2002 OPEN FORUM Abstracts
TIME REQUIRED TO PERFORM A SIMPLE VENTILATOR CHECK
William French, MA, RRT, Lakeland Community College, Kirtland, OH
Introduction
In recent years, the practice of performing
routine ventilator checks (VC) has been questioned. Nevertheless, the practice
persists in most acute care hospitals, usually every two to four hours, and
when ventilator changes are made. Generally, a ventilator check consists of
recording data such as ventilator settings, patient/ventilator interface data
(e.g. actual respiratory rate, return volume, peak inspiratory pressure, etc.),
and basic assessment data (e.g. heart rate, breath sounds, SpO2,
etc.). Although there is little documentation of need, respiratory therapy departments
probably require routine checks for the following reasons: 1) basic documentation
of satisfactory ventilator function, and 2) ensure that a therapist visits the
bedside on a timely basis. However, it is unlikely that administrators are aware
of how much time is actually spent in performing a routine VC. Thus, the purpose
of this study was to see how long it takes to perform a simple VC.
Methods
Ventilator flowsheets were obtained
from several local acute care hospitals. An intubated manniquin was placed on
a 7200 ventilator at the following settings: rate 12, Vt 400, O2
40%, PEEP +5, mode CMV, peak flow 50 Lpm, square wave. The simulation also had
a cardiac monitor displaying a regular rhythm and rate, and audible breath sounds.
Five respiratory therapy students near graduation and previously familiar with
the particular flowsheets and the process of performing VC were recruited. The
students were informed as to the nature of the project and were instructed to
perform the VC as though it were a real situation. For each flowsheet, three
students performed a VC, each independent of the other and without observing
each other. Each VC was timed with a digital stopwatch without the student being
aware of the time. The students were sequenced so that no student performed
more than one VC on the same flowsheet. In addition, for the second two sets
of checks, the ventilator settings were slightly altered.
Results
The first flowsheet required a total
of 26 separate items that had to be observed and recorded. The mean time required
to accomplish this was 4.1 minutes. The second flowsheet also required the recording
of 26 separate items. The mean time required to accomplish this was 3.3 minutes.
The third flowsheet required the recording of 21 items of information. The mean
time per VC was 3.9 minutes. When the three means were averaged together, the
time was 3.8 minutes.
Discussion
Obviously, this study was very limited
since it was done under simulated conditions in a quiet laboratory. However,
because of the stable nature of the simlated environment and the fact that the
patient/ventilator interface was ideal, the mean time recorded probably represents
the absolute minimum time required to perform a VC. From the perspective
of time management, if we assume that the average VC requires a minimum of about
4 minutes to perform, then a therapist assigned five ventilators in a typical
ICU would spend at least 20 minutes every round of checks just observing and
recording data.
OF-02-059