The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

IMPROVING A PEDIATRIC RESPIRATORY CARE CONSULT SERVICE FOR AIRWAY CLEARANCE: A FOUR YEAR REVIEW

Kathleen Deakins, Timothy Myers, Mary Lou Drahnak, Marsha Rogers; Pediatric Respiratory Care, UniersityHospitals Rainbow Babies & Children’s Hospital, Cleveland, OH

Introduction: The Pediatric Respiratory Care Consult Service for Airway Clearance is a clinical program designed to assist the physician in developing a Respiratory Care plan for airway clearance for the patient. From January 2005 to May 2009, 1,286 consults for airway clearance have been performed in pediatric patients. Cardiothoracic surgery patients were omitted from this population by request. Compliance with the four aspects of care have been addressed since the initiation of the program: performing initial consult within a specified time period (from the time it was ordered), notifying the physician about the respiratory plan of care, choosing the appropriate treatment using the airway clearance algorithm guideline, and follow up within 72 hours after therapy is started. The overall compliance rate was tracked since 2005 to determine whether therapists could meet these expectations. Since the beginning of program the compliance rate for all of these areas had been 70%. Methods/Intervention: In 2008, a performance improvement project was initiated with the intent to improve compliance with the four mechanisms of the consult service. In July 2008, an intervention including face-to-face education and a PowerPoint presentation was done to reemphasize the program objectives. A written exam including case scenarios and program details was given to all therapists. A passing score of 75% was required by all therapists. A tracking mechanism was employed to remind therapists to schedule follow up within a specified time period. Division nursing staff and physician education was also completed. Results: 98% of therapists passed the ACT exam. Compliance has gradually improved from 62% in 2005 to 71% in 2008 and has averaged 80% compliance (241 consults) over the past eight months (October 2008-May 2009) following the intervention. Conclusion: The Respiratory Care Consult Service provides a valuable service to assist the physician in determining the appropriate ACT therapy for the patient. Education interventions and testing has helped achieve better compliance with its four primary goals. Sponsored Research - None

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