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Bai X, Wan Z, Tang J, Zhang D, Shen K, Wu X, Qiao L, Zhou Y, Wang Y, Cheng W, Jiang W, Wang L, Tian X. The prevalence of burnout among pulmonologists or respiratory therapists pre- and post-COVID-19: a systematic review and meta-analysis. Ann Med 2023; 55:2234392. [PMID: 37459584 DOI: 10.1080/07853890.2023.2234392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVES The coronavirus disease-19 (COVID-19) increased the already heavy workload in the pulmonary and respiratory departments, which therefore possibly increased the prevalence of burnout among pulmonologists or respiratory therapists. We aimed to compare the differences in burnout among pulmonologists or respiratory therapists pre- and post-COVID-19 by doing a systematic review with meta-analysis. METHODS We searched pulmonologist, or pulmonary, or respiratory, and burnout up to 29 January 2023 in six databases. We included studies investigating pulmonologists or respiratory therapists and reporting the prevalence of burnout among them. The risk of bias was assessed by a tool for prevalence studies. The overall prevalence of burnout was pooled. RESULTS A total of 2859 records were identified and 16 studies were included in the final analysis. The included studies reported 3610 responding individuals and 2336 burnouts. The pooled prevalence of burnout was 61.7% (95% confidence interval (CI), 48.6-73.2%; I2 = 96.3%). The pooled prevalence of burnout during COVID-19 was significantly higher than it was prior to the outbreak (68.4% vs. 41.6%, p = .01). The result of the meta-regression revealed that COVID-19 coverage was significantly associated with the prevalence of burnout (p = .04). CONCLUSIONS Burnout was widely prevalent among pulmonologists or respiratory therapists and increasingly perceived during COVID-19. Therefore, interventions were needed to reduce burnout in this specialty.KEY MESSASGESThe coronavirus disease-19 increased the already heavy workload in the pulmonary and respiratory departments.Burnout was widely prevalent among pulmonologists or respiratory therapists and increasingly perceived during COVID-19.
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Affiliation(s)
- Xiaoyin Bai
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ziqi Wan
- Eight-Year Program, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jieying Tang
- Department of Surgery, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Dingding Zhang
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kaini Shen
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xia Wu
- Department of Medicine, Tufts Medical Center, Boston, MA, USA
| | - Lin Qiao
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yangzhong Zhou
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yaqi Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Cheng
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Jiang
- Department of Medical Intensive Care Unit, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Luo Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xinlun Tian
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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D'Alessandro-Lowe AM, Ritchie K, Brown A, Easterbrook B, Xue Y, Pichtikova M, Altman M, Beech I, Millman H, Foster F, Hassall K, Levy Y, Streiner DL, Hosseiny F, Rodrigues S, Heber A, O'Connor C, Schielke H, Malain A, McCabe RE, Lanius RA, McKinnon MC. Canadian respiratory therapists who considered leaving their clinical position experienced elevated moral distress and adverse psychological and functional outcomes during the COVID-19 pandemic. Health Promot Chronic Dis Prev Can 2023; 43:460-471. [PMID: 37991889 PMCID: PMC10753904 DOI: 10.24095/hpcdp.43.10/11.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Respiratory therapists (RTs) faced morally distressing situations throughout the COVID-19 pandemic, including working with limited resources and facilitating video calls for families of dying patients. Moral distress is associated with a host of adverse psychological and functional outcomes (e.g. depression, anxiety, symptoms of posttraumatic stress disorder [PTSD] and functional impairment) and consideration of position departure. The purpose of this study was to understand the impact of moral distress and its associated psychological and functional outcomes on consideration to leave a clinical position among Canadian RTs during the COVID-19 pandemic. METHODS Canadian RTs (N = 213) completed an online survey between February and June 2021. Basic demographic information (e.g. age, sex, gender) and psychometrically validated measures of moral distress, depression, anxiety, stress, PTSD, dissociation, functional impairment, resilience and adverse childhood experiences were collected. RESULTS One in four RTs reported considering leaving their position. RTs considering leaving reported elevated levels of moral distress and adverse psychological and functional outcomes compared to RTs not considering leaving. Over half (54.5%) of those considering leaving scored above the cut-off for potential diagnosis of PTSD. Previous consideration to leave a position and having left a position in the past each significantly increased the odds of currently considering leaving, along with system-related moral distress and symptoms of PTSD, but the contribution of these latter factors was small. CONCLUSIONS Canadian RTs considering leaving their position reported elevated levels of distress and adverse psychological and functional outcomes, yet these individual-level factors appear unlikely to be the primary factors underlying RTs' consideration to leave, because their effects were small. Further research is required to identify broader, organizational factors that may contribute to consideration of position departure among Canadian RTs.
