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Year : 2015  |  Volume : 3  |  Issue : 2  |  Page : 182-183

The implementation of protocols in the respiratory care profession: To what extent do they enhance patient care?


Department of Respiratory Care, College of Applied Medical Sciences, University of Dammam, Kingdom of Saudi Arabia

Date of Web Publication6-May-2015

Correspondence Address:
Saja A Al-Marshad
P.O. Box 3893, Dhahran 31311
Kingdom of Saudi Arabia
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DOI: 10.4103/1658-631X.156443

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How to cite this article:
Al-Marshad SA. The implementation of protocols in the respiratory care profession: To what extent do they enhance patient care?. Saudi J Med Med Sci 2015;3:182-3

How to cite this URL:
Al-Marshad SA. The implementation of protocols in the respiratory care profession: To what extent do they enhance patient care?. Saudi J Med Med Sci [serial online] 2015 [cited 2022 Jan 20];3:182-3. Available from: https://www.sjmms.net/text.asp?2015/3/2/182/156443

The profession of respiratory care (RC) is defined as a "health care discipline that specializes in the promotion of optimum cardiopulmonary function and health." [1] Respiratory therapists (RTs) started 80 years ago as oxygen technicians. At that time, their scope of practice was limited to: handling oxygen cylinders and initiating oxygen therapy as they were being trained on the job. The practice remained the same until the 40s and 50s of the last century when short professional training programs were initiated. [2] The respiratory profession has advanced a great deal since then. Currently, it involves numerous branches of critical care and cardiopulmonary medicine. Moreover, RTs are now obliged to apply their skills and knowledge directly to patient's care, specifically focusing on cardiopulmonary compromised patients. They are taught and trained to perform a variety of procedures for both critical and noncritical patients. These include, oxygen therapy, airway management, and mechanical ventilation. [3]

However, in any relatively new medical profession such as RC, the scope of practice should be regulated and managed with a manual on policies and procedures, rules, regulations and protocols. Previous studies have indicated that these respiratory medical protocols have yielded many advantages that have enhanced patient care. [4] More specifically, utilization of the resources of RC is one of the positive outcomes reported in the literature on account of the implementation of the respiratory protocols. [5] Medical protocols are usually based on the clinical practice guidelines (CPG) which can be defined as: "Systematically developed statements to assist practitioners" decisions about appropriate health care for specific clinical circumstances'. [6] Usually, a lot of attention is given to RC protocols and are adapted by organizations such as the American Association for Respiratory Care (AARC). It is our view that it is necessary to discuss the advantages and disadvantages of the protocols for patients, therapists as well as the profession itself.

Medical protocols are of great value in many hospitals, and are being used more and more frequently by most of the hospital departments to facilitate patient care. It is becoming increasingly difficult to ignore the advantages of their implementation in the everyday practice to establish standardized health care. In recent years, interest in the development and establishment of new protocols for every procedure in medicine has increased and since RC is a relatively new profession, the importance of professional development is even greater. Besides, the AARC has produced a list of CPGs that have been used by most RC departments to formulate their own protocols. Moreover, the advantages of developing and implementing respiratory protocols are well documented in research. This not only enhances patient care but also makes possible the judicious use of available hospital resources so that treatments are only initiated when indicated. [6] Previously, physician-based protocols were followed. That meant once a procedure was ordered by the physician, the RTs had to initiate the therapy regardless of their own assessment of the patient. The result was that the RTs were marginalized, since their assessment of the situation was not taken into consideration, leading sometimes to a waste of the hospital's resources as well as the RTs time and effort, if the treatment was not indicated.

Furthermore, protocol is a valuable tool in critical care where most RTs work. For instance, the protocol for weaning from mechanical ventilation was found to both reduce intensive care unit (ICU) stay, as well as prevent a variety of complications associated with long patient stay in the ICU.

Moreover, implementation of protocols has major advantages for the RT. It facilitates progress of work and controls the subjectivity of the therapists. It also allows them the freedom to establish evidenced-based care plan for their patients. In addition, it organizes the work and helps keep track of the patients who are under the care of the department. Follow-up of patient care is even more important than initiating the therapy. The entire process is impossible without proper follow-up with the use of protocols.

In conclusion, protocols are a very important part of medical practice. It is used to arrange and organize departmental procedures and scope of practice. Respiratory protocols are currently being developed and established by respiratory departments in many institutions all over the world. Research has shown that they enhance patient care and support careful utilization of medical services, and save therapists time and effort. Indeed, the movement to protocol based RC is helpful in controlling inappropriate use of the hospital resources. However, there are drawbacks to the process of protocol formulation for they are not easy to standardized because of the disparity of resources available to the different institutions.

 
  References Top

1.
American Association for Respiratory Care (AARC) (2009), Definition of Respiratory Care. Available from: http://www.aarc.org. [Last accessed on 2012 Sep 2].  Back to cited text no. 1
    
2.
Kacmarek RM, Durbin CG, Barnes TA, Kageler WV, Walton JR, O'Neil EH. Creating a vision for respiratory care in 2015 and beyond. Respir Care 2009;54:375-89.  Back to cited text no. 2
    
3.
Pierson JD. A decade of challenge and progress. Respir Care 2007;52:1680-5.  Back to cited text no. 3
    
4.
Stoller JK, Hoisington ER, Lemin ME, Karol JA, Chatburn RL, Mascha EJ, et al. Concordance of respiratory care plans generated by protocols from different hospitals: A comparative study. Respir Care 2007;52:1006-12.  Back to cited text no. 4
    
5.
Jerome HG, Field MJ. Clinical Practice Guidelines: Directions for a New Program. Washington, DC: The National Academies Press; 1990.  Back to cited text no. 5
    
6.
Stoller JK. The effectiveness of respiratory care protocols. Respir Care 2004;49:761-5.  Back to cited text no. 6
    




 

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