The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

RESPIRATORY CLINICAL LADDER IS KEY IN THE UTILIZATION OF EVIDENCE BASED RESPIRATORY CARE AND IMPROVED OUTCOMES

Carol A. Agard; Respiratory Care, Queen’s Medical Center, Honolulu, HI

BACKGROUND: To enhance our care delivery model and support changes to our evidence based practice, we developed a Respiratory Clinical Ladder as a method to implement practice changes. METHODS: The concept was developed by our leadership team, medical director and RCPs. Our Clinical Ladder (CL) proposal outlining objectives, requirements, timelines and costs associated with implementation, evaluation and maintenance was approved. The program includes two levels of advancement with a focus on performance improvement activities, proficiency of advanced skills and outcomes monitoring. Additional program requirements include length of employment, committee work, or obtaining an advance practice credential, continuing education credits and an above average performance appraisal rating. RESULTS: Over a four year period, eight staff or18% of eligible RCPs enrolled in the program. Four staff or 50% continued on to the advanced skill level. The primary reason for attrition was relocation. Projects to date that have shown positive outcomes are: Non Invasive Positive Pressure Ventilation success rate improved from 35% to 70%, implementation of neonatal high flow nasal cannula prevented the intubation and transfer of 48 neonates to a children’s hospital, access to metabolic monitoring was improved by 215%, the RCP role with the Rapid Response Team was validated through a survey tool, and High Frequency Oscillation Ventilation a modality not offered previously by our department was provided safely for 19 patients meeting specific criteria. An outcomes review of these patients was completed and an abstract has been submitted to the AARC Open Forum in 2009. An abstract of the NPPV project was presented at an earlier AARC event. All projects have improved RCP and CL staff skill levels. CONCLUSION: Over this period the CL Program has been key in implementing and sustaining evidence based respiratory care. We have improved our care delivery model, positively impacted patient safety and outcomes, as well as demonstrated the value of a skilled RCP as a vital member of the health care team. Sponsored Research - None

You are here: RCJournal.com » Past OPEN FORUM Abstracts » 2009 Abstracts » RESPIRATORY CLINICAL LADDER IS KEY IN THE UTILIZATION OF EVIDENCE BASED RESPIRATORY CARE AND IMPROVED OUTCOMES