Nurse specialist care for bronchiectasis

Bronchiectasis is a chronic lung disease characterised by productive cough and recurrent chest infections. Untreated patients have a poor quality of life and may eventually develop respiratory failure. This review evaluates the process of care in this group of patients and compares nurse led care with the traditional model of physician directed treatment. Only one trial was found to be suitable for evaluation and this showed no significant difference between nurse and doctor led care in terms of lung function, infective flare ups, or quality of life but significantly increased costs in nurse led care due to hospital admissions and use of intravenous antibiotics.

Authors' conclusions: 

This review has found one trial that does not demonstrate significant differences in clinical outcomes between nurse led care and doctor led care within the setting of a specialist clinic is, but there may be increased cost implications. Further research is required to review whether nurse led care provides the same outcomes in the community or secondary care setting.

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Background: 

Nurses have expanded and developed their roles to meet the needs of patients. This review evaluates the safety, effectiveness and health outcomes of nurses practising in autonomous roles, using advanced practice skills, within the context of a dedicated bronchiectasis clinic.

Objectives: 

To determine the effectiveness of nurse-led care in the management of bronchiectasis.

Search strategy: 

The Cochrane Airways Group Specialised Register and bibliographies of selected papers were searched. Searches were current as of July 2008.

Selection criteria: 

Randomised controlled trials were eligible for inclusion in the review.

Data collection and analysis: 

Two reviewers extracted and entered data from included studies.

Main results: 

One study was included in the review. No statistically significant changes were observed in infective exacerbations, lung function, exercise capacity, quality of life and hospital admissions. More healthcare resources were utilised by nurse-treated participants during the first arm of the study.

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