Respiratory Nurses Research Articles

Application of Case-based Learning in Respiratory Medicine Nursing Education

Objective: To explore the application effects of case-based learning in respiratory medicine nursing education. Methods: 60 nursing interns in the respiratory medicine department of our hospital from January 2023 to December 2023 were selected and randomly divided into a control group and an observation group, with 30 students in each group. The control group adopted traditional teaching methods, while the observation group adopted case-based learning based on traditional teaching methods. The differences in theoretical knowledge, operational skills, clinical thinking ability, and learning interest between the two groups were compared. Results: The scores of theoretical knowledge, operational skills, clinical thinking ability, and learning interest of the observation group were significantly higher than those of the control group, and the differences were statistically significant (P < 0.05). The satisfaction score of the observation group was significantly higher than that of the control group, with a significant difference (P < 0.05). Conclusion: Case-based learning can effectively improve the teaching effect of respiratory medicine nursing, cultivate students’ comprehensive abilities, and is worthy of promotion and application.

Application and Satisfaction Analysis of Humanized Quality Nursing Intervention in the Care of Patients with Critical Respiratory Failure

Objective: To implement humanized quality care in critical respiratory failure nursing, observe the effect, and analyze the satisfaction. Methods: 80 patients with severe respiratory failure were divided into 40 cases per group (admitted from February 2022 to December 2023) by double-blind method, the control group performed routine care, and the observation group was given humanized quality care. Results: After the nursing care, two respiratory function indexes of the observation group were lower than those of the control group, and two pulmonary function indexes were higher than those of the control group (P < 0.05); regarding the complication situation, the incidence rate of the observation group was lower (P < 0.05); regarding the nursing care satisfaction situation, the observation group had a higher level of total satisfaction (P < 0.05). Conclusion: The application of a humanized quality nursing intervention model in the care of critical respiratory failure can actively improve patients’ respiratory status and lung function, reduce complications, and satisfy patients.

Analysis of Effect of Improving Teaching Quality of Respiratory Clinical Nurse with Case-based Teaching Method and Traditional Teaching Mode

Analysis of Effect of Improving Teaching Quality of Respiratory Clinical Nurse with Case-based Teaching Method and Traditional Teaching Mode

Thoracic Society of Australia and New Zealand position statement: The safe clinical use of sputum induction for bio-sampling of the lower airways in children and adults.

Sputum induction is widely used in clinical settings for collection of biological samples from the lower airways. However, in recent years sputum induction has been associated with serious adverse events and even death. This position statement was commissioned by the Thoracic Society of Australia and New Zealand to address major adverse events of two deaths associated with sputum induction that have occurred in Australia in 2021, and outlines best practice for the safe use of sputum induction. The statement resulted from systematic literature searches by a multi-disciplinary group including respiratory physicians, nurses and physiotherapists (paediatric and adults focused). Consumers had input to an advanced draft of the position statement. The position statement covers indications for sputum induction, informed consent, scope of practice of personnel administering the procedure, infection control considerations, details about the sputum induction procedure, safety considerations and risk assessment in clinical settings.

Stressors, emotions, and social support systems among respiratory nurses during the Omicron outbreak in China: a qualitative study

BackgroundRespiratory nurses faced tremendous challenges when the Omicron variant spread rapidly in China from late 2022 to early 2023. An in-depth understanding of respiratory nurses’ experiences during challenging times can help to develop better management and support strategies. The present study was conducted to explore and describe the work experiences of nurses working in the Department of Pulmonary and Critical Care Medicine (PCCM) during the Omicron outbreak in China.MethodsThis study utilized a descriptive phenomenological method. Between January 9 and 22, 2023, semistructured and individual in-depth interviews were conducted with 11 respiratory nurses at a tertiary hospital in Wuhan, Hubei Province. A purposive sampling method was used to select the participants, and the sample size was determined based on data saturation. The data analysis was carried out using Colaizzi’s method.ResultsThree themes with ten subthemes emerged: (a) multiple stressors (intense workload due to high variability in COVID patients; worry about not having enough ability and energy to care for critically ill patients; fighting for anxious clients, colleagues, and selves); (b) mixed emotions (feelings of loss and responsibility; feelings of frustration and achievement; feelings of nervousness and security); and (c) a perceived social support system (team cohesion; family support; head nurse leadership; and the impact of social media).ConclusionNursing managers should be attentive to frontline nurses’ needs and occupational stress during novel coronavirus disease 2019 (COVID-19) outbreaks. Management should strengthen psychological and social support systems, optimize nursing leadership styles, and proactively consider the application of artificial intelligence (AI) technologies and products in clinical care to improve the ability of nurses to effectively respond to future public health crises.

