Diskus Inhaler Administration Procedure

• Diskus is a medicated inhaler.
• Glass of water is needed.
• Goal: To assist with safe and consistent inhaled medication administration.
• Schedule: See client specific instructions.
• Storage space: Cupboard - Location, Med-lock box (if required), Other.

Reportable Concerns

• Inability to complete task
• Change in client condition
• Client &/or family member(s) requesting change in the DOT (Directly Observed Therapy) procedure
• Increased shortness of breath
• Diskus is damaged
• Diskus has been wet (must be kept dry at all times)

Procedure

• Wash hands to maintain cleanliness as per standard precautions.
• Gather supplies and assemble on a clean, dry surface to complete task in an organized manner.
• Check #1 Identify the Rights of Medication Assistance to ensure the correct medication is given as ordered.
• If dose counter reads 'O', start a new Diskus to ensure medication is used within a safe time period.
• Remove the new Diskus from the box and remove the foil over-wrap pouch.
• Write the "pouch opened" and "use by" dates in the space provided on the label on the Diskus.
• The "use by" date is one month from date of opening.
• If new Diskus is started, repeat step 3 to ensure medication is correct and available.
• Open the Diskus by holding it in one hand and putting the thumb of your other hand on the thumb grip to access the mouthpiece and medication inside the Diskus.
• Push thumb away as far as it will go until the mouthpiece appears and snaps into position.
• Check #2 -Identify the Rights of Medication Assistance to ensure the correct medication is given as ordered.
• Tell client: "Just before you inhale the medication, you should breathe out as far as is comfortable to help the client understand how to use the Diskus properly.
• I will then place the mouthpiece of the Diskus to your lips and ask you to breathe in quickly and deeply through the Diskus, not through your nose.
• I will then remove the Diskus from your mouth.
• Try to hold the medication in by holding your breath for 10 seconds, or as long as is comfortable, then breathe out slowly.
• Do not breathe out through the Diskus."
• Check #3 Identify the Rights of Medication Assistance to ensure the correct medication is given as ordered.
• Check dose counter for number of doses remaining and document this number to ensure there is medication available.
• NOTE: Load the Diskus by holding it in a flat, level, horizontal position with the dose counter facing up to prepare a dose of medication for inhaling.
• Once the Diskus is loaded, it must be kept in a flat, level, horizontal position, and must not be shaken.
• Slide the lever away from the mouthpiece towards the dose counter as far as it will go.
• You will hear a click: the Diskus is now loaded.
• Look at the dose counter to make sure that it reads one number less than prior to loading to ensure a dose of medication is loaded.
• If the dose number has not gone down by one, note the number on the dose counter and repeat steps 11 and 12.
• Ask the client to breathe out as far as possible to prepare client to receive medication.
• Put the mouthpiece of the Diskus to the client's lips to prepare the client to receive medication.
• Ask the client to breathe in quickly and deeply through the Diskus, not through the nose to ensure the client receives the full dose of medication and to keep the Diskus dry.
• As soon as the client finishes breathing in, remove the Diskus from the client's lips.
• Remind the client to hold his/her breath for 10 seconds, or as long as is comfortable, then to breathe out slowly.
• Close the Diskus by putting your thumb on the thumb grip and sliding it towards the mouthpiece as far as it will go, until the Diskus clicks shut to reset the Diskus and make ready for the next dose.
• Instruct the client to rinse his/her mouth with water and spit water out to prevent mouth sores.
• Return the Diskus to the storage space to ensure safe storage of medication.
• Sign MAR/flow sheet and report and record any reportable concerns to maintain accurate records.

Step-by-step instructions for administering medication using a Diskus inhaler. Includes preparation, administration, and reportable concerns. Emphasizes safety, consistency, and adherence to medication rights.