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The scientific basis for protocol-directed respiratory care
Ariel M Modrykamien1, James K Stoller
1Pulmonary, Sleep and Critical Care Medicine Division, Creighton University School of Medicine, Omaha, Nebraska.
Respiratory Care
|September 26, 2013
Summary
Respiratory care protocols improve patient care by optimizing services in and out of the ICU. Evidence shows these guidelines enhance efficiency, reduce costs, and ensure appropriate respiratory therapy.
Area of Science:
- Respiratory Care
- Evidence-Based Medicine
- Healthcare Management
Background:
- Respiratory care protocols are guidelines for respiratory therapy services.
- Misallocation of respiratory care (over- or under-ordering) necessitates effective protocols.
- Protocols aim to optimize the delivery of respiratory therapy services.
Purpose of the Study:
- To review available studies on the effectiveness of respiratory care protocols.
- To assess protocol impact in Intensive Care Units (ICUs) and non-ICU settings.
- To identify gaps in current understanding of protocol effectiveness.
Main Methods:
- Systematic review of studies on respiratory care protocols.
- Categorization of studies into ICU and non-ICU settings.
- Analysis of randomized controlled trials (RCTs) and other study designs.
Main Results:
- ICU studies show protocols effectively liberate patients from mechanical ventilation, reducing stay and cost.
- Non-ICU studies demonstrate protocol effectiveness in guiding supplemental oxygen, hygiene, and patient placement.
- Comprehensive protocol programs enhance service allocation, leading to savings without adverse outcomes.
Conclusions:
- Overwhelming evidence supports the effectiveness of respiratory care protocols.
- Protocols are effective in both ICU and non-ICU settings.
- Further research is needed for settings outside acute care hospitals, such as geriatric and palliative care.
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