ID#: ______

Pediatric Emergency Physician Survey

Questions 1 to 4 relate to the following Clinical Scenario.

Please answer each question by placing an “X” in the box beside the response that best describes your opinion.

  1. Do you currently use MDI/Spacers for delivering bronchodilators to the child in this Clinical Scenario in your ED?

NO → Please go to Question 4

YES

↓ Please go to Question 2

  1. How often do you use MDI/Spacers (instead of Nebulizers) to treat this type of child?

100% (all of the time)

> 90% (almost all of the time)

50 – 90% (over half the time)

5 – 49% (less than half the time)

< 5% (rarely)

  1. In which age groups of children do you currently use MDI/Spacers for the severity of asthma described in the Clinical Scenario?(Please mark ALL THAT APPLY)

Infants (< 12 months old)

12 – 23 months old

2 – 5 year olds

6 – 10 years olds

> 10 years olds

  1. Do you believe that MDI/Spacers are at least as effective as Nebulizers for the ED treatment of the child described in the Clinical Scenario?

YES

NO

NOT SURE

  1. If you were to use (or do use) MDI/Spacer instead of Nebulizer to deliver bronchodilators in your ED what clinical outcome would you expect?

Much greater efficacy

Greater efficacy

Equal efficacy

Worse efficacy

Much worse efficacy

  1. MDI/Spacer administration of bronchodilators is associated with ______patient side effects compared to Nebulizers.

Many more

More

Equal

Fewer

Many fewer

  1. Switching from Nebulizers to MDI/Spacers for acute asthma treatment in the ED will result in parents being ______with their care.

Much more satisfied

More satisfied

Equally satisfied

Less satisfied

Much less satisfied

  1. “There is currently enough research evidence to justify switching from Nebulizers to MDI/Spacers in the ED”.
  1. “Nurses will find the technique of giving treatments by MDI/Spacer more difficult than Nebulizer”.
  1. “It will be easy to convince parents and patients to use MDI/Spacers instead of Nebulizers in the ED”.
  1. “Toddlers will be less happy receiving their treatment by MDI/Spacer compared to Nebulizer”
  1. “I have the knowledge and skills to use MDI/Spacers to deliver bronchodilators to my patients in the ED”
  1. “Switching to MDI/Spacers will result in higher costs to our ED”.
  1. “It will take up more of a nurses time to deliver a treatment by MDI/spacer compared to Nebulizers”.
  1. “Parents will find it easier to give a treatment by MDI/Spacer to their child compared to Nebulizer in the ED”.
  1. “MDI/Spacer use will result in patients staying longer in the ED”.
  1. “It will be/was difficult to change the practice in my ED and convince physicians and nurses to use MDI/Spacers instead of Nebulizers”.
  1. Are you aware of the research evidence that compares MDI/Spacer to Nebulizer for the ED delivery of bronchodilators for mild to moderate acute asthma exacerbations in children?

NO → Please go to Question 21

YES

↓ Please go to Question 19

  1. How familiar are you with this research?

Extremely familiar

Very familiar

Somewhat familiar

A little familiar

Not at all familiar

  1. The research evidence indicates that MDI/Spacer treatment is ______

less effective than Nebulizers

at least as effective as Nebulizers

NOT SURE

Actual or Potential Barrier

to Adopting Spacers in Your ED

/ 1
Not at all important / 2
Slightly important / 3
Moderately important / 4
Very important / 5
Extremely important

21.Cost to the ED

  1. Parental expectations to be treated with Nebulizers

  1. Concerns of increased nursing workload with Spacers

  1. Physicians in my ED who do not believe that MDI/Spacers are at least as effective as Nebulizers

  1. Emergency nurses inertia to change

  1. Concerns that the magnitude of the benefit of Spacers does not justify the time and effort needed for change

  1. Absence of a physician champion to lead the process of change

  1. Disagreement among “the experts” at my hospital as to the need for change

  1. Emergency physicians inertia to change

  1. The safety and feasibility of sterilizing and reusing the Spacers

  1. Lack of ready access to protocols using MDI/Spacers in the ED

  1. Nurses in my ED who do not believe that MDI/Spacers are at least as effective as Nebulizers

  1. Lack of an effective mechanism for organizational change in the ED

  1. Fear that parents will use high doses of bronchodilator by MDI/Spacer at home and children will come in sicker to the ED

  1. Are there any other barriers we have not mentioned that you feel are important? (Please list)
  1. If not already using them, does your ED plan to use MDI/Spacer in the near future (eg. Next 1-2 years)?

YES

NOT SURE

NO → please specify why ______

Thank you. This last part of the survey is directed at background information.

Please place an “X” in the appropriate box.

  1. How many years have you been in practice since finishing residency (or final postgraduate training)?

≤ 5

6 - 10

11 - 15

16 - 25

> 25

  1. What is your highest level of postgraduate training? (Please choose one)

MD

CCFP

CCFP-EM

FRCPC – Pediatrics

FRCPC – Emergency

Pediatric Emergency Fellowship

Other (Please specify):______

General Comments/Suggestions:

______

______

______

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