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A dyspnea evaluation protocol for respiratory therapists: a feasibility study.
Irene Karampela1, John Hansen-Flachen, Steven Smith
1Medical Intensive Care Unit and Respiratory Care Services, Hospital of the University of Pennsylvania, University of Pennsylvania Health System, 3400 Spruce Street, Founders Pavilion 9.066, Philadelphia, PA 19104, USA.
Respiratory Care
|October 2, 2002
Summary
Respiratory therapists (RTs) can integrate a dyspnea evaluation into routine assessments for mechanically ventilated patients. This protocol showed moderate success in identifying shortness of breath, aiding patient-centered care in intensive care units.
Area of Science:
- Critical Care Medicine
- Respiratory Therapy
- Patient Assessment
Background:
- Mechanically ventilated patients often experience dyspnea, impacting distress and care.
- Routine assessments by respiratory therapists (RTs) present an opportunity for dyspnea evaluation.
Purpose of the Study:
- To assess the feasibility of integrating a dyspnea evaluation protocol into routine bedside assessments by RTs.
- To determine the effectiveness of a simple dyspnea inquiry in mechanically ventilated patients.
Main Methods:
- A dyspnea assessment protocol was implemented in intensive care units (ICUs) at a university teaching hospital.
- RTs inquired about shortness of breath and its severity from responsive, mechanically ventilated patients every 4 hours.
- Data were collected from 324 patient ventilator flow sheets.
Main Results:
- The protocol compliance rate was 74%, with dyspnea scores recorded in 1,870 of 2,539 assessments.
- Patients were responsive to questions in 32.1% of encounters.
- Dyspnea was reported in 11% of encounters, most frequently described as mild.
Conclusions:
- Implementing a dyspnea evaluation protocol in routine RT assessments is moderately successful.
- This rapid bedside evaluation can help assess patient distress related to ventilator settings or sedation.
- The protocol supports a patient-centered approach to managing respiratory failure in the ICU.