Experiences of patients with advanced COPD affiliated to a cross-sectorial outgoing lung team: A qualitative study.

To explore experiences of patients affiliated to a cross-sectorial outgoing lung team. The outgoing lung team consisted of respiratory nurses from the hospital and community nurses. The lung team offered 24/7 help to patients with advanced chronic obstructive pulmonary disease (COPD) through visits and/or treatment in the patients' home. Affiliation to the lung team reduced both hospitalizations and length of hospital stay due to acute exacerbation of COPD. However, based on questionnaires on health-related quality of life, no significant differences were found between patients affiliated to the lung team and patients receiving usual care. A qualitative interview study. In total, 16 patients, aged 61-88 years were interviewed between February 2019 and July 2021. They had been affiliated to the outgoing lung team for 1-3 years. Semi-structured interviews were conducted in the patients' home and audio-recorded after informed consent was obtained. The interviews were transcribed verbatim and analysed, inspired by systematic text condensation by Malterud. Four themes emerged from the analysis: (1) feeling safe, (2) improvements in living with COPD, (3) avoiding hospitalization and (4) satisfied with staying at home. Affiliation to the cross-sectorial outgoing lung team gave the patients peace of mind and improved their ability to live with advanced COPD. The patients preferred contacting the lung team because they could stay at home and receive treatment, and thus avoid hospitalization. The findings from this study support that municipalities should consider implementing an outgoing lung team, as it has the potential to bring several benefits, including improving patient self-management. The manuscript adhered to Consolidated criteria for reporting qualitative research (COREQ) guideline. Patients were interviewed. Additionally, no patient or public contributed to the design or conduction of the study, analysis, or interpretation of the data.

The Impact of Respiratory Function Training and Rehabilitation Nursing on the Recovery of Patients With Mycoplasma Pneumoniae Pneumonia.

Introduction The goal of this study was to see how people who had been diagnosed with Mycoplasma pneumoniae pneumonia (MPP) responded to respiratory function training and rehabilitation (RFTR) nursing. Methodology A total of 122 patients (five to 12 years of age) diagnosed with Mycoplasma pneumoniae pneumonia (MPP) and refractory Mycoplasma pneumoniae pneumonia (RMPP) using enzyme-linked immunoassay and PCR were included in this study. These patients were hospitalized at a tertiary care hospital from February 2022 to December 2022. Upon admission, they were assigned a numerical identifier based on the order of admission. Subsequently, they were randomly allocated into two equal groups: the observation (OG) and the control (CG), with each group consisting of 61 patients. Nano-acupoint sticking (NAS) therapy along with respiratory function training and rehabilitation (RFTR) nursing interventions were implemented for patients in the OG. Results The observed disparities in forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and the ratio of FEV1 to FVC among the patients did not exhibit significant disparity prior to the commencement of treatment (p values of 0.700, 0.105, and 0.829, respectively). There was no significant difference observed in the range of inflammation in the right lung (p=0.523). Inflammation in the left lung and fluid volume in both lungs are statistically different in both groups (p values of 0.001 and 0.000, respectively). The patients in the observation group exhibited a shorter duration of cough and sputum, disappearance of lung sounds, and length of hospital stays (LOS) compared to the other groups, with statistical significance (p<0.05). Conclusion Nano-acupoint sticking (NAS) therapy with respiratory function training and rehabilitation (RFTR) in nursing practice has shown enhanced rehabilitation outcomes for individuals diagnosed with Mycoplasma pneumoniae pneumonia (MPP). The present study focuses on the application of NAS therapy in the context of RFTR for individuals diagnosed with MPP.

Exploration of Talent Training in Respiratory Therapy Nursing

As an emerging specialty in the past 20 years, respiratory therapy has attracted more attention due to epidemic of novel coronavirus pneumonia. The cultivation of respiratory care personnel is also particularly important. Therefore, our university has decided to set up a respiratory therapy nursing direction to cultivate more talents in this field, and now summarizes the thinking and exploration of talent training in order to promote the cultivation of such talents.

