Under-Trained Primary Care Nurses 'Uncomfortable' Treating Allergy, UK

Main Category: Nursing / Midwifery
Also Included In: Allergy
Article Date: 02 Jun 2008 - 8:00 PDT

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Three-quarters of primary care nurses have admitted to lacking even basic training in treating allergies, and more than half say they feel "uncomfortable" seeing patients with allergy-related conditions.

This is despite the fact that in the UK the incidence of common allergic diseases has trebled in the last 20 years, to become one of the highest in the world - one in three of the UK population will be affected by allergic disease at some time in their life.1

This is increasing the burden on primary care, where the majority of such patients first present and where most of those with more minor or moderate symptoms will remain for treatment.

However, in a survey of more than 1,100 primary care nurses by the journal Nursing in Practice - http://www.nursinginpractice.com - only 25% had any kind of training in allergy, and 53% felt uncomfortable working with patients with allergy-related conditions.

"Without formal training I'm lacking in confidence," said one practice nurse from Scotland. "I don't feel I know enough about allergy to be able to advise on anything more than on a superficial level," commented a practice nurse from Sheffield.

"Training in 'general' allergy is difficult for nurses to access locally," says John Collard, Clinical Director of Allergy UK. "The few nurses who have had training have normally done this in relation to a particular condition relating to allergy, such as asthma or eczema."

In addition, 23% of nurses who responded to the survey described themselves as the main nurse in their practice dealing with allergy. Yet, surprisingly, only 29% of these had any form of accredited training in allergy.

According to Marilyn Eveleigh, Consultant Editor of Nursing in Practice: "It is frustrating that nurses won't/can't undertake training. A one-day intense session would make such a difference to nursing confidence and patient support. Training is available but prioritising, funding and capacity are often lacking in primary care."

Dr Samantha Walker, Director of Education and Research at Education for Health, is keen to point out the benefits of improving allergy services. "There is evidence that training given to health professionals improves quality of life in patients with rhinitis."2 She also points to the importance of treating problems like hayfever given its impact on exam performance in teenagers.3

"Allergy is a condition ideally suited to management in primary care by GPs, nurses and pharmacists," says Marilyn Eveleigh. "Practice-based commissioning groups would be well advised to consider this as a cost-effective service for patients."

References
1. Royal College of Physicians. Allergy: the unmet need. London: RCP; 2003.
2. Price D, et al. Clin Exp Allergy 2007; 37(1):90-9.
3. Walker S, Khan-Wasti S, Fletcher M, et al. J Allergy Clin Immunol 2007;120:381-7.

You can read the full article online: http://www.nursinginpractice.com/surveys

Notes:

The Nursing in Practice Allergy Survey was conducted online at nursinginpractice.com from 4 March to 24 March 2008. A total of 1,183 primary care nurses completed the survey.

The survey was sponsored by UCB Pharma.

Other results:

A total of 102 respondents (8.6%) would recommend alternative/complementary therapies, ranging from homeopathy, acupuncture, herbal remedies to reflexology and Indian head massage. Mary Brydon, Allergy Nurse Consultant Primary Care for Norfolk Allergy Diagnostic And Advisory Service, is dubious of the effectiveness of these therapies: "The NHS Reviews and Dissemination publication in October 2007 states that: 'Herbal medicine has very sparse evidence base and there is no convincing evidence that it is effective in any indication.' The potential for adverse and negative interactions mean that its use cannot be recommended."

Anaphylaxis was one of the main allergy areas that our respondents had received any kind of training in. Just over half, 52.5%, had provided advice and information to patients and carers on how to treat anaphylaxis; and 41.1% said they felt comfortable training patients in self-managing anaphylaxis.

Almost a third (30.3%) of respondents regularly prescribe/supply medication for allergy. Of these, almost half (47%) said that price could affect their choice of medication. Most followed PCT guidance in this respect, but acknowledged that the PCT formulary was issued with cost-effectiveness in mind.

About Nursing in Practice and Campden Media

Nursing in Practice (http://www.nursinginpractice.com) is a bimonthly review journal produced by Campden Publishing that delivers accessible, relevant and informed news, indepth articles and comment on modern nursing practice in primary care. It is part of a family of products and services including events, exhibitions, online content and recruitment. All these products are specifically designed for practice nurses and other primary care specialists working across the UK and aim to promote best practice and thus improve patient care.

nursinginpractice.com is a free online service designed to complement the Nursing in Practice journal. Visitors to the site can get daily news online or delivered direct to their inbox by email each week. In addition to news, there is also a complete archive of all past issues of Nursing in Practice, regular online comment, a weekly quiz and many other features, including video presentations from our latest live events.

Nursing in Practice Events (nursinginpractice.com/events) is the largest free conference and expo series designed specifically to meet the educational needs of practice nurses and other primary care specialists. Each programme features an impressive collection of speakers delivering highly topical and relevant presentations that contribute to attendees' professional development. These educational conferences are complemented by an exhibition featuring key charities, product suppliers, educational institutes, services for primary care and recruitment specialists.

In 2008, Nursing in Practice Events will be visiting:
Manchester - Bridgewater Hall - Tuesday 20 May 2008
London - Business Design Centre - Tuesday 23 and Wednesday 24 September 2008
Birmingham - NEC - Wednesday - 19 November 2008

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Source: Nursing in Practice http://www.nursinginpractice.com