The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

HOW CREATING A COLLABORATIVE TREATMENT SCHEDULE FOR ADULT CYSTIC FIBROSIS PATIENTS CAN IMPROVE COMPLIANCE OF AIRWAY CLEARANCE THERAPY.

Tammy L. Kundinger, Anne L. Flaten; Respiratory Therapy, University of Wisconsin Hospital, Madison, WI

Background: University of Wisconsin Hospital is a center that specializes in the care of patients with Cystic Fibrosis(CF). Respiratory Therapists(RT) use a Respiratory Assess and Treat Protocol to determine the most appropriate care for the patient based on criteria defined by an assessment tool with algorithms. The Airway Clearance Algorithm includes guidelines specific to the care of a CF patient. A routine chart review revealed that these patients were not receiving all of the therapy as indicated per protocol due to patient unavailability, refusing therapy, and/or RT not documenting completely. With the support of the medical team, a treatment schedule was created for these patients to improve patient compliance to airway clearance therapy and the consistency of care. Method: Shortly after admission, RT met with the CF patient to develop a daily schedule that included airway clearance therapy four times per day. Thirty minute treatment times were available from 0730 through 1000 and then every four hours after the initial morning treatment. During the inpatient stay, if the patient was not compliant with the treatment schedule, the RT would notify the pulmonary nurse practitioner who in turn would follow up with the patient. This schedule was implemented with 23 adult CF patients that were admitted between 2/1/11-5/1/11. We reviewed the number of treatments that were scheduled to be provided and the number of treatments that were missed and compared it to the same data from prior admissions. Results: From 2/1/11-5/1/11, there were 1221 airway clearance treatments scheduled for 23 adult CF patients. Chart audits revealed that 84%(1028/1221) of the treatments were provided and 16%(193/1221) of the treatments were documented as refused by the patient. Prior admission data showed that there were 1213 airway clearance treatments scheduled for these same 23 patients. Chart audits revealed that only 71%(869/1213) of the treatments were provided and 28%(344/1213) were not given. The prior admission data did not include reasons why these treatments were missed. We suspect that this was due to the patient being unavailable, the patient refusing or incomplete documentation. Conclusion: A collaborative treatment schedule developed by the RT and patient and reinforced by the provider improves compliance of airway clearance therapy. Sponsored Research - None