Application of Flipped Classroom Combined with PBL Teaching Method in the Teaching of Respiratory Intensive Care Unit Nursing

Objective: The aim is to investigate the application effect of flipped classroom combined with problem-based learning (PBL) teaching method in the teaching of respiratory intensive care unit nursing. Methods: 100 fresh nursing students who were interned in the respiratory intensive care unit of our hospital from June 2020 to May 2022 were selected and randomly divided into 50 students in the control group and 50 students in the experimental group. The students in the control group were taught by PBL teaching method, and the students in the experimental group were taught by flipped classroom combined with PBL teaching method. After the completion of the teaching, the teachers combined the performance of the two groups of students, and scored them comprehensively in terms of their professional theoretical knowledge, clinical operation skills, independent learning ability, and teamwork ability, and carried out a survey of the experimental group’s students in terms of their satisfaction with the understanding of theoretical knowledge, clinical operation, independent learning ability, teamwork ability, and other dimensions. Results: There was no statistical significance in the specialized theoretical knowledge scores of the two groups of students (P &gt; 0.05). The scores of clinical operation, independent learning ability, and teamwork ability of the two groups of students were statistically significant (P &lt; 0.05), and all the scores of the students in the experimental group were higher than that of the control group. More than 90% of the students believed that the flipped classroom combined with PBL teaching method could assist in the comprehension of theoretical knowledge, improve the clinical operation skills, enhance the ability of independent learning and teamwork; there were 92% of the students supported the use of flipped classroom combined with PBL teaching in respiratory intensive care unit nursing teaching. Conclusion: In the teaching of respiratory intensive care unit nursing, the use of flipped classroom combined with PBL teaching method can improve the learning effect of students, and has certain value in teaching.

A strategic overview of chronic obstructive pulmonary disease

Beverley Bostock, chair of the Association of Respiratory Nurses' respiratory diseases committee, summarises key considerations for services treating patients with chronic obstructive pulmonary disease, including optimisation of diagnostics, involvement of the multidisciplinary team and a focus on comorbidities.

Breathing New Life Into Acute Respiratory Care: Proactively Improving Long-Term Outcomes

Admissions due to asthma contribute substantially to the burden faced by emergency departments (ED) worldwide, with a considerable impact arising from the high number of readmissions among patients with severe asthma. Repeated ED readmittance not only places considerable demand on healthcare resources, but also increases the humanistic burden on patients through reduced lung function, decreased quality of life, and increased exposure to systemic corticosteroids (SCS) and oral corticosteroids (OCS). In addition, patients are subject to the increased morbidity and mortality risk, and quality of life deficit associated with repeated asthma exacerbations. Admission to the ED should be seen as an opportunity to break this readmission cycle and prevent further admissions, while offering patient-centric benefits, such as investigation into the underlying causes of disease, and optimisation of care to prevent further exacerbations. Actions that require no additional resource may be taken directly in the ED, including biomarker tests among routine blood tests, or teaching inhaler technique as part of patient education and safety-netting. In addition, patient discharge may be considered as an opportunity for improving guidance implementation and breaking the cycle of readmission. Unlike emergency cardiac care, where &gt;90% of patients are discharged on secondary prevention drugs and 85% of patients are referred to follow-up rehabilitation, guidelines for care following an ED visit for asthma are not always followed. Furthermore, current tools designed to accelerate specialist referral are not always rigorously implemented following an ED visit, meaning that follow-up may be delayed. Finally, further efforts should be made to identify high-risk patients in the community earlier in the disease pathway, allowing timely intervention before further lung function impairment, or the onset of adverse events due to OCS over-exposure. This article summarises an AstraZeneca-sponsored symposium delivered on 12th September 2023, as part of the European Respiratory Society (ERS) International Congress in Milan, Italy. The faculty, consisting of David Price, Head of the Observational and Pragmatic Research Institute, Singapore; Mona Al-Ahmad, Consultant Allergist and Clinical Immunologist at the Ministry of Health in Kuwait; and Mohit Bhutani, Professor of Medicine at the University of Alberta, Edmonton, Canada, each gave a brief presentation on proactive strategies to improve long-term outcomes in acute respiratory care. During panel discussions following each presentation, Anne Marie Marley, Respiratory Nurse Consultant from Belfast Health and Social Care Trust, UK, provided examples of implementing transition of care by bridging hospital and community care settings.

Intensive out-of-hospital coaching for frequently hospitalized COPD patients: a before-after feasibility study.

