Measured Improvement in the Competency and Comfort Level of Respiratory Therapists Obtained Through the Implementation of a Program of Independent Ventilator Study,Review and Practice

Abstract

Background:

Respiratory Therapists in a small community Hospital need to maintain mechanical ventilation skills including accurate initial set up even though they may not regularly use mechanical ventilation. A unit of instruction including independent study modules, review of basic mechanical ventilator set up according to facility approved protocols and practice scenarios with rationale was developed to assess whether comfort and competency of the RT staff could be improved with participation.

Methods:

Pre and post participation comfort (using a Likert scale) and competency (using a timed assessment of initial ventilator settings according to approved facility protocols) by respiratory therapists in a small community hospital was measured. A unit of instruction including seven independent study modules, scenarios for practice with associated correct answers and rationale was developed. Participants completed the independent study modules and practiced equipment set up according to facility specific protocol parameters. A co-worker measured the time to complete set up and assessed the accuracy of settings for each module according to given parameters and answers/rationale. Comfort and competency of initial ventilator set up was measured following completion of the instruction and practice.

Results:

Prior to the study, 75% of the study participants felt that a unit of instruction on their facility ventilator and protocol parameters would be helpful with only 50% agreeing to a statement that they felt comfortable using the facility ventilator on their own. Prior to the unit of instruction, when given a written scenario and asked to set up the ventilator 43% of participants set up the ventilator correctly according to the facility protocols in under 5 min. Following the unit of study, 86% of participants set up the ventilator correctly and 100% were able to set it up in under 5 min. Following the unit of study 100% of the participants agreed (or strongly agreed) with a statement that they felt more confident using the facility ventilator protocols and 100% agreed with a statement that a review is important to maintain skills.

Conclusions:

Regular instruction, practice with feedback/rationale and monitoring can improve RT comfort and competence in relation to mechanical ventilator performance.