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

Abstract

To assess the range of activities performed by practice nurses in COPD management and their training for these tasks. A postal questionnaire was sent to the nurse with prime responsibility for respiratory care in 179 practices in Cornwall and Southwest Devon. 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. Nurses face many problems managing COPD in general practice including equipment, training and professional support.