This study assesses whether out-of-hospital coaching of re-hospitalized, severe COPD patients by specialized respiratory nurses is feasible in terms of cost-effectiveness, implementation, and recipient acceptability. The coaching was aimed at improving patients' health management abilities, motivation for healthy behavior, strengthening the professional and informal care network, stimulating physiotherapy treatment and exercise training, improving knowledge on symptom recognition and medication use, and providing safety and support. Cost-effectiveness of 6 months of out-of-hospital coaching was assessed based on a before-after intervention design, with real-life data and one-year follow-up. A total of 170 patients were included. Primary (questionnaires, meeting reports) and secondary data (insurance reimbursement data) were collected in one province in the Netherlands. The implementing and recipient acceptability was assessed based on the number of successfully delivered coaching sessions, questionnaire response rate, Patient Reported Experience Measure, and interviews with coaches. Post-intervention, the COPD-related hospitalization rate was reduced by 24%, and patients improved in terms of health status, anxiety, and nutritional status. Patients with a high mental burden and a poor score for health impairment and wellbeing at the start of the intervention showed the greatest reduction in hospitalizations. The coaching service was successfully implemented and considered acceptable by recipients, based on patient and coach satisfaction and clinical use of patient-reported measures. The study demonstrates the value of coaching patients out-of-hospital, with a strong link to primary care, but with support of hospital expertise, thereby adding to previous studies on disease- or self-management support in either primary or secondary care settings. Patients benefit from personal attention, practical advice, exercise training, and motivational meetings, thereby improving health status and reducing the likelihood of re-hospitalization and its associated costs.

Implementation of coordinated spontaneous awakening and breathing trials using telehealth-enabled, real-time audit and feedback for clinician adherence (TEACH): a type II hybrid effectiveness-implementation cluster-randomized trial

BackgroundIntensive care unit (ICU) patients on mechanical ventilation often require sedation and analgesia to improve comfort and decrease pain. Prolonged sedation and analgesia, however, may increase time on mechanical ventilation, risk for ventilator associated pneumonia, and delirium. Coordinated interruptions in sedation [spontaneous awakening trials (SATs)] and spontaneous breathing trials (SBTs) increase ventilator-free days and improve mortality. Coordination of SATs and SBTs is difficult with substantial implementation barriers due to difficult-to-execute sequencing between nurses and respiratory therapists. Telehealth-enabled remote care has the potential to overcome these barriers and improve coordinated SAT and SBT adherence by enabling proactive high-risk patient monitoring, surveillance, and real-time assistance to frontline ICU teams.MethodsThe telehealth-enabled, real-time audit and feedback for clinician adherence (TEACH) study will determine whether adding a telehealth augmented real-time audit and feedback to a usual supervisor-led audit and feedback intervention will yield higher coordinated SAT and SBT adherence and more ventilator-free days in mechanically ventilated patients than a usual supervisor-led audit and feedback intervention alone in a type II hybrid effectiveness-implementation cluster-randomized clinical trial in 12 Intermountain Health hospitals with 15 ICUs. In the active comparator control group (six hospitals), the only intervention is the usual supervisor-led audit and feedback implementation. The telehealth-enabled support (TEACH) intervention in six hospitals adds real-time identification of patients eligible for a coordinated SAT and SBT and consultative input from telehealth respiratory therapists, nurses, and physicians to the bedside clinicians to promote adherence including real-time assistance with execution. All intubated and mechanically ventilated patients ≥ 16 years of age are eligible for enrollment except for patients who die on the day of intubation or have preexisting brain death. Based on preliminary power analyses, we plan a 36-month intervention period that includes a 90-day run-in period. Estimated enrollment in the final analysis is up to 9900 mechanically ventilated patients over 33 months.DiscussionThe TEACH study will enhance implementation science by providing insight into how a telehealth intervention augmenting a usual audit and feedback implementation may improve adherence to coordinated SAT and SBT and increase ventilator-free days.Trial registrationClinicaltrials.gov, NCT05141396, registered 12/02/2021.

Perspectives on Sedation Among Interdisciplinary Team Members in ICU: A Survey Study.

