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Related Experiment Videos

Practice variation in respiratory therapy documentation during mechanical ventilation.

Saadia R Akhtar1, Jim Weaver, David J Pierson

  • 1Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, 325 Ninth Avenue, University of Washington, Seattle, WA 98104, USA.

Chest
|December 11, 2003
PubMed
Summary

Respiratory therapy documentation of ventilator settings shows significant variability. New guidelines are needed to ensure accurate record-keeping for lung-protective ventilation in ARDS patients.

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Area of Science:

  • Critical Care Medicine
  • Respiratory Therapy
  • Health Informatics

Background:

  • Implementing lung-protective ventilation for Acute Respiratory Distress Syndrome (ARDS) necessitates strong physician and respiratory therapy (RT) collaboration.
  • Accurate RT documentation of ventilator settings is crucial for effective communication and patient care.
  • Existing research on the quality and variability of RT documentation is limited.

Purpose of the Study:

  • To assess the quality and variability of respiratory therapy documentation of ventilator settings in hospitals.
  • To evaluate compliance with American Association for Respiratory Care (AARC) clinical practice guidelines (CPGs).
  • To identify documentation gaps for implementing lung-protective ventilation strategies.

Main Methods:

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  • A population-based cross-sectional study was conducted across 17 adult hospitals.
  • RT ICU flow sheets were compared against 1992 AARC CPGs for patient-ventilator system checks.
  • Interviews with RT managers and chart reviews of Acute Lung Injury (ALI)/ARDS patients were performed.

    • Main Results:

    • Substantial variability in RT documentation practices and AARC CPG compliance was observed.
    • Only 15 of 52 recommended AARC CPG items were universally included on blank RT flow sheets.
    • Documentation of key items for lung-protective ventilation, such as plateau pressure, was inconsistent across patient charts.

    Conclusions:

    • Significant variability exists in current respiratory therapy documentation practices.
    • The development of updated guidelines for documenting mechanical ventilation care is recommended.
    • Evaluating the impact of new guidelines on practice and patient outcomes is essential.