The Science Journal of the American Association for Respiratory Care

1999 OPEN FORUM Abstracts

A CONTINUOUS QUALITY IMPROVEMENT PROJECT: ASSURANCE OF CONTINUITY AND STANDARDS OF RESPIRATORY CARE.

Mary Kay Hamby RRT, RPFT and Peggy McDonagh Bravo RN, BSN Chelsea Community Hospital, Chelsea, Michigan.

Background: In an effort to respond to the increasing patient volume in Emergency Services and the waning of acute care patient volume, Chelsea Community Hospital implemented a cross training of Respiratory Therapists to the role of ER technician. Respiratory Therapists report to and provide care in Emergency Services from 5:30pm to 11:30pm. A Respiratory Therapist is on call for the night shift. As a result, Nurses on the Medical-Surgical, IC/CCU, Head Pain, Rehab and Behavioral Health Units are required to perform tests and treatments typically provided by the Respiratory Therapist.

Method: The Hospital Corporation of America method entitled FOCUS-PDCA was utilized to develop the improvement process. A survey of nurses was conducted addressing subjective data related to comfort levels and knowledge of nurses performing Respiratory tests/procedures. Questions were scaled using a 5 point scale with 1=strongly agree, and 5=strongly disagree. Data was analyzed using statistics of count and percentage. Surveys were utilized as measurement tools several times during the improvement process.

Results: Clarification of the need to improve the process was confirmed by the survey results. 32% of nurse respondents felt they were provided with proper instruction on how to perform respiratory tests/procedures. In an effort to improve the proficiency and confidence level of nurses to perform the tests/procedures, it was decided an educational forum was needed. Five rotating stations entitled NMT, ECG, Airway management, ABG and Tracheostomy Care comprised the ?Respiratory Fair?. Various preferences in learning including lecture, interactive discussion, redemonstration and self-paced reading were utilized to promote retention of content. Standardized format competencies with specific objectives were developed to accompany each station. Post evaluations indicated 100% of respondents felt program objectives were achieved, 100% felt the information provided was useful on a personal and professional level and 100% would recommend the Respiratory Fair to others. The process was re-evaluated with a 4-month post survey. To site a question posed to the staff, ?Do you feel comfortable performing the NMT procedure?? 92% of the nurses who attended the Respiratory Fair strongly agreed to their comfort level whereas only 54% who did not attend the Respiratory Fair strongly agreed.

Experience: It is necessary to communicate and work as an interdisciplinary team to continue to achieve high standards of patient care. This was a positive experience in that Respiratory Therapists and Nurses have a better understanding of the collaboration required to achieve our hospital goal of continuity of patient care.

Conclusions: The Respiratory Fair coordinated by Respiratory Therapists and Nurses achieved the team goal to assure continuity in the provision of patient care by educating caregivers in a consistent manner. The clinical competency tools allow the ability to teach and evaluate proficiency of regular staff and new employees on an on going basis. The results indicate a favorable perception of the Respiratory Fair program among the responding nurses. The respondents supported an offering of the Respiratory Fair on an annual basis.

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