Inhaled Therapy – Nebulizer

Nebulizer: A small machine that turns a liquid medication into a mist. The mist is inhaled through a mouthpiece or mask with slow deep breaths. This helps channel the medication to the lungs. Nebulizers are often used with children or any individual who cannot use other inhaler devices appropriately.

CSS Considerations

  • Determine the client’s eligibility to approve this delegated act to a PSW.
  • A direct order for medication administration is required and must be clear, complete, and appropriate.
  • If the direct order is unclear, incomplete, or inappropriate the CSS must:
    • Stop the delegation process to the PSW.
    • Follow up with the client/SDM/POA, HCCSS Care Coordinator and/or the prescriber in a timely manner.
  • Have knowledge about the medication(s) being administered, including therapeutic actions, and possible risks.
  • Assess the appropriateness of the medication practice by considering the following:
    • The client
    • The medication
    • The environment
    • The competency level of the available PSW
  • Consult with the client, SDM or POA, and a HCCSS Care Coordinator when client outcomes are not as expected, or if the client’s needs exceed the scope of practice of the PSW.
  • This medication administration policy and procedure encompasses inhaled medication only.
  • The nebule must be in its original packaging, unopened or unused.

PSW Considerations

  • Report to the office at 416-635-2860 if:
    • The client refused to take medications
    • The medication supply is running low
    • There are any issues with the mask, tubing, or machinery
    • The medications for the scheduled visit or upcoming visit are missing/finished/not available
    • The client is showing signs of an abnormal or allergic reaction before or after taking their medication. For example:
      • Hives (raised, puffy areas on the skin that itch intensely)
      • Rash (skin that changes in colour or texture and may look irritated or inflamed)
      • Itching
      • Swelling
      • Shortness of breath (e.g. breathlessness, feeling of suffocation, intense tightening of the chest)

Required Supplies

  • Compressor
  • Tubing
  • Nebulizer chamber
  • Face mask
  • Nebulizer with medication
  • Normal saline (if needed)
  • Gloves
  • Towel or cloth to wipe client’s face

Procedure for Administering a Nebulizer

  1. Before beginning, check the client’s care plan in your Circle of Care mobile device to confirm that “Inhaled Therapy: Nebulizer” is scheduled.
  2. Gather all the necessary supplies.
  3. Ensure the compressor is plugged in.
  4. Perform hand hygiene and put on gloves.
  5. Open the container (nebule) with the medication.
  6. Put the medication and saline in the nebulizer chamber.
  7. Place the mask over the client’s nose and mouth and ensure there is a firm seal.
  8. Ensure the client is comfortable.
  9. Turn on the compressor machine and observe for the formation of sufficient mist.
  10. Keep the mask on the client’s face until the mist stops.
  11. Remove the mask.
  12. Turn off the compressor.
  13. Wipe the client’s face.
  14. Take the mask and nebulizer chamber apart.
  15. Rinse the mask and chamber in warm water and let air dry.
  16. Remove gloves and perform hand hygiene
  17. Check “completed without issue” in the mobile app and report to the office at 416-635-2860 if there are any concerns.

Video Resource

Please click on the video link below for a visual demonstration of the procedure:

References