ADULT ASTHMA REVIEW IN GENERAL-PRACTICE - NURSES PERCEPTION OF THEIR ROLE

Background. Asthma clinics have become widespread in general practice with nurses now playing an important role in asthma review. However, l ittle is known about training of nurses carrying out reviews and how t his affects the nurse role in patient management. Objectives. We aimed to discover the level of asthma training of practice nurses carrying out review of adult asthma patients in one Health Authority and to see if this has any effect on their perception of their role. Method. All 187 practice nurses in Grampian were sent a postal questionnaire inve stigating how asthma review is organized in general practice, their ro le in review and the asthma training they had received. Personal inter views were carried out with 17 nurses, exploring in more depth the top ics covered in the questionnaire. Results. A total of 167 nurses from 92% of the practices in Grampian responded, of whom 61% carried out as thma reviews. Among nurses carrying out reviews 71% did so on their ow n. 49% of nurses had or were training for advanced asthma qualificatio n. Nurses without an asthma qualification were significantly more like ly to feel that their training was not sufficient for their asthma rel ated tasks (54% versus 11%, P = 0.0002). Nurses without advanced asthm a qualifications were less likely to provide or review a self-manageme nt plan (29% versus 49%, P = 0.01), to review patient PEF recording (3 8% versus 65%, P < 0.01), to discuss patient worries (75% versus 94%, P < 0.05) or to make the initial diagnosis of asthma (24% versus 76%, P < 0.005). Nurses were unlikely to view their role as fully responsib le unless they had an asthma qualification (13% versus 49%, P < 0.001) . Conclusion. Nurses without advanced asthma qualifications do not fee l fully confident in responsibility for patient management. Nurses wit hout training are more likely to only carry out routine monitoring at reviews while nurses with asthma training are more likely to actively develop patient self-management skills. This suggests that nurses shou ld be supported to obtain asthma qualifications if they are to give th e best possible care to asthma patients.