Utilization of Respiratory Therapist-driven Skin Breakdown Protocols in US Hospitals

Respiratory therapists (RTs) commonly use medical devices to assist breathing, which increases the risk for hospital-acquired pressure injuries. Prophylactic skin measures can help reduce these device-related skin injuries. The primary aim of this study was to determine how many hospitals within the United States utilize RT-driven protocols to prevent respiratory device-related skin injuries.

This was a descriptive, cross-sectional survey of US hospitals, conducted between March 2023 and May 2023 through an online survey. Information related to the hospital setting, RT involvement with hospital skin committees, and RT departmental initiatives related to preventing respiratory device skin breakdown was collected.

A total of 100 participants fully completed the survey: 50 directors/managers, 27 direct care staff, 22 clinical educators, and 1 quality improvement specialist. Among the respondents, 60% worked in academic hospitals with >300 beds. At the institution level, 77% of respondents collaborated with the hospital-wide skin committee, and 80% were involved in respiratory device-related skin breakdown initiatives. In terms of RT departments, 63% respondents had RT-driven protocols to prevent respiratory device-related skin breakdown, and 47% had RT departmental committees to review these skin breakdowns. For education, 84% of the respondents received education on skin breakdown prevention, and 40% of the respondents received training annually. In the past year, 41% of the respondents reported 5 or fewer incidences of respiratory device-related skin breakdown.

This survey study found that approximately two-thirds of the respondents utilize RT-driven protocols and approximately half employ an internal RT committee to review skin breakdown.