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Affiliation(s)
| | - Kimberly Ritchie
- McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
| | | | | | - Yuanxin Xue
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Mina Pichtikova
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Max Altman
- McMaster University, Hamilton, Ontario, Canada
| | - Isaac Beech
- McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
| | | | - Fatima Foster
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Kelly Hassall
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Yarden Levy
- McMaster University, Hamilton, Ontario, Canada
| | - David L Streiner
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Fardous Hosseiny
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
- Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, Ontario, Canada
| | - Sara Rodrigues
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
- Institute of Mental Health Research at the Royal, University of Ottawa, Ottawa, Ontario, Canada
| | - Alexandra Heber
- McMaster University, Hamilton, Ontario, Canada
- Veterans Affairs Canada, Ottawa, Ontario, Canada
| | | | | | - Ann Malain
- Homewood Health Centre, Guelph, Ontario, Canada
| | - Randi E McCabe
- McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Ruth A Lanius
- Homewood Research Institute, Guelph, Ontario, Canada
- University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Margaret C McKinnon
- McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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Allender EA, Bottema SM, Bosley CL, Holst SJ, Clark WJ, Weaver AL, Rivera-Chiauzzi EY, Finney RE. Use of the Revised Second Victim Experience and Support Tool to Examine Second Victim Experiences of Respiratory Therapists. Respir Care 2023; 68:749-759. [PMID: 37041030 DOI: 10.4187/respcare.10719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
BACKGROUND Respiratory therapists (RTs) work alongside allied health staff, nurses, and physicians during stressful and traumatic events that can be associated with emotional and physiological implications known as second victim (SV) experiences (SVEs). This study aimed to evaluate SVEs of RTs, including both positive and negative implications. METHODS RTs within a large academic health care organization across Minnesota, Wisconsin, Florida, and Arizona were asked to participate in an anonymous survey that included the validated Second Victim Experience and Support Tool-Revised to assess SVEs as well as desired support services. RESULTS Of the RTs invited to participate, 30.8% (171/555) completed the survey. Of the 171 survey respondents, 91.2% (156) reported that they had been part of a stressful or traumatic work-related event as an RT, student, or department support staff member. Emotional or physiologic implications experienced by respondents as SVs included anxiety 39.1% (61/156), reliving of the event 36.5% (57/156), sleeplessness 32.1% (50/156), and guilt 28.2% (44/156). Following a stressful clinical event, 14.8% (22/149) experienced psychological distress, 14.2% (21/148) experienced physical distress, 17.7% (26/147) indicated lack of institutional support, and 15.6% (23/147) indicated turnover intentions. Enhanced resilience and growth were reported by 9.5% (14/147). Clinical and non-clinical events were reported as possible triggers for SVEs. Nearly half of respondents 49.4% (77/156) indicated feeling like an SV due to events related to COVID-19. Peer support was the highest ranked form of desired support following an SVE by 57.7% (90/156). CONCLUSIONS RTs are involved in stressful or traumatic clinical events, resulting in psychological/physical distress and turnover intentions. The COVID-19 pandemic has had a significant impact on RTs' SVEs, highlighting the importance of addressing the SV phenomenon among this population.
