The Science Journal of the American Association for Respiratory Care

1999 OPEN FORUM Abstracts

STAFFING FOR A RESPIRATORY CARE INTENSE STUDY DESPITE A HIGH VACANCY RATE

Nancy E. Collar, BA, RRT, Perinatal/Pediatric specialist, Bonnie J. Kingsley, RN, MSN, James P. Lamberti, MD, Respiratory Care Services, Inova Fairfax Hospital, Falls Church, VA.

BACKGROUND: We were introduced to a partial liquid ventilation study (PLV) in the fall of 1998. This study is extremely respiratory intensive, with the instillation of liquid being maintained at a very specific level for forty-eight to one hundred twenty hours, requiring one-on-one care from a Respiratory Care Practitioner (RCP).

METHOD: We have a very active respiratory department with 100 RCPs covering eight intensive care units and ventilating more than two thousand patients per year. On top of this workload, our department has consistently operated with a fifteen percent vacancy rate for the past year. Because of the intensity of the PLV study, we initially felt it would be time prohibitive for us to participate in a study such as this. Our normal staff workloads would impede the unit RCP from spending the necessary time with the PLV patient. However, after much creative thought, we came up with a plan of action that has proven to be extremely successful! We asked our staff for volunteers interested in compromising the team that would care for patients enrolled in this study. Thirteen RCPs were chosen to make up this team, educated on the details and strict adherence of the study and scheduled, over and above their budgeted hours, so one RCP is on-call twenty four hours a day, seven days a week (they are paid from the PLV study budget). When a PLV patient is enrolled, the on-call PLV RCP comes in to take care of the PLV patient one-on-one for the duration of the patients course on liquid.

In order to make the protocol more user friendly for the RCP, branch logic diagrams were extrapolated from the protocol. The diagrams were designed to make the bedside application of the protocol smoother and to be a quick resource for the RCP. Tables were also designed to make the required date gathering more concise and ready for the statistician.

Results: The implementation of this study protocol at our institution has been a tremendous success with a smooth course. It is our belief that this path has been so smooth as a result of the user friendly resources made available to us.

Conclusions: With much creative thought, labor intense, respiratory care, studies such as PLV can be successfully undertaken despite high vacancy rates.

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