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Research ArticleOriginal Research

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

Megan Acho, Eric Kriner, Nicole N Sartain, Souvik Chatterjee, Junfeng Sun, Burton W Lee and Nitin Seam
Respiratory Care November 2022, respcare.09903; DOI: https://doi.org/10.4187/respcare.09903
Megan Acho
Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
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  • For correspondence: [email protected]
Eric Kriner
Respiratory Care Division, MedStar Washington Hospital Center, Washington, District of Columbia.
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Nicole N Sartain
Department of Critical Care Medicine, National Institutes of Health, Bethesda, Maryland.
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Souvik Chatterjee
Division of Pulmonary and Critical Care, Johns Hopkins University, Baltimore, Maryland.
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Junfeng Sun
Department of Critical Care Medicine, National Institutes of Health, Bethesda, Maryland.
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Burton W Lee
Department of Critical Care Medicine, National Institutes of Health, Bethesda, Maryland.
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Nitin Seam
Department of Critical Care Medicine, National Institutes of Health, Bethesda, Maryland.
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Abstract

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.

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).

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.

  • mechanical ventilation
  • waveform analysis
  • health professions education

Footnotes

  • Correspondence: Megan Acho MD. E-mail: achom{at}med.umich.edu
  • Copyright © 2022 by Daedalus Enterprises

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Respiratory Care: 68 (2)
Respiratory Care
Vol. 68, Issue 2
1 Feb 2023
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Impact of a Mechanical Ventilation Curriculum on Respiratory Therapist Recognition of Patient-Ventilator Asynchrony
Megan Acho, Eric Kriner, Nicole N Sartain, Souvik Chatterjee, Junfeng Sun, Burton W Lee, Nitin Seam
Respiratory Care Nov 2022, respcare.09903; DOI: 10.4187/respcare.09903

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Impact of a Mechanical Ventilation Curriculum on Respiratory Therapist Recognition of Patient-Ventilator Asynchrony
Megan Acho, Eric Kriner, Nicole N Sartain, Souvik Chatterjee, Junfeng Sun, Burton W Lee, Nitin Seam
Respiratory Care Nov 2022, respcare.09903; DOI: 10.4187/respcare.09903
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  • mechanical ventilation
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  • health professions education

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