The Science Journal of the American Association for Respiratory Care

2002 OPEN FORUM Abstracts

CLINICAL AND ECONOMIC IMPACT RESULTING FROM A HOSPITAL-WIDE CONVERSION FROM SMALL VOLUME NEBULIZERS TO THE AEROECLIPSE BREATH ACTUATED NEBULIZERS

Robert S. Pikarsky, BSRT, Russell Acevedo, MD, FCCP, Crouse Hospital, Syracuse, NY.

PURPOSE: The Respiratory Department converted from the Airlife Misty-Neb (SVN) (Allegiance Healthcare Corporation) to the AeroEclipse Breath Actuated Nebulizer (BAN) (Monaghan Medical Corp. Plattsburgh, N.Y.). This study explores the clinical and economic impact of these interventions.

Methods: Patients capable of performing aerosol therapy by mouthpiece were converted to BAN. All aerosols treatments, including breakthrough treatments, delivered between 7/1/01 and 2/28/02 were recorded. Fifty-four percent of the nebulizers purchased during this period were BAN. The 5.6-minute timesaving of the BAN over the SVN was from our previous pilot study1. The FTE average cost (salary/benefits)= $20.25/hr. The average treatments per patient - day (4.90) were determined from the treatment records. Each patient received an average of 2.5 nebulizers during their admission.

Results: Economic Impact: The table shows the total number of treatments with estimated timesaving of 0.6 FTE over the 8-month period, or 0.9 FTE annualized ($37,746). Total number of nebulizers used was estimated at 1,359, 53.8% were BAN. The increase cost of the BAN was $4,153. Overall savings was $33,592.

Resource Utilization: Compared with the same months studied of the prior year, omitted treatments due to ?Therapist Unavailable? decreased from 1.79% to 1.40% (p<.001). Worked FTEs decreased from 38.05 in 2000 to 33.42 in first quarter 2002. Paid FTEs decreased from 43.76 to 37.59 in the same time periods.

Total treatments 16,651 Total treatments 16,651
% Conversion 54% Ave Tx /pt-day 4.90
# Treatments BAN 8,958 Ave pt-days 3,398
Time saved per treatment (min) 5.6 Ave nebs/pt-day 2.5
Hours saved 829 Total nebs used 1,359
FTE (8 months) 0.60 Cost of each Misty Neb $0.76
FTE Annualized 0.90 Cost of each AeroEclipse $4.55
    % Conversion 54%
1.0 FTE RT $42,120 Cost with conversion $3,801
0.9 FTE Savings with AeroEclipse $37,746 Cost without conversion $1,032
Conversion cost difference -$4,153 Conversion cost difference $2,769
Total Savings $33,592 Annualized increase $4,153

CONCLUSION: Hospital-wide conversion to BAN is cost-effective due to the decrease in administration time. Therapist availability was enhanced, contributing to a significant reduction in omitted treatments.

CLINICAL IMPLICATIONS: The conversion to BAN allows the ability to meet our patient care demands and for the reallocation of workforce needs in a manner that is clinically and economically advantageous. This may be one of several strategies to address the problems of Respiratory Care Staff shortages or high seasonal effect in the acute care facility. Quality is enhanced by decreasing the incidence of omitted therapy.

1 CHEST 2001;120(4)218S

OF-02-055

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