Dr Lindsay Welch
Research and Education Sub Committee, The Association of Respiratory Nurse Specialists (ARNS)
Beverly Bostock
Asthma Lead, The Association of Respiratory nurse Specialists (ARNS)
Spirometry testing was stopped in general practice clinics during the pandemic because of the risk of spreading COVID-19. Safety considerations are now needed for recommencing services.
Spirometry is a procedure that measures lung volumes and serves as a diagnostic tool to confirm or rule out a clinical diagnosis of conditions such as asthma and chronic obstructive pulmonary disease (COPD). It can also measure the effect of disease on lung function, screen individuals at risk of having respiratory diseases and aid further assessment (Welch, 2016).
Respiratory assessments need to be performed at the onset of any new respiratory symptoms, to acquire objective diagnosis and during annual checks to monitor disease progression.
Risks to practitioners
Spirometry testing was stopped in general practice clinics during the pandemic because of the risk of spreading the virus during the procedure, which requires people to blow hard and repeatedly into the spirometer. The COVID-19 infection is transmitted through respiratory droplets, coughing, sneezing and expiration.
Respiratory assessments need to be performed at the onset of any new respiratory symptoms, to acquire objective diagnosis and during annual checks to monitor disease progression.
The World Health Organization has recommended a range of infection control procedures to minimise this risk but community and primary care infrastructures are not designed to accommodate this increased level of infection control precautions. Surgeries are often based in older houses, with no extra ventilation and limited space to conduct clinical procedures.
Rethinking community respiratory care
Nonetheless, plans are in place to reinstate safe and effective lung function testing and assessment in the community as soon as possible. Primary care networks are working towards providing centralised diagnostic hubs, where expert nursing staff lead on accurate and proficient assessment, diagnosis and identification of treatment goals, promoting nurse led respiratory diagnostics and yearly respiratory assessment in a safe, dignified and sustainable way.
Chris Loveridge, an experienced general practice nurse who has working in this field for many years is currently developing a Primary Care Diagnostic Hub in Coventry. She says:
“This is an exciting opportunity to transform respiratory care and do things differently and more effectively on every level. Our hub will ensure that holistic assessments are carried out by fully trained nurses and healthcare professionals who are experts in respiratory care. As well as being able to provide a full assessment of people presenting with respiratory symptoms, the hub will also ensure ongoing education and support for clinicians and patients alike.”
Nurses are also at the forefront of developing and implementing technology to enhance assessments, including remote inhaler checks as ensuring people can use and inhale their medications correctly is so important as is exploring and improving inhaler device selection.
