P234 Training Deficiencies and Lack of Confidence Around Knowledge in Primary Care Nurses Treating Asthma and COPD Patients
There has been an increasing shift of respiratory care from secondary to primary. We have undertaken a training needs analysis by questionairre of primary care nurses who treat patients with Asthma and COPD in all 511 practises in the East of England. 63% responded. Nurses were asked to grade their confidence levels from high (5) to low (1) in aspects of Asthma and COPD. Chi-square was used for statistical analysis.
ASTHMA. 63% had a diploma. 90% followed BTS/SIGN guidelines. There was a high confidence level in 27% for differential diagnosis, 52% for inhaler devices and how to use them, 24% for interpretation of spirometry, 39% for emergency treatment, 22% for dealing with children 5–12 years old. High confidence was significantly greater (<0.001) in those with an asthma diploma.
COPD. 35% had a diploma. 82% followed NICE or GOLD guidelines. 76% ran clinics. There was a high confidence in 37% diagnosis, 37% for management and monitoring, 26% for interpreting spirometry, 32% in emergency treatment. High confidence was significantly greater in those with a COPD diploma. Nurses were asked if they were aware of services and confident how to refer; 94% were for smoking cessation, 55% for spirometry, 35% for oxygen assessment, 63% for pulmonary rehabilitation. The level of awareness was significantly higher for the latter two in those with a diploma.
ONGOING TRAINING OPPORTUNITIES Nurses were asked where and how often training was accessed on a scale 1–5. The most frequent (5) was self-directed learning in 37% and from the pharmaceutical industry 17%; the least (1) were time to learn 46%, monitoring with a practice expert 45%, secondary care provider 43%.
Conclusions This study has revealed serious deficiencies in training with many having no diploma. The benefit of having a diploma is shown in greater confidence in knowledge and in awareness of services and how to refer. On-going professional education is haphazard. If increasing care is going to be successfully transferred into primary both these issues must be addressed.