The role of the practice nurse in the management of chronic obstructive pulmonary disease (COPD)

Abstract

Aims: To assess the range of activities performed by practice nurses in COPD management and their training for these tasks. Methods: A postal questionnaire was sent to the nurse with prime responsibility for respiratory care in 179 practices in Cornwall and Southwest Devon. Results: The response rate was 64%. Spirometers were available in 64% of practices (range 0-6 per practice). Of these, spirometry was performed by nurses alone in 72%; in 44% spirometry was performed less than once a week. Spirometry was used for diagnosis in 91%; monitoring in 87% and screening asymptomatic smokers in 45%. Reversibility testing was performed by 61% of the practices. Formal training in spirometry had been undertaken by 52%, informal training in 41% and none in 7%. They would like to see the development of one-stop COPD clinics, support from specialist nurses and pulmonary rehabilitation, preferably based in the community. Conclusion: Nurses face many problems managing COPD in general practice including equipment, training and professional support.