2002 OPEN FORUM Abstracts
DETERMINING THE EFFECTIVENESS OF HAVING A RESOURCE BOOK IN THE PEDIATRIC INTENSIVE CARE UNIT
Kathy Urmetz, RRT, James E. Martin, RRT, Departments of Pulmonary Services and Pediatrics, MetroHealth Medical Center, Cleveland, Ohio
BACKGROUND: The Pulmonary Services Department of our 700+ bed academic community hospital is made up of 61 respiratory therapists who belong to either an adult core (surgical and medical specialties) or the pediatric core (neonatal and pediatric intensive care units, and general pediatric and adult floors). To allow for an equitable time in each area, a two-week rotation schedule within each core was initiated. The average time between rotations is 6 to 8 weeks. The pediatric rotation includes 22 registered respiratory therapists (16 primary and 6 secondary who assist the primary therapist). As part of the pediatric core, the Pediatric Intensive Care Unit [PICU] is unique in that its senses cover a wide range of patient ages and acute and chronic illness. To assist their fellow practitioners, a group of primary PICU therapists put together a PICU Resource Book [PRB]. The resource book is comprised of patient notes on those who frequent the PICU, detailed description of equipment set-ups and photographs, calculations for initiating continuous and intermittent medications, and ventilator strategies for different age groups and disease states using the five different types of ventilators.
METHOD: A survey was developed to determine the frequency therapists referred to the PRB, the sections referred to most often, and if the availability of the PRB initiated therapy quicker and added to the therapist?s self-confidence when assigned to the PICU. The survey was placed in the mailboxes of 61 respiratory therapists and 2 clinical education specialists.
Results: 34 of the 63 [54%] surveys were returned. 2 clinical specialists, 15 adult core, and 17 pediatric core therapist completed the survey. The pediatric core?s results were used for analysis. 17 of the 22 responded [77%] to the survey (14 primary, 3 secondary). 50% of the therapists have >5 years experience in the respiratory field, and 43% of the primary PICU therapists have >5 years experience in the PICU. All of the 17 who responded were familiar with the PRB. In a six-month period, 79% of the primary therapists referred to the PRB occasionally (2-12 times) while 100% of the secondary PICU therapist referred to it infrequently (<2 times). The Clinical Education Specialists also used the PRB as one of their tools for familiarizing students and orientating new therapists to the unit. 57% of the primary therapists referred to the patient notes and equipment set-up most frequently, followed by photographs of equipment set-ups and calculations while 100% of the secondary therapists referred most frequently to set-ups and photographs. All therapists believe that the availability of the PRB made them more self-reliant. 94% believe the book added to their self-confidence in the unit and made them more efficient. 77% believe the PRB assisted them in initiating therapy quicker. All of PICU therapists would like to see the same type of resource book in other ICU areas.
CONCLUSION: Respiratory therapists routinely assigned for a two-week rotation in Pediatric ICU areas could benefit from putting together a resource book specific to that area. The availability of this book could make them more efficient and self reliant when assigned to the area.