The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

THE EFFECT OF A TREATMENT FREQUENCY PROTOCOL ON APPROPRIATE UTILIZATION OF AEROSOL THERAPY.

Rebecca Vidrine, Jules Poirier, Teri Keller, William Borron; Respiratory Care, West Jefferson Medical Center, Marrero

Background: The Hospital’s conversion to a computerized provider order entry (CPOE) with an electronic medical record eliminated the hard copy of the patient’s medical record. Prior to this, alerts to physician by the respiratory therapists were placed on the medical record communicating any change in a patient’s pulmonary status and suggested treatment frequency. Without this avenue, an alternate plan was developed. And the treatment frequency protocol was initiated. Method: The treatment frequency protocol was developed using the Cleveland Clinic‘s Respiratory Therapy Consult service as an evidence-based guideline. This protocol included bedside patient assessment, review of test results, and use of a scoring matrix to determine recommended treatment frequency. A convenience sample of inpatients ordered on aerosol therapy to deliver inhaled medications was assessed within 24 hours of the initial physician order using the protocol by designated assessment therapists, who evaluated patients 7 days/week. Results: Over an 8-month period, 1,282 patients were assessed using the treatment frequency protocol. Our results showed that 7% of ordered aerosol treatments were not indicated and thus discontinued. Also, seen was 43% of the ordered treatments indicated a decrease in frequency within 24 hrs of admit using the protocol. 3% of the ordered treatments were increased within 24 hrs of admit. Following protocol implementation, an average drop of 25% in aerosol treatment volume resulted each month as compared to the same timeframe in 2010. With this protocol in place, there was a staff reduction of 3.7 FTEs, primarily from the 11 pm - 7 am shift staff as well as a patient cost savings with the appropriate utilization of treatment frequency totaling $942,123 during the 8-month period. Conclusion: The Treatment Frequency Protocol resolved the lack of an avenue for respiratory therapists to communicate changes in patient’s respiratory status to physicians and thus changes in treatment plan. Subsequently, the protocol has had a significant impact with eliminating inappropriate treatments resulting in decreased staff levels and has cost savings for the patient and the hospital. Sponsored Research - None