NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update Acute

Respiratory Inhalers - Identification Guide

In 2014, NHSGGC Acute spent approximately £1.5M on respiratory inhalers and a 'Respiratory Inhalers - Identification Guide' was developed to address issues such as wastage, incorrect prescribing and inappropriate supply. The guide contains images of inhaler products as well as recommendations for nurses to consider prior to supply to a patient, and information on inhaler cost. Click on the hyperlink above for an image of the guide.


Key messages

 1.  Use the guide to ensure:

  • The correct inhaler device and strength is prescribed (refer to the guide for examples of how inhalers should be prescribed on the Kardex).
  • The correct inhaler device and strength is issued to the patient (if they do not have their own supply). 

2.  Clinical areas without a hard copy of the guide should contact Medicines Information on 0141 211 4407.


Evaluation of the guide

Nurse education

Nursing staff, on seven wards over two hospital sites, completed an initial questionnaire to determine their baseline knowledge of inhaler products. Four to six weeks after targeted education on the guide, they completed a follow-up questionnaire.  Key findings at follow-up were:

• More nurses were able to identify the drug, the drug class and the colour of the inhaler device from the brand name.

• More nurses correctly estimated the cost of different inhaler devices (with the exception of a Ventolin Accuhaler® where the cost was overestimated) and the annual expenditure on inhalers.

• In addition to other standard sources, 50% of nurses said they would now use the guide to identify inhalers and ensure the correct inhaler was ordered /issued.

• Eighty-six percent of nurses stated that they had changed their practice as a result of the education session. 

• Of 86% of nurses who had used the guide since the education session, 83% stated the guide was ‘very useful’ and the remainder stated it was ‘useful’. All of them reported that they would definitely use the guide as a learning tool and reported that it was easy for patients to identify their inhaler device(s) by using the pictures in the guide.


Assessment of prescribing

Junior doctors on medical and surgical receiving units on one hospital site received targeted education on the guide and gave positive feedback. Inhaler prescribing was assessed by reviewing Kardexes before and after education and introduction of the guide.  The results showed that correct prescribing of inhalers increased overall by 11%.


Future development
The content of the guide is due for review as a number of new inhaler devices have become available over the last couple of years. If you have any comments or suggestions for future development of the guide, please contact Elaine.mcivor@ggc.scot.nhs.uk.  Your continued support and promotion of the guide to nursing, medical and pharmacy colleagues is appreciated.