2001 OPEN FORUM Abstracts
PREVALENCE AND PERCEPTIONSOF IMPLEMENTATION OF PATIENT CARE PROTOCOLS BY RESPIRATORY THERAPISTS IN ARKANSAS
Ron Cothran, Jr., BS, RRT, CPFT,Pueblo Community College, Pueblo, Colorado, Theresa Gramlich, MS, RRT, MildredSavidge, PhD. University of Arkansas for Medical Sciences, Little Rock Arkansas
Background: Evidence stronglypoints to the efficacy of implementation of patient care protocols (PCPs) byrespiratory therapists. However, data concerning the prevalence and perceptionsof respiratory therapists' PCP implementation in Arkansas was lacking. The purposeof this study was to determine PCP prevalence and perceptions of barriers toimplementation and benefits in Arkansas hospitals.
Method: A qualitative surveyinstrument was developed to determine the use and distribution of patient careprotocols used in Arkansas hospitals, as well as implementation responsibility,barriers to implementation, and types of outcomes. The survey instrument wasthen pilot tested for reliability by 6 acute care facilities in Colorado knownto be using PCPs. We then distributed surveys to respiratory care departmentsof the entire population of hospitals that were members of the Arkansas HospitalAssociation.
Results: We mailed the surveyto 78 respiratory care departments. Of these, 38 (49%) completed and returnedthe survey. Three of four respondents reported PCP implementation. Non-criticalcare areas were the most prevalent setting for PCPs; they were also operationalin emergency departments and intensive care units. These findings were welldistributed across the state. Perceived barriers to implementation were insufficienciesof physician support and respiratory therapists' education level, proactivity,self-efficacy, and time. Perceived benefits were improvements in the following:patient care, length of stay, allocation of staff and services, hastened weaningfrom mechanical ventilation, staff self-worth, and collaboration between respiratorytherapists and physicians.
Conclusions: Among our studysample, respiratory therapists have commonly implemented PCPs in Arkansas. Perceivedbarriers were related to lack of physician support and respiratory therapists'insufficiencies. Perceived benefits included enhanced patient care and respiratorytherapists' job satisfaction. Limitations to this study included a return rateless than 100%, and possible Hawthorne bias from RCPs who answered survey questions.Overall our data suggests a need to improve the education, confidence, and assertivenesslevel of RCPs in the implementation and usage of patient care protocols.