Managers Should Push For Respiratory Protocols
One of the most interesting things to me is that hospitals have been so slow to adopt protocols. Respiratory protocols not only allow therapists to use their expertise, but have also been shown to decrease a patient's length of stay and reduce readmission rates. Many hospitals have protocols for some things we do: pulse oximetry as a response to someone "crashing" or instructing an incentive spirometer after surgery. Other hospitals have protocols for pneumonia, but not for ventilator care. Most emergency rooms lack protocols for breathing treatments and blood gases. Some of you may work in more progressive hospitals that do these things, but many do not; I think that is wrong. It would be nice to see protocols for "routines" we find ourselves in.
I have said several times that respiratory therapists are some of the brightest, most involved folks in the hospital. It does not matter if they are just a routine COPDer in for a tune up or a post-operative open heart patient, few other clinicians spend more time with patients or are more involved with their care than respiratory therapists. Hospitals that do not have protocols that call upon the therapist to do his or her job as best they can are missing the boat.
In my opinion, managers need to push for protocols. Almost everything in the hospital is automated now and many times our care plans could be too. There is plenty of data to back up protocols and protocols also help therapists prioritize things. Often, just relying on therapists to do "x" amount of treatments in a shift leads to work being done that does not need to be done. You cannot run a ventilator aggressively and with attention to detail when you have another 36 treatments on the floor; even the most talented and professional therapist will get distracted. Managers need to manage the demands placed on respiratory therapists and make sure that important work is not being overtaken by mindless, routine stuff. That is a hard challenge in the days of low staffing and high treatments but if we are to be a valid profession it is something we need to think about.
That's just my opinion,
Jimmy R. Thacker, MHA, CRT, AE-C
Editor's note: How can respiratory therapy departments encourage protocol adoption among staff and physicians? Take a look at this short article for tips on overcoming the challenges of adopting protocols.