A comparison of respiratory care workload with 2 different nebulizers

Aerosol therapy via small-volume nebulizer (SVN) accounts for a large proportion of the respiratory care workload. Treatment time is mostly nebulization time, which is highly variable, depending on SVN design. We studied the workload effect of adopting a faster nebulizer. We hypothesized that time saved by faster SVN treatment can be used by respiratory therapists for other patient-care activities.

We compared day-shift workload distribution in a post-thoracic-surgery ward during 2 consecutive 30-day periods. To deliver bronchodilators (3 mL unit dose), during the baseline period we used the VixOne nebulizer (average nebulization time 9 min), and during the intervention period we used the NebuTech HDN (nebulization time limited to 3 min). We recorded the per-shift number of various respiratory-therapy procedures, which have been assigned standard treatment times, and compared the per-shift numbers of procedures during the baseline and intervention periods.

The per-shift number of procedures were similar during the baseline and intervention periods (33.8/shift vs 33.3/shift, P = .68), as was the per-shift number of SVN treatments (11.9/shift vs 11.8/shift, respectively, P = .81). The per-shift time required for the procedures was greater during the baseline period (4.7 h vs 3.6 h, P < .001). The per-shift time available to deliver optional value-added respiratory therapies was higher in the intervention period (0.75 h vs 0.50 h, P < .04). The time savings from the faster nebulizer corresponded to 1.8 full-time equivalents and theoretical net annual savings of $66,491. We did not use treatment "stacking" (ie, simultaneous administration of SVN treatments to multiple patients).

The NebuTech HDN substantially reduces SVN-administration time, without adverse effects or events, and the time savings were used for value-added patient-care activities. Shorter treatment times can play a role in coping with the national shortage of qualified respiratory therapists.