Administering Medication via a Dry Powder Inhaler

Goal: The patient receives the medication via a dry powder inhaler using the correct technique.

1. Gather equipment. Check each medication order against the original order in the medical record, according to facility policy. Clarify any inconsistencies. Check the patient’s chart for allergies.

2. Know the actions, special nursing considerations, safe dose ranges, purpose of administration, and adverse effects of the medications to be administered. Consider the appropriateness of the medication for this patient.

3. Perform hand hygiene.

4. Move the medication cart to the outside of the patient’s room or prepare for administration in the medication area.

5. Unlock the medication cart or drawer. Enter pass code and scan employee identification, if required.

6. Prepare medications for one patient at a time.

7. Read the CMAR/MAR and select the proper medication from the patient’s medication drawer or unit stock.

8. Compare the label with the CMAR/MAR. Check expiration dates and perform calculations, if necessary. Scan the bar code on the package, if required.

9. When all medications for one patient have been prepared, recheck the label with the CMAR/MAR before taking them to the patient.

10. Lock the medication cart before leaving it.

11. Transport medications to the patient’s bedside carefully, and keep the medications in sight at all times.

12. Ensure that the patient receives the medications at the correct time.

13. Perform hand hygiene and put on PPE, if indicated.

14. Identify the patient. Usually, the patient should be identified using two methods. Compare information with the CMAR/MAR.

a. Check the name and identification number on the vpatient’s identification band.
b. Ask the patient to state his or her name and birth date, based on facility policy.
c. If the patient cannot identify him- or herself, verify the patient’s identification with a staff member who knows the patient for the second source.

15. Complete necessary assessments before administering medications. Check the patient’s allergy bracelet or ask the patient about allergies. Explain what you are going to do, and the reason for doing it, to the patient.

16. Scan the patient’s bar code on the identification band, if required.

17. Remove the mouthpiece cover or remove from storage container. Load a dose into the device as directed by the manufacturer, if necessary. Alternately, activate the inhaler, if necessary, according to manufacturer’s directions.

18. Have the patient breathe out slowly and completely, without breathing into the DPI.

19. Patient should place teeth over, and seal lips around, the mouthpiece. Do not block the opening with the tongue or teeth.

20. Breathe in quickly and deeply through the mouth, for longer than 2 to 3 seconds.

21. Remove inhaler from mouth. Instruct patient to hold the breath for 5 to 10 seconds, or as long as possible, and then to exhale slowly through pursed lips.

22. Wait 1 to 5 minutes, as prescribed, before administering the next puff.

23. After the prescribed amount of puffs has been administered, have patient replace the cap or storage container.

24. Have the patient gargle and rinse with tap water after using DPI, as necessary. Clean the DPI according to the manufacturer’s directions.

25. Remove gloves and additional PPE, if used. Perform hand hygiene.

26. Document the administration of the medication immediately after administration.

27. Evaluate patient’s response to medication within appropriate time frame. Reassess lung sounds, oxygenation saturation if ordered, and respirations.