To explore the interdisciplinary team members' beliefs and attitudes about sedation when caring for mechanically ventilated patients in the ICU. Cross-sectional survey. A 17-bed cardiothoracic ICU at a tertiary care academic hospital in Colorado. All nurses, physicians, advanced practice providers (APPs), respiratory therapists, physical therapists (PTs), and occupational therapists (OTs) who work in the cardiothoracic ICU. None. We modified a validated survey instrument to evaluate perspectives on sedation across members of the interdisciplinary ICU team. Survey responses were collected anonymously from 111 members (81% response rate). Respondents were predominantly female (70 [63%]). Most respondents across disciplines (94%) believed that their sedation practice made a difference in patients' outcomes. More nurses (48%), APPs (62%), and respiratory therapists (50%) believed that sedation could help alleviate the psychologic stress that patients experience on the ventilator than physicians (19%) and PTs/OTs (0%) (p = 0.008). The proportion of respondents who preferred to be sedated if they were mechanically ventilated themselves varied widely by discipline: respiratory therapists (88%), nurses (83%), APPs (54%), PTs/OTs (38%), and physicians (19%) (p < 0.001). In our exploratory analysis, listeners of an educational podcast had beliefs and attitudes more aligned with best evidence-based practices than nonlisteners. We discovered significant interdisciplinary differences in the beliefs and attitudes regarding sedation use in the ICU. Since all ICU team members are involved in managing mechanically ventilated patients in the ICU, aligning the mental models of sedation may be essential to enhance interprofessional collaboration and promote sedation best practices.

Nurses' Knowledge, Perceptions and Practices Regarding the Use of Respiratory Protective Equipment during the Coronavirus Pandemic

Background: Nurses are at high risk of several respiratory hazards comprising respiratory pathogens. So, respiratory protective equipment (RPE) are vital to protect nurses from novel coronavirus (2019-nCoV) outbreak. Purpose: The current study aimed to examine the knowledge level, practice and perceptions among nurses in a specialized cancer center using RPE. Methods: A descriptive study design was used. The Occupational Safety and Health Administration Questionnaire was utilized to collect data. The data was collected from 387 nurses working at a specialized cancer center as a convenience sampling technique. Results: An overall number of 387 staff nurses participated in the study. The majority of nurses had moderate knowledge levels, where the mean total score of nurses' knowledge was 12.98, with a range between 4 and 20. Also, the majority of nurses had good perceptions regarding the use of RPE (Total mean= 30.44, SD= 3.62). Regarding practice, most of the nurses wash their hands after contact with the outer surface of the respirator (F= 357, 92.2%). Conclusion: The good nurses' knowledge and perceptions regarding RPE's use were sufficient to provide an adequate practice level. However, implementing the RPE policy in hospitals could be useful to enhance the nurses' and other healthcare workers' knowledge, perceptions and practice regarding RPE. Implications for Nursing: Good practices are a crucial element in respiratory safety and nurses' protection against their place of work respiratory hazards. Keywords: 2019-nCoV, Nurses, Knowledge, Perceptions, Practice, Respiratory protective equipment

How to spot the red flags and other warning signs for respiratory illness in children

There has been a recent resurgence in traditional respiratory infections and nurses are encouraged to be inquisitive in their interactions with children and families

ERS International Congress 2022: highlights from the Allied Respiratory Professionals Assembly.

In this article, we provide a brief overview of some of the outstanding sessions that were (co)organised by the Allied Respiratory Professionals Assembly during the 2022 European Respiratory Society International Congress, which was held in a hybrid format. Early Career Members from Assembly 9 summarised the content of the sessions, with the support of the Officers from the four Assembly groups: Respiratory Function Technologists and Scientists (Group 9.01); Physiotherapists (Group 9.02); Nurses (Group 9.03); and Psychologists and Behavioural Scientists (Group 9.04). The sessions covered the following topics: recent advances in cardiopulmonary exercise and challenge testing; the role and new trends in physiotherapy, exercise and physical activity promotion interventions in chronic respiratory diseases; development of the international curriculum for respiratory nurses and nursing aspects in disease management; and treatment adherence, e-health interventions and post-coronavirus disease 2019 challenges. This Highlights article targets delegates who attended the Congress sessions, as well as those who were unable to attend, and provides valuable insight into the latest scientific data and emerging areas affecting the clinical practice of Allied Respiratory Professionals.

