2001 OPEN FORUM Abstracts
Information Availableat the Bedside of Ventilator Patients in the Adult Intensive Care Unit
W. French, MA, RRT, C. Egan,CRT, J. Gallagher, CRT, D. Zukoski, CRT; Lakeland Community College, Kirtland,OH
Introduction:The abundance of information typically available in the ICU has been the topicof frequent discussion. However, to date, no one has quantified or categorizedthe information potentially availabe to the respiratory therapsit (RT) at thebedside of an adult ventilator patient in this setting. Realizing that a completelisting of all these individual bits of information might be useful to educatorswriting case studies and teaching ventilator management, managers looking attime and staffing issues, and bedside clinicians, we compiled such a list.
Methods: Using the modifiedDelphi technique, three RT students in their last semester were asked to developa list of all information available to the RT at the bedside of a ventilatorpatient. Their lists were to be based on personal observation and experiencein at least two different adult ICUs, using standard volume ventilators (e.g.P-B 7200). After the first lists were compiled, the group met and, with thehelp of a facilitator, pared the list down. This procedure was done three times.After the third compilation and paring of the list, it was then put into itsfinal form by the facilitator.
Results: The final list consistsof ninety-eight separate items of directly observable information distributedamong the following five categories: ventilator function, patient/ventilatorinterface, patient, external monitors, and immediate patient environment. Inaddition, a sixth category of communicated information (e.g. medical record,other caregivers, etc.) consisted of at least ten separate information items.
Discussion: The results indicatethat the RT must evaluated and assimilate a substantial amount of informationevery time he/she approaches a patient receiving ventilatory support. How manyof the ninety-eight items the individual RT actually considers during any singlepatient encounter has yet to be studied, and probably varies from patient topatient. In addition, this study only looked at adult ICU patients. The listwould probably be shorter for ventilator patients in post-acute care environments,and longer for neonatal/pediatric patients, and patients receiving non-conventionalforms of ventilatory support (e.g. jet ventilation, etc.).