Resp Care
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Prefilled disposable oxygen humidification units have been shown to decrease the likelihood of contamination when compared to reusable oxygen humidification units. However, prefilled disposable humidifiers are expensive when used for single patients, especially in areas of high turnover, and it is not known whether these units need to be routinely changed before they are empty. The number of patients safely using a prefilled disposable humidifier has not been documented in previously reported work. Are patients at risk of nosocomial infections due to cross-contamination when prefilled disposable oxygen humidifiers are applied to multi-patient use? What are the cost benefits of multiple patient use of prefilled disposable oxygen humidifiers? When local practice or physician preference dictates the use of humidification for low-flow oxygen, these questions need to be answered. ⋯ Our results show that prefilled disposable oxygen humidifiers can be used without cross-contamination, on multiple patients, for a period of 1 month. The use of prefilled humidifiers in this way represents a substantial cost saving when compared to reusable humidifiers.
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We conducted this study to determine the inspiratory and expiratory flow resistance of the valves of eight commercially available mouth-to-mask ventilation devices. ⋯ In some cases, the resistance through these devices might be considered excessive; however, most of the devices meet the International Standards Organization (ISO) standard (back pressure < 5 cm H2O at 50 L/min).
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Respiratory care as an organized discipline is only about 45 years old, and the management of this dynamic allied health profession has usually been characterized by a demand-for-service mentality. As pressure continues to control costs, those departments that maximize quality patient care cost-effectively with thoroughly documented outcomes are in a better position to compete for future resources. The practice of respiratory care is changing as is the practice of medical care in general. ⋯ We have developed and implemented a comprehensive patient-data-based approach to the management of respiratory care. The essential elements of this approach are (1) relative-value-unit procedure base; (2) individual, shift, and department productivity that is attached to the annual performance review process; (3) management reporting on a 24-hour basis, with biweekly review at the management level; (4) development and implementation of a comprehensive patient-data-documentation system that permits automatic patient billing and 100% data review for quality-assurance documentation; (5) the development of a medical alerting system that alerts the Medical Director and Respiratory Care staff to potentially harmful events that, if untreated, may result in increased morbidity or mortality; and (6) the development of concurrent and retrospective tools for patient-outcomes research. These functions are supported by an active Medical Informatics Department that is nationally recognized in medical computing and logic application.
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At present, the principal advantage of computer-assisted quality assurance is the acquisition of quality assurance date without resource-consuming chart reviews. A surveillance program like the medical director's alert may reduce morbidity and mortality. Previous research suggests that inadequate oxygen therapy or failures in airway management are important causes of preventable deaths in hospitals. ⋯ The immediate needs of patients are addressed through a daily surveillance system (medical director's alert). The departmental quality assurance program utilizes a separate program that monitors clinical indicators of staff performance in terms of stated departmental policies and procedures (rate-based clinical indicators). The availability of an integrated patient database allows these functions to be performed without labor-intensive chart audits.