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Affiliation(s)
- Erica A Allender
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Sophia M Bottema
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Christopher L Bosley
- Department of Anesthesiology and Perioperative Medicine-Respiratory Care, Mayo Clinic, Rochester, Minnesota
| | - Stephanie J Holst
- Department of Anesthesiology and Perioperative Medicine-Respiratory Care, Mayo Clinic, Rochester, Minnesota
| | - William J Clark
- Department of Anesthesiology and Perioperative Medicine-Respiratory Care, Mayo Clinic, Rochester, Minnesota
| | - Amy L Weaver
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota
| | | | - Robyn E Finney
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
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Al Nufaiei ZF, Alluhibi RH, Almoshaigeh SN, Alzahrani RM, Baaqeel WO, Al Zhranei RM, Al-Shareef AS, Zipp GP. The experience of Saudi respiratory therapists dealing with COVID-19 patients: A qualitative study. J Educ Health Promot 2023; 12:47. [PMID: 37113431 PMCID: PMC10127490 DOI: 10.4103/jehp.jehp_328_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 11/11/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND Healthcare professionals have fought hard to restrain the COVID-19 pandemic by providing high-quality care for their infected patients, but in doing so they have developed fears of becoming sick and feelings of isolation and loneliness. The lived experience of respiratory therapists (RTs) in Saudi Arabia who works with these infected patients needs further investigation. The study sought to describe the experiences and coping strategies of Saudi RT managing patients with COVID-19. MATERIALS AND METHODS The study utilized qualitative research methods, specifically employing a phenomenological research design. A total of 25 Saudi RT (RTs) who were in direct contact with COVID-19 patients were selected after they agreed to participate in this study. The study followed a one-on-one semi-structured interview process using the Zoom platform. This qualitative data collection technique focuses on the participants' lived experiences and feelings to discover shared patterns. The data were analyzed via an inductive approach. RESULTS Six themes were found in the RT perceptions including stress while treating COVID patients, managing the fear of catching of Covid 19, feelings towards COVID-19 patients, challenges faced by female RTs, workplace experiences, and excessive workload. CONCLUSIONS RTs feelings dramatically changed throughout the COVID-19 pandemic. All the RTs have developed a self-copying style that has helped them improve their psychosocial behavior to face the pandemic. During the outbreak, frontline RTs' positive and negative emotions intertwined and coexisted. Negative emotions predominated in the beginning, while good feelings emerged gradually. Self-coping methods and psychosocial development were significant factors in RTs mental health while caring for COVID-19 patients.
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Affiliation(s)
- Ziyad F. Al Nufaiei
- Respiratory Therapy Department, College of Applied Medical Sciences-Jeddah, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Research Office, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Reem H. Alluhibi
- Respiratory Therapy Department, College of Applied Medical Sciences-Jeddah, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Research Office, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Sama N. Almoshaigeh
- Respiratory Therapy Department, College of Applied Medical Sciences-Jeddah, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Research Office, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Raghad M. Alzahrani
- Respiratory Therapy Department, College of Applied Medical Sciences-Jeddah, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Research Office, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Wed O. Baaqeel
- Respiratory Therapy Department, College of Applied Medical Sciences-Jeddah, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Research Office, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Raid M. Al Zhranei
- Respiratory Therapy Department, College of Applied Medical Sciences-Jeddah, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Research Office, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Ali S. Al-Shareef
- Respiratory Therapy Department, College of Applied Medical Sciences-Jeddah, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Research Office, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia
| | - Genevieve P. Zipp
- Department of Interprofessional Health Sciences and Health Administration, Director, Center for Interprofessional Education in Health Sciences, GEM Fellow, Praxis Program of the Advanced Seminar on Mission, Center for Vocation and Servant, Leadership and The Center for Catholic Studies, Bernard J. Lonergan Institute 123 Metro Boulevard/Room 0432/Nutley, NJ 07110, USA
