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Effective respiratory care involves delivering treatments:

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that confer benefit to patients.

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From a systems perspectiv

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effective respiratory care involves allocating respiratory therapy only to those patients likely to derive benefit and not providing treatments to individuals for whom the treatments are unlikely to confer benefit.

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Effective respiratory care requires that 2 main conditions are satisfied:

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. The treatments have efficacy for the clinical problems that prompt their being ordered. 2. That respiratory therapy is allocated appropriately: that is, those patients likely to benefit from a given treatment are receiving appropriate treatments and those patients for whom the treatment is unlikely to confer benefit (because they do not have a condition for which the treatment has efficacy) do not receive the treatment.

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MEDICAL DICTIONARY DEFINATION

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an explicit, detailed plan of an experiment, procedure, or test.

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Key elements of a respiratory care protocol program

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Strong and committed medical direction Capable RTs Active quality monitoring Collaborative environment among RTs, physicians, and nurses Responsiveness of all participants to address and correct problems

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Elements of an acceptable respiratory care protocol as described by the American College of Chest Physicians

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Clearly stated objectives Outline that includes an algorithm Description of alternative choices at decision and action points Description of potential complications and corrections Description of end points and decision points at which the physician must be contacted Protocol program

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Respiratory care protocol may be constructed for

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Individual therapies Aerosol therapy Bronchopulmonary hygiene Bronchodilator therapy 02 Therapy Hyperinflation techniques Suctioning Pulse oximetry Can also be developed for specific purposes: Arterial blood gas (ABG) sampling Weaning from mechanical ventilation Decannulating a tracheostomy Titrating 02 therapy

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Physicians are likely to accept RT Protocols if:

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. The protocol will enhance their patients' care . Preserve the physician's ability to specify order if desired . Maintain the physician' awareness of changes in a patient's condition and care plans . Having trust in the quality, Professionalism and competence of the respiratory staff

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Nurses are likely to accept RT Protocols if:

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They are persuaded that protocols will enhance the efficiency of care Help relieve sometimes excessive nursing workloads Preserve communication with the bedside nurse regarding the patient's plan of treatment

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RT'S WILL SUCCESSFUL IMPLEMENT AND ACCEPT RT PROTOCOL IF:

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Have a desire to be progressive Have confidence in their own assessment and communication skills Have a willingness to change and embrace new strategies in care plans Take "ownership" of the protocol process (participating in drafting policies and strategies)

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WHAT HAS NOT CHANGED:

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Patients are arriving in the hospital Emergency rooms and through Admissions with a greater frequency. Many non-COPD patients have comorbid conditions which are triggering dyspnea, wheezing, and chest tightness. Bronchodilator therapy orders can be of limited effectiveness to these patients

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HEALTH CARE GROWING PAINS WHAT HAS CHANGED:

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The pace of change in health care has changed the fundamental methods of how we are delivering care to our patients. Our focus has shifted, in large part, to delivering quality care in an efficient, effective manner with statistical markers which can rank or rate the delivered services. Changing attitudes of ordering physicians and others to utilize therapist driven protocols remains our focus.

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Hospital administrators are likely to accept RT Protocols if:

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The protocol enhance patient care Improve allocation of respiratory care services Reduce costs

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All these key players in an effective protocol environment believe that

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The protocol enhance patient care Improve allocation of respiratory care services Reduce costs

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SUCCESSFUL IMPLEMENTATION REQUIRES ACCEPTANCE FROM

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Hospital administrators Physicians Nurses And RT's

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Respiratory protocols may be utilized by

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A written outline format An algorithm

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RESPIRATORY CARE PROTOCOLS – Flashcards

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