Respiratory Care Protocols & Implementation

• Respiratory Care Protocols enhance the distribution of respiratory care services.
• Utilizing care protocols can reveal financial losses from misallocated care.
• Respiratory care protocols are guidelines for delivering appropriate treatments and services, often written as outlines or algorithms.
• Respiratory therapists should possess knowledge of modalities, communication, and assessment skills to effectively execute protocols.
• Protocols can be for individual therapies or for a specific purpose.

Key Elements of a Respiratory Care Protocol Program

• Strong and committed medical direction
• Engaged therapists
• Active quality monitoring
• A collaborative environment
• Responsiveness to address and correct problems

Elements of Acceptable RT Protocol (ACCP)

• Clearly stated objectives
• An outline that includes an algorithm
• Descriptions of alternatives at action points
• Descriptions of possible complications
• Description of endpoints
• Description of decision points where MD contact is needed.
• A protocol program

Advantages of RT Protocols

• Improved service distribution without an increase in treatment frequency
• Provides cost savings
• Allows for more dynamic respiratory care
• Adjustments of services based on patient needs
• More versatile use of services

RT Consult Service

• It uses a comprehensive approach for using protocols
• To evaluate and treat the patient according to established guidelines.

Sequence of Events for a RT Consult Service

• An MD writes an order for a protocol/consult.
• The RN/unit secretary notifies the RT evaluator.
• The RT assesses the patient.
• The RT writes a care plan using indications and algorithms, and includes it in the chart for MD review.
• The RT covering the unit delivers care.
• The patient is assessed for changes in status and modifications.
• The physician is notified of patient deterioration.
• Treatment is discontinued when no longer needed.
• Notification is placed in the chart.

Monitoring Quality RT Care

• JCAHO requires a quality assurance plan.
• The plan should include a system for quality control.
• It also requires efforts for continuous quality improvement (CQI).
• CQI is an ongoing process designed to detect/correct factors hindering the provision of quality and cost-effective healthcare.

9 Steps for a Quality Assurance Plan

• ID problems
• Determine causes
• Rank problems
• Develop strategies to resolve problems
• Develop measurement techniques
• Implement strategies
• Analyze/compile results
• Report results
• Evaluate the outcome of intervention

Goals of a RT CQI Plan (AARC)

• Provide ongoing monitoring of care quality
• Ensure cost-effective methods
• Ensure effective methods
• Identify, rank, and resolve patient care-related issues

Methods of Monitoring

• Utilize an audit system
• Giving feedback
• Performing case studies to assess respiratory therapists

S.O.A.P. Notes

• Subjective data
• Objective data
• Assessment notes
• Plans

Subjective Data

• Information obtained from the patient or their relatives
• Includes statements such as "My chest hurts when I take a deep breath."

Objective Data

• Information based on caregiver observations or the patient's physical exam

Assessment

• An analysis of the patient's problem (e.g., pneumonia continues)

Plan

• Describes the course of action to resolve the problem (e.g., assist with coughing and deep breathing every 2 hours)

Respiratory care protocols are guidelines for delivering appropriate treatments and services, often written as outlines or algorithms. Key elements include committed medical direction, engaged therapists, and active quality monitoring. Therapists need knowledge of modalities, communication, and assessment skills.