Respiratory Therapy Policy Changes

The primary purpose of this memo is to prepare employees for the department of respiratory therapy about the current changes in the protocol of practice in adult respiratory therapy. The letter creates awareness of the fundamental guidelines on when a physician should allow the therapist to initiate, stop or adjust particular respiratory therapy modalities The procedure is in compliance with National Institutes of Health requirements for patients aged 18 and above as articulated by Pinciroli, Mietto & Berra (2013). The letter provides information regarding the policy, modalities, procedure, indications, and contraindications. All employees in respiratory departments are expected to take note of the changes to ensure efficient handling of facilities within the department as well as practical administration of patients.

Explanation

Policy Changes:

Respiratory therapy will be carried out as ordered by the physician who will be having a standing order for the protocols to be applied.  The delivery of RT by the protocol is currently limited to the treatment modalities. Valved holding chamber as well as actuation tools will be utilized as acquired from RT and will be kept in the rooms of patients. The changes are in line with the details provided by Pinciroli, Mietto & Berra (2013), whereby the rescue medication will be expected to be stored at the bedside of the patient, while order must be written regarding the home supply of RT medications.  The assessment of the patient should happen within 30 minutes after receiving the request.

Modalities:

There are also few changes made on modalities associated with RT protocols. One of the changes is the introduction of Modified Pulmonary Stress (MPS), whereby the patient is expected to meet the indications in MPS policy as well as procedure. As provided by Sigalet, Donnon & Grant, (2015), if the physician ordered for the RT, MPS will also be performed to assess the supplemental oxygen required as well as the need for pulmonary rehabilitation. However, when physician orders for non-protocol pulmonary RT, a courtesy call must be made to a pulmonary physician before making any adjustments on RT.

Change of Procedure:

The RT protocol will be primarily based on the old practices that have been applied in recent incidences. However, there are slight changes that have been made in chart review, physical assessment, and evaluation for therapy. During chart review, oxygen will be considered a medication and will be included in home medication unless advised otherwise by the physician.  The patent will also be required to provide details such as chief history and pulmonary history before admission. Physical assessment currently as presented by Sigalet, Donnon & Grant, (2015) should include apparent hypoxemia as well as acute hypercarbia test. The initial evaluation for therapy will be accompanied by re-evaluation if critical changes are witnessed during clinical status.

Indication:

Administering of RT will be based on the presence of the signs and symptoms concerning clinical assessment warrant listed under the RT modalities. The RT protocols will be only provided when ordered by the physician.

Contradictions:

There are also changes in contradiction section that workers in RT department are expected to note. The absence of vital details required during therapy, the patient must send back for further evaluation by either protocol or non-protocol physician.

The changes focus on improving the quality of care in the respiratory therapy department. Therefore, we encourage you to take note and incorporate them in your in the previous protocol.

The changes must be incorporated before 2nd February 2018. Disciplinary action may be taken to the practitioners who violate the deadline.

If you have any questions, feel free to contact [email/phone] for further explanation.  

References

Pinciroli, R., Mietto, C., & Berra, L. (2013). Respiratory therapy device modifications to prevent ventilator-associated pneumonia. Current opinion in infectious diseases, 26(2), 175-183.

Sigalet, E. L., Donnon, T. L., & Grant, V. (2015). Insight into team competence in medical, nursing and respiratory therapy students. Journal of interprofessional care, 29(1), 62-67.