Impact of Respiratory Clinical Nurse Specialist attendance in a General Respiratory Clinic

The respiratory service in Our Lady of Lourdes Hospital in Drogheda, Ireland has expanded rapidly over the past threeyears to accommodate the increased workload associated with the Covid-19 pandemic. The clinical nurse specialist (CNS) role is crucial in managing patients with chronic airway disease and is aligned with five core competencies focused on patient care, timely access to diagnostics and evaluation, treatment optimization, and adherece to the regime. The introduction and impact of a Respiratory CNS presence in a general respiratory clinic was evaluated. In particular we assessed the role of the Respiratory CNS in disease education, community integration, inhaled therapy assessment and optimisation and self-management action plans. Results showed that inhaler technique review is essential with a high percentage of patients seens by the CNS requiring a change of inhaler due to ineffective technique, inadequate inspiratory flow rate or insufficient dose for the disease condition. The respiratory CNS provides an important service in the Respiratory clinic and should be considered as an essential component in multidisciplinary outpatient service provision.