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Milo RB, Gómez E, Suarez C, Calero P, Connelly CD. Nurses and Respiratory Therapists Lived Experience During COVID-19 Pandemic: A Qualitative Study. SAGE Open Nurs 2023; 9:23779608231196843. [PMID: 37675150 PMCID: PMC10478530 DOI: 10.1177/23779608231196843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/23/2023] [Accepted: 08/05/2023] [Indexed: 09/08/2023] Open
Abstract
Introduction Nurses and respiratory therapists working on the frontline during the pandemic surge were short-staffed and worked extended hours while adding new tasks to already demanding workloads. As the world watched news covering COVID-19's effect, nurses and respiratory therapists lived through the daily stress of treating each patient with care, dignity, and compassion. Limited studies have focused on this population, which is vital to providing care and saving lives; research is needed to understand nurses' and respiratory therapists' experiences during the COVID-19 pandemic. Objective The study aimed to understand nurses' and respiratory therapists' experiences during the COVID-19 pandemic. Methods A qualitative descriptive study, informed by naturalistic philosophy, was designed to obtain a detailed account of participants' experiences during the pandemic surge. A purposive sample was recruited and enrolled from the community through professional organizations and snowball sampling from December 2021 to September 2022. Data was analyzed using thematic analysis. Results Participants were seven registered nurses and six respiratory therapists employed full-time in an intensive care unit, step-down intensive care unit, emergency department, or medical-surgical unit; seven (53.8%) with an associate degree, and six (46.2%) with a bachelor's degree. Eight (66.7%) self-identified as White, one Asian, one non-Hispanic Black, and two Pacific Islanders. The mean age was 40, and 10 (76.9%) were female. Six primary themes emerged: (a) the work-life experience before the COVID-19 pandemic, (b) the work-life experience during the COVID-19 pandemic, (c) the personal life experience during COVID-19, (d) the coping period, (e) the professional role change, and (f) the work and personal life experiences post COVID-19 surge. Conclusion The knowledge gained from this study can help improve understanding of the professional quality of life, the need for organizational and community support, and for healthcare professionals to seek help and practice self-care to prevent burnout and secondary traumatic stress.
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Affiliation(s)
- Razel Bacuetes Milo
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, CA, USA
| | - Elvira Gómez
- California State University San Marcos, San Marcos, CA, USA
| | - Carol Suarez
- CEHHS School of Nursing, California State University San Marcos, San Marcos, CA, USA
| | - Patricia Calero
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, CA, USA
| | - Cynthia D. Connelly
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, CA, USA
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Ahmad RG, Gadah YS, Yamani RA, Almaimani BH, Alganas BM, Alsaleh A, Ahmed ME. The relationship between physical activity and burnout among respiratory therapists in Jeddah City, Saudi Arabia. Can J Respir Ther 2022; 58:204-208. [PMID: 36545462 PMCID: PMC9757124 DOI: 10.29390/cjrt-2022-029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background/objective Burnout is a condition in which a person feels physically fatigued and mentally drained. It occurs after a long period of work-related stress and may lead to mental disorders, such as depression and anxiety. Therefore, healthcare providers especially require early intervention. Regular physical activity has been reported to benefit individuals with mental illness, suggesting that a relationship between physical activity and burnout might exist. Hence, this study's objective was to analyze the relationship between physical activity and burnout among respiratory therapists and student interns in Jeddah City, Saudi Arabia. Methods A cross-sectional descriptive study with respiratory therapists and interns working in public and private hospitals was conducted from November 2, 2020, to November 27, 2020. Participants responded to an electronic survey consisting of the Maslach Burnout Inventory - Human Services Survey for Medical Personnel, which measures the burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment. They also completed the International Physical Activity Questionnaire - Long Form and a demographic questionnaire. Results Among the 250 eligible respiratory therapists and interns, data from the 152 respondents who completed the electronic survey were analyzed. Although no association between physical activity and burnout was found, a significant effect of the novel coronavirus disease 2019 (COVID-19) on physical activity and significant associations of high burnout (emotional exhaustion) with nationality and smoking were found. Conclusion No association was found between burnout level and physical activity. Confounding factors, such as the COVID-19 pandemic during the study's data collection and analyses, likely contributed to the study's findings.
