References
The importance of obtaining a sputum sample and how it can aid diagnosis and treatment
Abstract
Respiratory disease has a major impact on the NHS and continues to be a growing problem as each year passes. However, through improving diagnosis and management of respiratory disease the problem could be lessened. Taking a sputum sample is common practice within respiratory medicine especially for patients with chronic obstructive pulmonary disease (COPD) and helps to diagnose, confirm infection and offer correct treatment. It is important that the multidisciplinary team are aware of how to appropriately obtain sputum samples and when to request them. It is important as a respiratory health professional to understand the patient's usual sputum history including colour, amount and viscosity. Antibiotic stewardship aims to reduce antibiotic resistance through offering the most appropriate antibiotics for those with a bacterial infection and to discourage antibiotic prescribing for those that have not. This should result in better patient outcomes and lower healthcare costs.
In the UK one in five people have been diagnosed with a respiratory disease (Public Health England (PHE), 2015)— around 12 million people in total in 2013 (British Lung Foundation, 2016: 14). The true figure is likely to be higher, taking into account undiagnosed cases of respiratory diseases such as chronic obstructive pulmonary disease (COPD) (PHE, 2015). Lung disease is a major burden on UK health services resulting in over 700 000 hospital admissions each year. Improving diagnosis and disease management are important in the strategy to decrease both the societal burden and the personal burden borne by patients and carers (Kuprys-Lipinska and Kuna, 2014; PHE, 2015; British Lung Foundation, 2016).
The collection of sputum is one of the most common tests within respiratory medicine (Hickin et al, 2015). Sputum is (coughed up and spat out) salivary matter mixed with mucus or pus from the respiratory tract. Mucus is naturally made by the cells in the trachea and bronchial tubes and lines the airways to prevent harmful substances entering the lungs by keeping the airways moist, which prevents dust, viruses and bacteria from passing into the lungs (Preston and Kelly, 2017). If any substances do enter the lungs the cilia will attempt to remove them, enabling the individual to swallow the mucus or cough it out (Fahy and Dickey, 2010; Preston and Kelly, 2017). In chronic respiratory disease too much mucus is often produced causing the cells that produce the mucus to expand, resulting in limited airflow, breathlessness and cough, often impacting on ventilation and causing infection (Preston and Kelly, 2017; Global Initiative for Chronic Obstructive Lung Disease (GOLD), 2019).
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