Beverley Bostock RGN MSc MA QN
Advanced Nurse Practitioner, Mann Cottage Surgery & Chair of the Respiratory Diseases Committee, ARNS
A significant proportion of respiratory care and diagnosis is undertaken by qualified specialist nurses and other healthcare professionals. This allows for more streamlined care management.
Respiratory conditions account for the majority of appointments in general practice and a high proportion of hospital appointments.1 A high level of further education and training allows specialist nurses and other healthcare professionals to investigate, diagnose and treat these conditions and discharge people from hospitals.2
Importance of diagnosis in respiratory care
Effective management starts with the correct diagnosis. We are seeing greater investment in supporting general practice to carry out the tests which have been shown to support the diagnostic process.
Taking a robust history is key to making any diagnosis, but examination and tests can help to confirm whether the person with respiratory symptoms (cough, wheezing, breathlessness, sputum production) has asthma, chronic obstructive pulmonary disease (COPD) or another condition.
These tests can include spirometry — which can identify abnormalities in airflow through the lungs — and fractional exhaled nitric oxide (FeNO) testing — which can demonstrate the presence of inflammation in the airways. Blood tests, X-rays and scans can also help to confirm or refute a suspected diagnosis.
Effective management starts
with the correct diagnosis.
Better diagnostic process with respiratory tests
Anyone carrying out diagnostic tests will have had specific training on how to carry out the test and/or interpret the result. The skill is to put together all the information — history, examination and objective tests — so that the clinician is confident that the diagnosis is correct.
The pandemic led to the cessation of many of these tests as there was a risk of spreading airborne infections. However, the situation is gradually returning to normal, and many practices are offering these routinely once more. Information about the tests can be found from sources such as the Asthma + Lung UK website or through discussion with the clinical staff in the practice or hospital.
[1] GBD Chronic Respiratory Disease Collaborators (2020). Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. Respiratory medicine, 8(6), 585–596. https://doi.org/10.1016/S2213-2600(20)30105-3
[2] Patel I. (2021). Integrated respiratory care. Clinics in Integrated Care, 6, 100053. https://doi.org/10.1016/j.intcar.2021.100053
