2001 OPEN FORUM Abstracts
Spirometryperformed by Respiratory Care Practitioners (RCP?s) at the bedside to achieveAmerican Thoracic Society (ATS) recommendations
James T. ShreveBS, RRT, RPFT, James P. Lamberti M.D. Inova Fairfax Hospital, Falls Church,VA
Background:Bedside spirometry is provided to perform diagnostic spirometry at the bedside.This allows the patient to remain in their room during testing versus transportingthe patient to another area of the hospital for testing. Providing testing atthe bedside improves timeliness of diagnostic testing.
Purpose:To assess the improvement of Respiratory Care Practitioners (RCP?s) competencyperforming bedside spirometry to meet American Thoracic Society (ATS) recommendations.
Method:A retrospective review of 58 bedside spirometry reports during a one month periodwas conducted to determine if bedside spirometry met ATS recommendations forspirometry. The criteria included: spirometry calibration on the day of testing,a minimum of two acceptable maneuvers obtained, three acceptable FVC efforts,the two largest FVC and FEV1 agree within 200 ml, back-extrapolation shouldbe less than 5% or 0.15 L whichever is greater, a plateau in the volume-timespirogram with exhalation time at least 6 seconds or until there is no volumechange for at least 1 second. A registered pulmonary function technologist completedthe review.
Results:47% of the spirometry reports reviewed did meet the above-described ATS recommendations.A poster presentation was presented to the staff and instruction provided reviewingthe proper technique for performing spirometry. After 90 days a second reviewof 60 bedside spirometry reports was completed. An improvement of 28% was achieved.ATS recomendations were met in 75% of the patients after additional staff trainingwas provided.
Conclusion:RCP?s can provide bedside spirometry that meet ATS recommendations with propertraining and continuing education and competency. An ongoing quality controlprogram can ensure accurate data is obtained in the majority of patients.