Resp Care
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During the months of July, August, and September 1993, we implemented a respiratory care assessment-treatment pilot study on the orthopedic surgery floor in our hospital. The purpose of the study was to determine feasibility and establish cost-effective treatment plans with quality patient outcomes, while maintaining appropriate communications with physicians and nursing staff. ⋯ The use of respiratory care protocols is an acceptable method of developing clinically effective and fiscally responsible care plans. RCPs at our hospital were able to implement care plans that resulted in cost savings without a measured change in patient outcomes. Approval has been extended from the Executive Committee of the medical staff to expand hospital-wide.
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The effectiveness of collaborative self-management of respiratory disorders has been most clearly demonstrated in asthma. In both adults and children with severe asthma requiring emergency care and hospitalizations, collaborative self-management can decrease not only the need for emergency care and hospitalization but also time lost from work and school, thereby increasing the patients' ability to be full and active participants in the community. Collaborative self-management is best provided in a comprehensive program that includes ready access to healthcare professionals, education, behavioral therapy, and peak-flow monitoring. ⋯ Even if medical investigations had not demonstrated any beneficial effects of collaborative self-management, patients have the right to participate in decisions affecting their healthcare and are increasingly exercising that right. Respiratory care practitioners are in a unique position to enhance collaborative self-management. In the home environment, RCPs can foster smoking cessation and serve as a liaison between patients and physicians.(ABSTRACT TRUNCATED AT 400 WORDS)
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Review Comparative Study
Center-based vs patient-based diagnosis and therapy of sleep-related respiratory disorders and the role of the respiratory care practitioner.
Unlike center-based laboratories that follow prescribed technical standards, patient-based studies lack technical standardization. Whereas center-based studies are usually performed by technicians who have met certain professional criteria, patient-based studies can be performed by anyone, even those without clinical training. Although guidelines are currently being developed to direct the use of unattended monitoring in the home, a need exists for specific guidelines that delineate professional qualifications for those who initiate and titrate therapy for patients with sleep-related respiratory disorders. ⋯ A need exists for multicenter, peer-reviewed, controlled studies to establish standard recording variables and machine specifications for unattended monitoring devices. Also, the role and cost-benefit ratio of unattended monitoring in healthcare delivery need to be defined. Therefore, with the demand for technology-oriented research, clinical outcome studies, and professional standards, more respiratory care practitioners have the opportunity to expand their practice into the field of sleep medicine.