2007 OPEN FORUM Abstracts
---- A REGIONAL SURVEY IN BEIJING, CHINA
CURRENT PRACTICES FOR RESPIRATORY CARE IN THE ICU ---- A REGIONAL SURVEY IN BEIJING, CHINA
J. Li1, Q. Zhan1, Z. Liang2, M. Du3, H. Dai1, B. Sun1
[Background] It is widely recognized that respiratory therapists (RT) contribute importantly to ICU outcomes. However, there was no RT in the mainland of China until 2004, when the first trained RT graduated. Little information is available on current practice. Accordingly, we performed a survey to determine who actually performed respiratory care and how they worked, their attitudes towards RT profession.
[Methods] Using survey methodology, we developed a questionnaire and distributed it by mail to ICU directors or nursing headers at all 50 high-level (level III) hospitals in Beijing. Nonresponders were contacted by phone to complete the survey.
[Results] We obtained responses from 70 ICUs in 43 hospitals, 31 of which were teaching hospitals. The response rate was 86%. The total numbers of ICU beds, doctors and nurses were 604, 433 and 1199, respectively.
I.For respiratory care providers, doctors accomplished mechanical ventilation such as setting modes and parameters, weaning, and extubation, et al, while airway management such as suction, humidification, nebulization and circuit changing were nursesâ duties. Ventilators were checked and maintained by technicians.
II.For clinical work, the most popular ventilation modes were SIMV (87.3%), PSV (69%); Initial tidal volume was set mostly by estimating (72%) or doctorsâ experience (14%), less by calculating exact weight (8%). Parameters which were registered per hour by nurses were respiratory rate (90.1%), tidal volume (87.3%.Spontaneous breathing trial was tried every day only in 7% ICU, while 45.1% ICU did it only before weaning. 55% ICU checked ventilator before use, while 15% once a month, 24% once in half a year. Similarly, ventilator got maintenance after use in 46% ICU. The majority of ICU still changed ventilator circuits termly : 57.7% changed once a week, 26.8% changed every day.
III.For the health stuffâs attitudes: 88.7% responders had heard of RT vocation before. The aspects which they considered suitable for RT to work were mechanical ventilation (67.6%), airway management (47.9%). 86% thought they would need a RT.
[Conclusion] Most of the respiratory care was still provided by nurses and doctors at the ICU, however, operations were variable but mostly not normative. It was partly due to professional stuffs lacking. ICU executives noticed this problem. well-trained respiratory therapists would be needed increasingly in the near future of China.