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Table 3 Annual check list

From: Hypertonic saline in people with cystic fibrosis: review of comparative studies and clinical practice

Annual check-list

Patient’s name

YEAR

ITEMS

Date

yes/no

Date

yes/no

date

yes/no

Have the objectives of aerosol therapy been clarified?

      

Has the action of the individual drugs been explained?

      

Does the person agree on the prescribed therapy?

      

Have the drugs in the prescription been checked?

      

Have the type of dilutions been checked?

      

Has the patient’s nebulizer equipment been checked?

      

It has been asked if they are used?

      

Have they been checked by the physiotherapist?

      

Were verbal instructions given?

      

Has the patient been given the opportunity to directly show how to manage and use the devices?

      

Written instructions: have they been delivered?

      

Written instructions: have they been understood?

      

Has the patient been given time and means to reformulate the educational and technical aspects, express doubts, ask for clarification?

      

Was the opinion on the feeling of effectiveness of the drug asked?

      

Has the duration of aerosol therapy with individual drugs been asked?

      

Is the aerosol completely taken?

      

Has the logic of the drug intake sequence in relation to physiotherapy been clarified?

      

Has the last replacement of the hose, filters, head, nebulizer, engineering review, etc. been checked?

      

Is the difference between cleaning and disinfection clear?

      

Has it been investigated how cleaning and disinfection are done?

      

And the frequency of cleaning and disinfection?

      

Operator signature

      
  1. Taken and translated from: Gruppo di Studio Multidisciplinare della SIFC sull’Aderenza Terapeutica in Fibrosi Cistica. “La valutazione e l’implementazione dell’aderenza allaterapia inalatoria e alla fisioterapia respiratoria nella Fibrosi Cistica”. Orizzonti -Supplemento al n.2–2016: 19