- High quality standard operating procedures (SOPs) are the cornerstone of mitigating risk and reducing cross infection between staff and patients undergoing spirometry
- There is a clinical need to re-introduce spirometry to the community setting to facilitate accurate diagnosis of airways diseases
- The exact number of patients in the backlog for diagnostic spirometry is unknown, it is estimated to be around 200–250 patients per 500,000 population (PCRS 2021)
- Groups of patients for whom diagnostic spirometry will potentially impact their treatment pathway or determine their onward care should be prioritised (PCRS 2021)
- Consider spirometry for those patients with a provisional diagnosis but poor response to treatment (PCRS 2021)
- Routine spirometry is of low priority and evidence shows little clinical value (PCRS 2021)
- Spirometry should be performed by an appropriately trained health care professional who is competent (NES 2021)
- Current guidance from Antimicrobial Resistance and Healthcare Associated Infection Scotland (ARHAI) in collaboration with New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) and Public Health England (PHE) (https://hpspubsrepo.blob.core.windows.net/hps-website/nss/3055/documents/1_agp-sbar.pdf) lists the procedures currently designated as aerosol generating: spirometry is not considered to be an aerosol generating procedure (AGP).
- British Thoracic Society (BTS), Association of Respiratory Nurse Specialists (ARNS), Primary Care Respiratory Society (PCRS) and the Association for Respiratory Technology and Physiology (ARTP) (https://www.pcrs-uk.org/sites/pcrs-uk.org/files/ReinstatingSpirometry270421.pdf) outline a pragmatic approach to the return of spirometry services in community settings.
- This document contains guidance on the prioritisation of spirometry, and appropriate measures to mitigate against potential infection. Although spirometry is considered to be non-AGP, spirometry associated cough has the potential to generate aerosol droplets so mitigating measures are recommended.
- The operating method and re-introduction of spirometry is in compliance with: A guide to performing diagnostic spirometry (PCC 2013); ATS/ERS Standardisation of Spirometry 2019 update An Official American Thoracic Society and European Respiratory Society (ATS/ERS 2019); Risk Minimisation in Spirometry Re-start (BTS/ARTP 2021).
- This document will standardise the procedure for re-introducing quality assured spirometry to meet quality assurance and infection prevention and control measures
- This document will prioritise patient safety in compliance with professional organisation standards and governance requirements.
For more information on Spirometry, see PCRS website