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Abstract
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.
Results
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.