Hi

Hilary and I worked together as SEQOHS assessors and this question was asked before - in response I wrote to some learned people to ask advice but no satisfactory reply received. I don't think there is a correct answer for frequency of Spirometry training as there is no guidance that I am aware of (happy to be corrected though).  This is true of many procedures in OH - such as hand arm vibration assessment, management referrals, even doing a fork lift truck medical. I believe OH services should draft their own guidance based on audit of practice, customer feedback, reviews, frequency of use and severity of risk of harm to health (isocyanates and flour dust are among the top five that cause occupational asthma).

I was given Spirometry training by Microlab and Vitalograph and both were excellent but my real skills developed after by constant use and dealing with issues arising.  I have also had training from Paul Cullinan (sigh!) and been invited to talk on the course at the Brompton when I was Group OH Manager for Premier Foods (Hovis/flour dust).  Whilst I agree that the course was brilliant there was no practical element to the day and it was all theory/discussion.  So I think we have to be careful when we recommend a course as there are so many to chose from and attendance at training does not necessarily mean competency.  

In my career I have observed and assessed OH practitioners who have attended courses but they have never ever touched a spirometer or those who have the certificate but have not linked the training they have had to actual practice - sadly they think they are competent but make fundamental clinical mistakes which would make the procedure invalid for legal purposes.  And racking my brains for other examples, I seem to remember that someone on the list posted a comment about being on a HAVs course and not actually done any clinical work?  This is where issues arise and not just in spirometry. I understand that you can train to be a nurse now via the Open University, what's that about?  

So I understand why the question is asked but really the question is how does a practitioner know if they are competent in any particular OH skill? I thought I was competent when I did my first Spirometry course and had the certificate to prove it - dealing with patients and their techniques for blowing into that blessed tube and subsequent readings added a whole new dimension.    

I believe we need to move away from prescriptive training regimes and base OH practitioner competency on observed/monitored outcomes which is what SEQOHS advocates.  If we don't perform as expected then more frequent training may be required.  I believe that annual (monthly, 3 yearly etc) training regimes are a safety blanket approach to clinical supervision and the start of the journey to competency rather than the end.
 
Regards
 
Jane        




Jane Coombs MSc RGN CMIOSH OHNC DMS              
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Date: Thu, 13 Jun 2013 07:05:04 +0100
From: [log in to unmask]">[log in to unmask]
Subject: [OCC-HEALTH] Spirometry
To: [log in to unmask]">[log in to unmask]

Thanks for that info, Hilary. I wonder if there  is a time interval that is expected by SEQOHS assessors between refreshers,, eg every 3 or 5 years. I know that for Immunisation Updates the HPA recommends annual updates , but this is because the drug/vaccination regimes change  and updates are needed for anaphylaxis and CPR......

Cheers
Diane Romano-Woodward









      
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