2006 OPEN FORUM Abstracts
THE CURRENT STATE-WIDE USE OF AIRWAY CLEARANCE TECHNIQUES
Sarah Varekojis, PhD, RRT,
Sarah McNee, B.S., RRT, Christine Snider, B.S., RRT, and Katrina Strayer, B.S.,
CRT; Respiratory Therapy Division,
School of Allied Medical Professions, The Ohio State University, Columbus,
Ohio.
Background: Patients
with impaired airway clearance can experience many pulmonary complications
which can lead to higher medical expenses.
A variety of techniques have been shown to be clinically effective in removing
bronchial secretions. The purpose of this survey is to describe the use of
airway clearance techniques in Ohio hospitals as reported by respiratory
therapy department managers, and determine if current practice differs by use
of therapist-driven protocols, region of the state, type of hospital, size of
hospital, or size of department.
Methods: A survey research design was
employed to answer the research questions. A survey instrument was developed to
measure the various aspects of airway clearance technique use in
Ohio
hospitals and to obtain demographic information
about each hospital. The survey instrument was mailed with an accompanying
cover letter and postage-paid return envelope to the manager of the respiratory
therapy department at every hospital in
Ohio
. Descriptive statistics were employed to
address several research questions and chi square and t-tests were employed as
appropriate. The alpha level was set a priori at 0.05.
Results: 67 of
the 174 department managers returned the survey. The most frequently used
technique was incentive spirometry. IS, cough and
deep breathe, suctioning, and PD&P were used
always to sometimes, bed percussion, huff coughing, cough assist, and AcapellaTM were used sometimes to rarely, and EzPAP®, HFCWO, IPV®, IPPB, and Flutter® were all
used rarely to never. Autogenic drainage was used least frequently, almost
never. The three factors with the most influence on how frequently a technique
is used were physician preference, therapist preference, and protocols or
clinical pathways, with availability of equipment and patient preference the
next most influential, and cost and time the least influential. PD&P, Acapella, and HFCWO are the most expensive techniques, and IS, cough and deep breathe and suctioning are the least
expensive. HFCWO, PD&P,
and IPV are allotted the most time for administration
and huff coughing, cough and deep breathe, and suctioning are allotted the
least time for administration.
Conclusions: There appears to be a trend
toward use of simple airway clearance techniques in
Ohio
's hospitals. However, there are some notable
differences in practice with larger hospitals and departments, community
hospitals, and hospitals with protocols more likely to use the newer devices
like IPV®, HFCWO, EzPAP® and AcapellaTM.
It is recommended that this study be repeated on a national scale to determine
if the findings in
Ohio
are similar to the rest of the country.