B62-06 “Lasting Impact Through Simple Training”: Enhancing Inhaler Technique Training for Pediatric Providers

Abstract Rationale Inhaler-technique errors remain a frequent and preventable contributor to suboptimal asthma control, resulting in poor medication delivery, persistent symptoms, and avoidable healthcare utilization. Pediatric providers are often the first point of instruction for families, yet effective demonstration of proper technique is not consistently ensured. Recognizing this, we developed and implemented a structured, low-cost educational bundle aimed at improving and sustaining provider competency in inhaler technique across both inpatient and outpatient pediatric services. Methods Thirteen pediatric providers—comprised of attending physicians, residents, and nurse practitioners (NPs) participated in this quality improvement initiative. The intervention included three key components: (1) a standardized CDC-produced video on inhaler use, (2) a brief live demonstration (∼5 minutes) of spacer technique with both mouthpiece and mask interfaces, and (3) distribution of an illustrated one-page handout designed for quick clinical reference. Performance was assessed using validated checklists (11 steps for mouthpiece, 10 for mask) derived from CDC guidance and refined through expert review by a pediatric pulmonologist. Mastery was defined as ≥ 10/11 steps for mouthpiece and ≥9/10 for mask. Assessments were conducted at baseline, immediately post-intervention, and at 8-week follow-up to evaluate retention. Interrater reliability was ensured by double-scoring 10% of evaluations with a target of ≥ 80% concordance. Results Substantial improvement was demonstrated across all provider categories. For spacer with mouthpiece, mean scores increased from 5.54 at baseline to 11.00 immediately post-training, with retention at 10.69 at 8 weeks. Mastery rates rose from 7.7% to 100% immediately post-training and were sustained at 92.3% at follow-up. For spacer with mask, mean scores improved from 5.23 to 10.00 post-training and remained at 9.85 at 8 weeks; mastery increased from 15.4% to 100% and was fully retained. At 8 weeks, attendings maintained perfect scores (11.0/11 mouthpiece; 10.0/10 mask), residents achieved full mastery for mouthpiece (11.0/11) and near-perfect scores for mask (9.71/10), while NPs retained mastery for mask (10.0/10) but fell slightly below mastery for mouthpiece (9.67/11). Importantly, all groups achieved 100% mastery immediately following the intervention. Conclusion A brief, scalable educational intervention produced rapid, universal improvement in inhaler technique competency among pediatric providers, with strong retention at 8 weeks. The intervention required minimal resources and was easily incorporated into clinical workflow. One observed decline was a slight reduction in mouthpiece performance among nurse practitioners which highlights the importance of reinforcement. This low-cost, reproducible model holds promise for improving provider education, strengthening patient instruction, and ultimately enhancing asthma outcomes in underserved pediatric populations. This abstract is funded by: None