The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

THE USE OF AIRWAY CLEARANCE TECHNIQUES IN THE UNITED STATES

Georgianna Sergakis1, Sarah M. Varekojis1, Nicholas Koski1,2, Matthew Weaver1, Amanda Wuske1,2; 1Respiratory Therapy Division School of Allied Medical Professions, The Ohio State University, Columbus, OH; 2Respiratory Therapy, OSU Medical Center, Columbus, OH

Background: Clinical complications from retained pulmonary secretions are serious and can be costly to both the patient and healthcare system. To prevent and treat these complications, Respiratory Therapists utilize a variety of airway clearance techniques, many of which have been shown to be clinically effective. Therefore, the choice of technique is often based upon additional variables. The purpose of this study was to determine the variables that drive the current practices of airway clearance around the nation and determine if practice varies by type of patient, size of institution, type of institution, region or by use of therapist- driven protocol. Methods: An online survey of airway clearance practices and demographic information was sent to 650 Respiratory Therapy managers from the AARC Management section list serve. The pilot study modeled a previous state survey performed in Ohio. Descriptive statistics and chi square analysis were employed to analyze results. Results: 158 individuals responded to the survey. The single most frequently used airway clearance techniques were Acapella™, C & DB, and IS. Regarding frequency of use, more than half of respondents reported they often used IS, C& DB, Acapella™, and suctioning. In contrast, more than 67% stated they never used Autogenic Drainage, IPV®or IPPB. The greatest influences on decision making for airway clearance were protocol (23%) and physician preference (23%) followed by evidence based research (20%) and patient compliance (12%). 51% of respondents reported protocol use for airway clearance at their institution. When analyzing respondent variation there were no marginally valid chi-squares. However, there were notable patterns in airway clearance modality by patient population, protocol use and type of institution. Conclusions: Consistent with the literature, airway clearance techniques vary by institution and are often tailored. Self-administered airway clearance techniques were preferred. More labor and clinician-intensive techniques were not used. This is consistent with providing airway clearance techniques that are easy to use and likely to have increased patient compliance. Choices were influenced by preference, providing consistent care and maximizing quality for individual patients and not focused on factors of convenience such as cost or productivity. These choices are integral in addressing complications from retained secretions, thereby conserving future healthcare dollars. Sponsored Research - None

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