How to improve the future efficiency of Covid-19 treatment centers? A hybrid framework combining artificial neural network and congestion approach of data envelopment analysis

Covid-19 virus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) threatens the health of human beings worldwide, imposing a concern for the world and prompting governments to control the contagion. Although vaccination is a proper tool to control the transmission, the efficient allocation of limited health-care resources to massive patients can improve the effectiveness of medical services. Relying on the Artificial Neural Network (ANN), the aim of this research is to enhance the future efficiency of Covid-19 treatment centers by forecasting their efficiency and providing benchmarks. To do this, we use the congestion approach of data envelopment analysis (DEA) based on the theory of economies of scale principles. In the traditional input-oriented DEA, inefficient decision-making units (DMUs) can become efficient merely by reducing the inputs. However, this may not always be true in real-world applications such as improving the efficiency of COVID-19 treatment centers (DMUs). Meaning that the treatment centers with less congested inputs (e.g., ventilators, test equipment, pulmonologists, and nurses, etc.) normally have higher mortality rates. For this reason, in this study, we take the congested inputs approach into account to provide proper benchmarks for the inefficient treatment centers. According to the congestion approach of DEA, an optimum increase in congested inputs can lead to a greater than a proportional increment in outputs. In other words, if more respiratory equipment, pulmonologists, patient rooms, nurses and beds, etc. are allocated to Covid-19 treatment centers, not only the number of deaths (undesirable outputs) are decreased, but also the number of recoveries (desirable outputs) are increased. Such an optimal rise in the congested inputs is determined in pairwise comparisons derived from the model. Accordingly, in this study, first, considering the congestion approach of DEA and historical data of five periods, we identify the initial efficiency of Iranian Covid-19 treatment centers. Then, by running ANN, we forecast the future inputs and outputs, the overall efficiency, and rank of the treatment centers. By doing this, the prospective efficient and inefficient DMUs are identified, and appropriate benchmarks are determined.

Factors influencing quality of life in children with tracheostomy with emphasis on home care visits: a multi-centre investigation.

Only a few studies have assessed the quality of life in children with tracheostomies. This study aimed to evaluate the quality of life and the factors influencing it in these children. This cross-sectional, two-centre study was conducted on paediatric patients living in the community with a tracheostomy by using the Pediatric Quality of Life Inventory. Clinical and demographic information of patients, as well as parents' socioeconomic factors, were obtained. A total of 53 patients met our inclusion criteria, and their parents agreed to participate. The mean age of patients was 6.85 years, and 21 patients were ventilator-dependent. The total paediatric health-related quality of life score was 59.28, and the family impact score was 68.49. In non-ventilator-dependent patients, multivariate analyses indicated that social functioning and health-related quality of life were negatively affected by the duration of tracheostomy. The Quality of Life of ventilator-dependent patients was influenced by care visits and the presence of pulmonary co-morbidities. Children with tracheostomies have a lower quality of life than healthy children do. Routine care visits by a respiratory therapist and nurses yielded significantly improved quality of life in ventilator-dependent children.

Need and baseline for harmonising nursing education in respiratory care: preliminary results of a global survey.

The COVID-19 pandemic confirmed that respiratory nurses are critical healthcare providers. Limited knowledge is available about appropriate education to prepare nurses to deliver high-quality respiratory care. A survey was developed by the International Coalition for Respiratory Nursing (ICRN) group to identify the need for a respiratory nursing core curriculum. A 39-item survey was distributed to 33 respiratory nursing experts in 27 countries. Questions asked about current roles, perception of need, expectations for a core curriculum project and respiratory content in nursing education in their countries. 30 responses from 25 countries were analysed; participants predominantly worked in academia (53.3%, 16/30) and clinical practice (40%, 12/30). In total, 97% (29/30) confirmed a need for a core respiratory nursing curriculum. Post-registration nursing programmes at bachelor (83.3%, 25/30) and masters (63.3%, 19/30) levels include internal/medical nursing care; less than half identified separate respiratory nursing content. The core educational programme developed should include knowledge (70%, 21/30), skills (60%, 18/30), and competencies (50%, 15/30), with separate paediatric and adult content. Survey results confirm a wide variation in nursing education and respiratory nursing education across the world, with many countries lacking any formal educational programmes to prepare nurses capable of providing enhanced quality respiratory care. These findings support the need for a core respiratory curriculum. To advance this significant work the ICRN group plans to conduct a Delphi study to identify core curriculum requirements for respiratory nursing education at pre-registration and advanced educational levels to flexibly meet each country's specific educational requirements for recognition of respiratory nursing speciality practice.