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Affiliation(s)
- Rami Ghazi Ahmad
- Psychiatry Section, Medicine Department, Ministry of National Guard – Health Affairs, Jeddah, Saudi Arabia,King Abdullah International Medical Research Center, Jeddah 21423, Saudi Arabia
| | - Yaser Sabri Gadah
- King Abdullah International Medical Research Center, Jeddah 21423, Saudi Arabia,College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia,Department of Respiratory Therapy, Tabarjal General Hospital, Ministry of Health, Aljouf, Saudi Arabia
| | - Rayan Ahmed Yamani
- King Abdullah International Medical Research Center, Jeddah 21423, Saudi Arabia,College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia,Department of Respiratory Therapy, Sukoon International Extended Care Centre, Jeddah, Saudi Arabia
| | - Bakor Hashim Almaimani
- King Abdullah International Medical Research Center, Jeddah 21423, Saudi Arabia,College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Badr Mohammed Alganas
- King Abdullah International Medical Research Center, Jeddah 21423, Saudi Arabia,College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ahmad Alsaleh
- Psychiatry Section, Medicine Department, Ministry of National Guard – Health Affairs, Jeddah, Saudi Arabia,King Abdullah International Medical Research Center, Jeddah 21423, Saudi Arabia,Assistant Professor of Psychiatry, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mohamed Eldigire Ahmed
- King Abdullah International Medical Research Center, Jeddah 21423, Saudi Arabia,PhD Assistant Professor Biostatistics College of Science and Health Professions, Jeddah, Saudi Arabia
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Spirczak A, Kaur R, Vines DL. Burnout among respiratory therapists during COVID-19 pandemic. Can J Respir Ther 2022; 58:191-198. [PMID: 36514322 PMCID: PMC9718067 DOI: 10.29390/cjrt-2022-049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Respiratory therapists (RTs) faced many unpredicted challenges and higher stress levels while managing critically ill patients with the coronavirus disease (COVID-19). This study's primary objective was to evaluate the compassion satisfaction and compassion fatigue among RTs in the United States during the COVID-19 pandemic. Methods This cross-sectional, descriptive, survey-based study conducted from July 2020 to August 2020 was administered to all active members of the American Association of Respiratory Care via AARConnect. RTs' characteristics including personal, job-specific, and organizational factors were collected. Professional Quality of Life Scale (ProQOL, version 5) was used to measure compassion satisfaction and fatigue. Results A total of 218 participants fully completed the survey, 143 (65.6%) were female, 107 (49.1%) were between 35 and 54 years of age and 72 (33%) were above 55 years of age. Compassion satisfaction was moderate in 123 (56.4%) and high in 93 (42.7%) RTs. Higher compassion satisfaction was found in RTs who have a higher salary (P = 0.003), work overtime (P = 0.01), hold leadership positions (P < 0.001), work in research/education (P < 0.001) and work for departments that provide help in managing burnout and stress (P = 0.007) and that promote a positive work environment (P < 0.001). Burnout score was low in 90 (41.3%) and moderate in 127 (58.3%) RTs. Higher burnout was found among younger RTs (P = 0.019), those with fewer years of experience (P = 0.013) and those with less than a year at their current job (P = 0.045). Secondary traumatic stress (STS) was low in 106 (48.6%) and moderate in 112 (51.4%) RTs. Higher STS levels were noted among younger RTs (P = 0.02) and RTs with lower education levels (P = 0.016). Conclusion This survey study identified various personal, job and organizational related factors associated with increased compassion satisfaction as well as compassion fatigue among RTs.
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Affiliation(s)
- Anna Spirczak
- Department of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, IL, USA
| | - Ramandeep Kaur
- Department of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, IL, USA
| | - David L Vines
- Department of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, IL, USA
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Quach S, Reise K, McGregor C, Papaconstantinou E, Nonoyama ML. A Delphi Survey of Canadian Respiratory Therapists' Practice Statements on Pediatric Mechanical Ventilation. Respir Care 2022; 67:1420-1436. [PMID: 35922069 PMCID: PMC9993971 DOI: 10.4187/respcare.09886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pediatric mechanical ventilation practice guidelines are not well established; therefore, the European Society for Paediatric and Neonatal Intensive Care (ESPNIC) developed consensus recommendations on pediatric mechanical ventilation management in 2017. However, the guideline's applicability in different health care settings is unknown. This study aimed to determine the consensus on pediatric mechanical ventilation practices from Canadian respiratory therapists' (RTs) perspectives and consensually validate aspects of the ESPNIC guideline. METHODS A 3-round modified electronic Delphi survey was conducted; contents were guided by ESPNIC. Participants were RTs with at least 5 years of experience working in standalone pediatric ICUs or units with dedicated pediatric intensive care beds across Canada. Round 1 collected open-text feedback, and subsequent rounds gathered feedback using a 6-point Likert scale. Consensus was defined as ≥ 75% agreement; if consensus was unmet, statements were revised for re-ranking in the subsequent round. RESULTS Fifty-two RTs from 14 different pediatric facilities participated in at least one of the 3 rounds. Rounds 1, 2, and 3 had a response rate of 80%, 93%, and 96%, respectively. A total of 59 practice statements achieved consensus by the end of round 3, categorized into 10 sections: (1) noninvasive ventilation and high-flow oxygen therapy, (2) tidal volume and inspiratory pressures, (3) breathing frequency and inspiratory times, (4) PEEP and FIO2 , (5) advanced modes of ventilation, (6) weaning, (7) physiological targets, (8) monitoring, (9) general, and (10) equipment adjuncts. Cumulative text feedback guided the formation of the clinical remarks to supplement these practice statements. CONCLUSIONS This was the first study to survey RTs for their perspectives on the general practice of pediatric mechanical ventilation management in Canada, generally aligning with the ESPNIC guideline. These practice statements considered information from health organizations and institutes, supplemented with clinical remarks. Future studies are necessary to verify and understand these practices' effectiveness.
