The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

A COMPUTERIZED RESPIRATORY THERAPY DRIVEN PROTOCOL IMPROVES VENTILATOR ORDER RECONCILIATION.

Matthew Davis1, Jennifer M. Davis1,2, Rob Smith1, Carl Shanholtz2,1, Giora Netzer2, Xinggang Liu2; 1Respiratory Care, University of Maryland Medical Center, Baltimore, MD; 2Pulmonary & Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD

Background Ventilator order reconciliation or the matching of ventilator orders to ventilator settings can vary widely. We describe and assess the effect of a computerized respiratory therapist driven protocol (c-TDP) on ventilator order reconciliation. Methods A single-center prospective, quasi-experimental design was performed comparing 1476 ventilator days in eight intensive care units (ICU) between 09/21/07 and 07/08/08 before the initiation of the c-TDP with 552 ventilator days between 11/18/08 and 11/03/09 after its implementation. The c-TDP consists of eight pathways initially ordered by the physician, with respiratory therapy performing ventilator changes and updating ventilator orders based on the algorithms within these pathways. The consistency of ventilator orders to ventilator settings per ventilator day was assessed and evaluated in each ICU bed once monthly before and after the protocol’s initiation. Results The consistency of ventilator orders to ventilator settings improved significantly after the protocol’s implementation (47% vs. 77%, p < 0.001). Improvement was found in each ICU type studied: medical (50% vs. 80%, p < 0.001), surgical (34% vs.72%, p < 0.001), and trauma (55% vs. 80%, p < 0.001). The magnitude of change by ICU type was similar (p=0.34). Conclusion This c-TDP improved ventilator order reconciliation. This protocol may reduce the error rate associated with the ventilator order reconciliation while potentially improving communication within the multi-disciplinary team. Sponsored Research - None