The Science Journal of the American Association for Respiratory Care
Background: There is no published standard for the ratio of staff to patients during exercise sessions in outpatient pulmonary rehabilitation. The lack of a standard raises concern about patient safety and the ability of the staff to supervise and monitor patients adequately.
Methods: To determine if a staff to patient ratio standard exists, the directors of the 46 outpatient pulmonary rehabilitation programs in Ohio were surveyed. Directors of 40 (87%) responded, and the responses from the 36 who conducted pulmonary exercise sessions separately from cardiac sessions were analyzed. The size of the programs ranged widely from serving 100 patients/week down to 2 patients/week.
Results: The maximum number of staff in an exercise session was 2, with a median of 1. The maximum number of patients in a session was 20, with median of 4. This resulted in a calculated 1:4 staff to patient ratio. Program directors were also asked to rank the importance of 8 factors in determining the reported ratio. From highest to lowest importance the factors were ranked: patient safety (which 55% of directors rated as first in importance), severity of pulmonary disease, availability of space or equipment, entry test data, pulmonary diagnosis, presence of cardiac problems, convenience, and other. Sixty percent of programs restricted the number of patients in their exercise sessions based on their staff to patient ratio. Conclusion: A state-wide standard has been determined from practice. Exercise staff work with small groups with a ratio of about 1:4 in order to assure patient safety, deal with patients' health problems, and provide adequate facilities. A majority of programs restrict the number of patients per staff to maintain a prescribed ratio during exercise.