The Science Journal of the American Association for Respiratory Care

1998 OPEN FORUM Abstracts

A SUB-SET OF FINDINGS FROM A SURVEY OF RESPIRATORY CARE SERVICES: CLINICAL PRACTICE GUIDELINES AND RESTRUCTURING.

John W. Salyer BS, RRT. Karen K. Baldesare-Burton RN, RRT. Respiratory Care Service, Primary Children's Medical Center. School of Medicine, University of Utah.

Introduction: Restructuring and the use of clinical practice guidelines are two topics that have generated considerable interest in the respiratory care community. As part of a larger survey we sought to assess some aspects of two important issues. Methods: In early 1996 a 100 question survey instrument was developed and mailed to 3854 RCS in the U.S. and Canada. The mailing list was developed from a listing of department heads that are members of the AARC. Responses were scored by a computerized scanning system. We report only questions related to the topics mentioned above.

Results: There were 1093 responses of which 15 were unreadable due to damage to the answer sheet, leaving 1078 (28%). Responses were received from all 50 states, Canada (n=11), Guam, and the Virgin Islands. The distribution of responses by geographic region was very similar to the distribution of all hospitals reported by the American Hospital Association. The tables below describes our findings.

% All

Restructuring Issue Responders

Currently or about to start cross-training

RN's/LPN's to do respiratory procedures 44.9 %

Currently or about to start cross-training

non-licensed staff to do respiratory procedures 18.0 %

Currently or about to start cross-training RCP's

to do nursing procedures 58.2 %

Hospital has brought in outside consultants to

significantly redesign hospital operations 38.0 %

Respiratory department has experienced a reduction

in force in past 18 months 37.4 %

% All

Type of Clinical Practice Guidelines : Responders

(currently being used or about to start)

Aerosolized bronchodilator administration 72

Chest physiotherapy 53

Continuous pulse oximetry 52

Weaning from mechanical ventilation 60

Oxygen therapy 77

Use of respiratory "assessor" program 24

Discussion: We did not attempt to contact non-responders, thus our sample is self-selected, and potentially biased. However, the large size of our sample should make these findings of interest to the respiratory care community. There is clearly a lot of restructuring activity taking place in hospitals that affect the practice of respiratory care. Our results indicate that the respiratory care community is actively embracing the use of clinical practice guidelines. We believe this is important to the future of patient care.

The 44th International Respiratory Congress Abstracts-On-DiskĀ®, November 7 - 10, 1998, Atlanta, Georgia.

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