Resp Care
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Review Comparative Study
Novel strategies for delivering oxygen: reservoir cannula, demand flow, and transtracheal oxygen administration.
Oxygen-conserving devices can decrease costs because less oxygen is used. However, they may also add costs due to the more complex equipment involved (ie, device and catheter replacement). Oxygen is relatively expensive. ⋯ By promoting mobility and improving adherence to continuous oxygen therapy, oxygen-conserving systems may increase the amount of oxygen used, thus offsetting savings. It is shortsighted to focus only on reducing the costs of oxygen administration. Attention also needs to be directed to patient outcomes such as functional status, use of healthcare services, and quality of life.
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Healthcare policymakers, governmental and private alike, are now faced with an enormous challenge. Demands for improved access to cost-effective and high quality healthcare are emanating from all segments of our society. Clearly, the traditional model of admitting patients to an acute care hospital as a first-line intervention is losing favor. ⋯ Home respiratory equipment and supplies, while an important component of managing chronic respiratory disease, are only effective if used safely, properly, and in compliance with the prescribing physician's intentions. The use of skilled and dedicated home respiratory therapists to train patients, monitor and assess outcomes, and communicate with the prescribing physician ensures optimum results. It is time for reimbursement policies to recognize this vital role played by home respiratory therapists.
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Checking and maintaining mechanical ventilators traditionally have been the responsibility of the respiratory care practitioner and among the many reasons that the need for the profession of respiratory care persists. The increasing complexity of the mechanical ventilator itself and the appropriate application and monitoring of the various modes available in a single device are such reasons. ⋯ The perception of an institution's need for trained respiratory care specialists is affected by both the quality and quantity of service that each individual RCP offers to the care of patients. Our skills and performance should be patient-centered not device-centered so that our assessment and monitoring of patients includes more than just "writing down the numbers." Finally, respiratory care research must continue to subject the old dogma to rigorous scrutiny while searching for new and innovative ways to care for our patients.
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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.