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The latest information about the 2019 Novel Coronavirus, including vaccine clinics for 12-17 year-olds.

La información más reciente sobre el nuevo Coronavirus de 2019, incluidas las clínicas de vacunación para jóvenes de 12 a 17 años.

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Rebecca Ivancie, MD

  • Rebecca Ann Wolk

Work and Education

Professional Education

University of Southern California Keck School of Medicine, Los Angeles, CA, 5/15/2009

Residency

Children's Hospital & Research Center Oakland Pediatric Residency, Oakland, CA, 6/30/2012

Fellowship

UCSD/Rady Children's Hospital, San Diego, CA, 6/30/2016

Board Certifications

Pediatrics, American Board of Pediatrics

All Publications

Imperative Instruction for Pressurized Metered-Dose Inhalers: Provider Perspectives RESPIRATORY CARE Schmitz, D. C., Ivancie, R. A., Rhee, K. E., Pierce, H. C., Cantu, A. O., Fisher, E. S. 2019; 64 (3): 29298

Abstract

Reports show that many patients do not use their pressurized metered-dose inhalers (pMDIs) effectively. The National Heart, Lung, and Blood Institute recommends that health-care providers educate and assess patients' pMDI technique at each opportunity. However, limited data exist regarding how often pediatric primary care providers perform assessments and which methods they use. We sought to (1) identify instructional methods used to teach pMDI use, (2) describe how pMDI use is reassessed at follow-up visits, and (3) describe primary care provider attitudes and barriers to in-office pMDI instruction.A 34-item electronic survey was distributed from August to December 2016 via E-mail to local pediatric primary care providers. Descriptive statistics were used for analysis.Sixty two of 223 potential primary care providers (28%) responded. Physicians and nurse practitioners were identified most often as the providers of pMDI education (53%). When first prescribing a pMDI, only 10% reported having the patient practice inhaler use in the office and receive feedback. Only 19% "always" reassessed the technique, even for patients with poorly controlled asthma. Among those who reassessed the technique, most (76%) did so verbally, and only 42% asked the patients to demonstrate pMDI use. Only 32% reported that typical patient education in their setting was adequate to ensure proper pMDI use. Commonly cited barriers included time (84%) and access to demo pMDIs (67%). Provider solutions included video tutorials and access to demo inhalers.Many pediatric primary care providers did not demonstrate or have patients practice pMDI use when teaching or assessing pMDI technique, and the reassessment rate was low even for patients with poorly controlled asthma. Identifying and training a consistent pMDI educator and obtaining demo pMDIs may abate some barriers. Respiratory therapists could appropriately fulfill this educator role. Brief, repeated pMDI practice for motor learning could promote more stable pMDI mastery.

View details for PubMedID 30254041

Sepsis Caring for the Hospitalized Child: A Handbook of Inpatient Pediatrics Ivancie, R. edited by Gershel, J., Rauch, D. A. 2017; 2nd: 439446