a Tertiary Health Care Hospital in Kabul. Int J Chron Obstruct Pulmon Dis. 2023;18:365-71.
Ng SW, Lit MPK, Lai AYK. Nurses' Reports of Inhaler Use Errors in Patients with Chronic Obstructive Pulmonary Disease in Hong Kong. Int J Chron Obstruct Pulmon Dis. 2024;19:2775-85.
Mangaiyarkarasi, Pandey E, Keretta U. A Study to Assess the Effectiveness of Structured Teaching Program on Knowledge and Practice Regarding Nebulization in Children (0–5 year) among Student Nurses. Int J Nurs Res. 2023;09(01):12–6.
M. Ameen E, H. Nasr M, H. Bakr Z. Nurse’ Performance Regarding Care of Patients with Chronic Obstructive Pulmonary Disease on Nebulizer Therapy. Egypt J Heal Care. 2022;13(4):1114–25.
Zaki R, Taha N, Hamd E, Abdelhamid F. Nurses’ Role Regarding Nebulization Therapy for Patients with Mechanical Ventilation in Emergency Care Unit. Zagazig Nurs J. 2024;20(1):133–47.
Tu Y, Yao Q, Chen Y, Ren Y, Fang B, Li X, et al. Knowledge, attitudes, and practices of inhalation device use among patients with chronic obstructive pulmonary disease. Sci Rep. 2025;15(1):1–12.
Sivadasan S, Krishnan A, Dhayalan SV, Aiyalu R. A Systematic Review on KAP of Nebulization Therapy at Home. J Pharm Technol. 2021;37(5):254–9.
Biney IN, Ari A, Barjaktarevic IZ, Carlin B, Christiani DC, Cochran L, et al. Guidance on Mitigating the Risk of Transmitting Respiratory Infections During Nebulization by the COPD Foundation Nebulizer Consortium. Chest. 2024;165(3):653–68.
Gracia G, Romina V, Martínez B, Grande-ratti MF, Federico G. Efficacy of an educational intervention in the management of an inhalation device among nursing professionals of an emergency department. 2022;32:279–83.
Marko M, Klimczak M, Sobczak M, Wojakiewicz M, Tomasz D, Emeryk A, et al. Effective inhaler technique education is achievable - assessment and comparison of five inhaler devices errors. 2025;(April):1–11.
Eltabakh AE, Elsman S, El-Shenawi S, Nabil A. Factors Hindering The Effect of The Nebulization Therapy among Critically Ill Mechanically Ventilated Patients. Alexandria Sci Nurs J. 2021;23(2):79–91.
Sun Q, Chang W, Liu X, Xie J, Qiu H, Yang Y, et al. Aerosol therapy during mechanical ventilation in intensive care units: A questionnaire-based survey of 2203 ICU medical staff in China. J Intensive Med. 2022;2(3):189–94.
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Copyright (c) 2025 Malik Aman, Adnan Ahmad, Faiz Ur Rahman, Wajahat Ullah, Iftikhar Ahmad, Amir Dawood, Hamza Naeem, Hazrat Ullah, Dunya Dar (Author)
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