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Developing structured clinical review templates in an integrated respiratory team during COVID-19: a qualitative review

13 January 2025
Volume 34 · Issue 1

Abstract

Introduction:

In response to the SARS-CoV-2 pandemic in March 2020 and required adherence to infection control measures and patient and staff safety, an integrated respiratory team (IRT) developed guideline-based templates to support the team in teleconsultation reviews of their patients. Patients had been diagnosed with sleep disordered breathing, chronic obstructive pulmonary disease, asthma, interstitial lung disease or had oxygen assessment needs.

Methods:

Nine IRT members collaboratively developed content for the templates to assist in clinical reviews. In February 2023 semi-structured interviews were conducted and recorded with eight of the IRT members using Microsoft Teams, then thematically analysed.

Results:

Qualitative analysis revealed 13 themes. The templates were considered time-saving and advantageous in teleconsultation reviews. They supported evidence-based, structured, and consistent reviews. They were felt to uphold patient safety, supporting knowledge and skills. IRT members reported the templates had no adverse effects on autonomy, patient-professional relationships or person-centred care. They facilitated good multidisciplinary team working and communication. One interviewee reported that the templates supported the Nursing and Midwifery Council Code.

Conclusion:

The templates continue to be used across the regional service by the IRT. Their benefit has been realised beyond the pandemic. Refinements will be made as guidelines are updated. The development of these innovative templates may be of interest and value to other respiratory teams.

The NHS Dumfries and Galloway Integrated Respiratory Team (IRT) works across a 2500 square mile remote and rural health region in the UK and provides a service to a population of 148000, with 45% of the population living remotely from the largest town settlement (National Records of Scotland, 2024). The IRT provides a regional service for people with chronic obstructive pulmonary disease (COPD), adult asthma, sleep disordered breathing, long-term oxygen therapy requirements, and interstitial lung disease. The IRT consisted of nine respiratory nurse specialists.

The arrival of the SARS-CoV-2 pandemic in March 2020 was a major challenge for the IRT to be able to provide safe, effective and evidence-based care remotely over the course of the pandemic. The IRT agreed that it was vital to re-evaluate all standard operating procedures to enable the team to continue to provide a high standard of ongoing care for patients referred to and within the service.

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