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Impact of a Mechanical Ventilation Curriculum on Respiratory Therapist Recognition of Patient-Ventilator Asynchrony.

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Citation: Respiratory Care. 67(12):1597-1602, 2022 Dec.PMID: 36318981Institution: MedStar Washington Hospital CenterDepartment: Respiratory TherapyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Respiration, Artificial | *Ventilators, Mechanical | Curriculum | HumansYear: 2022 Local holdings: Available online from MWHC library: 2003 - 2008, Available in print through MWHC library: 1999 - 2008ISSN:

0020-1324

Name of journal: Respiratory careAbstract: BACKGROUND: Respiratory therapists (RTs) play a crucial role in managing mechanically ventilated patients, such as addressing patient-ventilator asynchronies that may contribute to patient harm. Waveform analysis is integral to the evaluation of patient-ventilator asynchronies; despite this, no published studies have assessed the ability of practicing RTs to interpret ventilator waveform abnormalities.CONCLUSIONS: RTs may benefit from additional training in ventilator waveform interpretation, especially early in their clinical training. More work is needed to determine the optimal length and content of a mechanical ventilation curriculum for RTs. Copyright © 2022 by Daedalus Enterprises.METHODS: The study took place between June 2017-February 2019. Eighty-six RTs from 2 academic medical centers enrolled in a one-day mechanical ventilation course. The scores of 79 first-time attendees were included in the analysis. Prior to and following the course, RTs were asked to identify abnormalities on a 5-question, multiple-choice ventilator waveform exam. They were also asked to provide a self-assessment of their ventilator management skills on a 1 (complete novice) to 5 (expert) scale.RESULTS: Initial scores were low but improved after one day of ventilator instruction (19.4 +/- 17.1 vs 29.6 +/- 19.0, P < .001). No significant difference was noted in mean confidence levels between the pre- and post-course assessments (3.8 +/- 0.9 vs 3.8 +/- 1.0, P = .56). RTs with fewer years of clinical experience (0-10 y) had a statistically significant improvement in their post-course test scores relative to their pre-course scores (0-5 y: 12.5 +/- 10.1 to 46.0 +/- 10.8, P < .001; 6-10 y: 18.7 +/- 15.8 to 32.1 +/- 16.7, P = .02), whereas those with > 11 y of clinical experience did not (11-20 y: 22.4 +/- 15.5 to 27.4 +/- 19.0, P = .44; 21+ y: 19.6 +/- 22.1 to 15.3 +/- 13.8, P = .50).All authors: Acho M, Chatterjee S, Kriner E, Lee BW, Sartain NN, Seam N, Sun JFiscal year: FY2023 Digital Object Identifier:

https://dx.doi.org/10.4187/respcare.09903

Date added to catalog: 2022-12-13

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	36318981	Available		36318981

Available online from MWHC library: 2003 - 2008, Available in print through MWHC library: 1999 - 2008

BACKGROUND: Respiratory therapists (RTs) play a crucial role in managing mechanically ventilated patients, such as addressing patient-ventilator asynchronies that may contribute to patient harm. Waveform analysis is integral to the evaluation of patient-ventilator asynchronies; despite this, no published studies have assessed the ability of practicing RTs to interpret ventilator waveform abnormalities.

CONCLUSIONS: RTs may benefit from additional training in ventilator waveform interpretation, especially early in their clinical training. More work is needed to determine the optimal length and content of a mechanical ventilation curriculum for RTs. Copyright © 2022 by Daedalus Enterprises.

METHODS: The study took place between June 2017-February 2019. Eighty-six RTs from 2 academic medical centers enrolled in a one-day mechanical ventilation course. The scores of 79 first-time attendees were included in the analysis. Prior to and following the course, RTs were asked to identify abnormalities on a 5-question, multiple-choice ventilator waveform exam. They were also asked to provide a self-assessment of their ventilator management skills on a 1 (complete novice) to 5 (expert) scale.

RESULTS: Initial scores were low but improved after one day of ventilator instruction (19.4 +/- 17.1 vs 29.6 +/- 19.0, P < .001). No significant difference was noted in mean confidence levels between the pre- and post-course assessments (3.8 +/- 0.9 vs 3.8 +/- 1.0, P = .56). RTs with fewer years of clinical experience (0-10 y) had a statistically significant improvement in their post-course test scores relative to their pre-course scores (0-5 y: 12.5 +/- 10.1 to 46.0 +/- 10.8, P < .001; 6-10 y: 18.7 +/- 15.8 to 32.1 +/- 16.7, P = .02), whereas those with > 11 y of clinical experience did not (11-20 y: 22.4 +/- 15.5 to 27.4 +/- 19.0, P = .44; 21+ y: 19.6 +/- 22.1 to 15.3 +/- 13.8, P = .50).

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