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Affiliation(s)
- Shirley Quach
- The Hospital for Sick Children, Department of Respiratory Therapy, Toronto, Ontario, Canada; McMaster University, School of Rehabilitation Sciences, Institute for Applied Health Sciences, Hamilton, Ontario, Canada; and Ontario Tech University, Faculty of Health Sciences, Oshawa, Ontario, Canada
| | - Katherine Reise
- The Hospital for Sick Children, Department of Respiratory Therapy, Toronto, Ontario, Canada
| | - Carolyn McGregor
- Ontario Tech University, Faculty of Health Sciences, Oshawa, Ontario, Canada; and University of Technology, Sydney, New South Wales, Australia
| | | | - Mika L Nonoyama
- The Hospital for Sick Children, Department of Respiratory Therapy, Toronto, Ontario, Canada; and Ontario Tech University, Faculty of Health Sciences, Oshawa, Ontario, Canada.
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Sreedharan JK, Rao UK, Al Ahmari M, Kotian SM, Mokshanatha PB. Validation of a structured questionnaire to assess the perception and satisfaction of respiratory therapy students toward career prospects and learning resources. Can J Respir Ther 2022; 58:162-168. [PMID: 36299617 PMCID: PMC9541297 DOI: 10.29390/cjrt-2022-032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Respiratory therapy is an emerging profession that has existed in India since 1995. Respiratory therapy students will play a significant role in strengthening various aspects of healthcare in the future. There are no validated instruments to evaluate students' perceptions of their careers and satisfaction with the learning resources. The primary objective of the current study is to develop and validate a structured questionnaire (SQ) for respiratory therapy students in India, encompassing all the components of their career development and satisfaction. METHODS Based on the literature review and content validity from respiratory therapy experts through multiple focused group discussions, a reliable SQ was generated with 40 items based on the Likert scale. After getting institutional ethics clearance and informed consent, the SQ was administered to 904 respiratory therapy students across the country. We performed principal component analysis (PCA), structural equation modeling, and confirmatory factor analysis (CFA) for the global fit. Cronbach's alpha was performed to estimate the internal consistency. RESULTS The PCA generated a 4-factor model, and internal consistency for the total scale exceeded the standard criterion of >0.70. Satisfactory goodness of fit data were yielded from CFA. Average variances extracted were higher than the correlation coefficients of the factors, which show sufficient discriminant validity. CONCLUSION This study shows a clinically acceptable model, it fits and suggests the possibility of applying a SQ to a respiratory therapy student with relatively good construct validity and internal consistency, based on the results of CFA.
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Affiliation(s)
- Jithin K. Sreedharan
- Srinivas Institute of Medical Sciences, Srinivas University, Mukka, Mangaluru, Karnataka,Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran
| | - Udaya Kumar Rao
- Srinivas Institute of Medical Sciences, Srinivas University, Mukka, Mangaluru, Karnataka
| | - Mohammed Al Ahmari
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran
| | - Shashidhar M. Kotian
- Srinivas Institute of Medical Sciences, Srinivas University, Mukka, Mangaluru, Karnataka
| | - Praveen B. Mokshanatha
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran
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Pezzimenti HL, Achuff PA, Hales RL, Ginda ME, Dominick CL, