Quality in the practice of respiratory care encompasses what?
It encompasses the personnel who perform respiratory care, the equipment used, and the method or manner in which care is provided
Who is professionally responsible for the clinical function of the respiratory care department?
What is the most essential aspect of providing quality respiratory care?
To ensure that the care being provided is indicated and that it is delivered competently and appropriately
What is the chief reason that respiratory care protocols were developed and are currently being used in hospitals throughout North America?
Which of the following factors is important in determining the quality of care delivered by respiratory therapist?
Training, education, experience and professionalism
For the CRT credential what does the T stand for
Hospitality care dictation programs are reviewed by which committee to ensure quality?
Committee on accreditation for respiratory care (CoARC)
The word credentialing in general refers to what?
Refers to the recognition of individuals in particular occupations or professions
What terms used to describe the process in which a government agency gives an individual permission to practice an occupation
what agencies responsible for ensuring quality in respiratory care through voluntary certification and registration
What organization is responsible for credentialing respiratory therapists
National board for respiratory care (NBRC)
HIPPA was established in 1996 to set standards related to sharing confidential health history information about patients what does the P stand for
Responsibility for the technical direction of the respiratory care department lies with whom
The manager of the respiratory care department
Which of the following is the key element respiratory care protocol program
Delivering appropriate treatments and services that are indicated,delivered by the correct method
Which of the following is an essential element of a comprehensive protocol program
Respiratory therapy consult service
What voluntary accrediting agency monitors quality in respiratory care departments
The Joint Commission (TJC)
Current JCAHO standards for accreditation emphasize which of the following
Organization wide efforts to continuous quality improvement (CQI)
To monitor correctness of respiratory care plans, which of the following should be used
Respiratory care plans may be monitored by the following
Therapists who are experienced in providing respiratory care and patient assessment
What system has the federal government developed to evaluate the quality of care given to Medicare beneficiaries
Peer review organization (PRO)
The effectiveness of the patient-focused care model has been limited by which one of the following
Decentralizing equipment, extensive cross-training
What is one advantage that has been shown of respiratory care protocols
Avoid delivering services to patients not likely to benefit
What term is used in current health care that refers to an organized strategy of delivering care to a large group of individuals
Treatment based on careful review of available literature is known as
What term is used to describe the work done by a researcher who reviews numerous studies on a topic and gives more weight to the more rigorous ones before making recommendations
TABLE 2-1
Frequency of Misallocation of Respiratory Care Services in Selected Series
Type of Service | Author | Date | Patient Type | No. Patients | Frequency of Overordering | Frequency of Underordering |
Supplemental oxygen | Zibrak et al6 | 1986 | Adults | NS | 55% reduction in incentive spirometry after therapist supervision began | NA |
Brougher et al7 | 1986 | Adult, non-ICU inpatients | 77 | 38% ordered to receive oxygen despite adequate oxygenation | NA | |
Small et al8 | 1992 | Adult, non-ICU inpatients | 47 | 72% of patients checked had PaO2 > 60 mm Hg or SaO2 > 90% but were prescribed oxygen | NA | |
Kester and Stoller3 | 1992 | Adult, non-ICU inpatients | 230 | 28% for supplemental oxygen | 8% for supplemental oxygen | |
Albin et al9 | 1992 | Adult, non-ICU inpatients | 274 | 61% ordered to receive supplemental oxygen despite SaO2 ≥ 92% | 21% underordered, including 19% prescribed to receive inadequate O2 flow rates | |
Shelledy et al12 | 2004 | Adults | 75 | 0 | 5.3% indicated but not ordered | |
Bronchial hygiene techniques | Zibrak et al6 | 1986 | Adults | NS | 55% reduction in incentive spirometry after therapist supervision began | NA |
Shapiro et al10 | 1988 | Adult, non-ICU inpatients | 3400 evaluations | 61% reduction of bronchial hygiene after system implemented | NA | |
Kester and Stoller3 | 1992 | Adult, non-ICU inpatients | 230 | 32% | 8% | |
Shelledy et al12 | 2004 | Adults | 75 | 37.5% | 8% | |
Bronchodilator therapy | Zibrak et al6 | 1986 | Adults | NS | 50% reduction in incentive aerosolized medication after therapist supervision began | NA |
Kester and Stoller3 | 1992 | Adult, non-ICU inpatients | 230 | 12% | 12% | |
Shelledy et al12 | 2004 | Adults | 75 | 34.4% | 5.3% | |
Kester and Stoller3 | 1992 | Adult, non-ICU inpatient | 230 | 40% | 6.7% | |
ABGs | Browning et al11 | 1989 | Surgical ICU inpatients | 724 ABGs | 42.7% inappropriately ordered before guidelines implemented | NA |
NS, Not stated; NA, not assessed.
Modified from Stoller JK: The rationale for therapist-driven protocols. Respir Care Clin N Am 2:1–14, 1996.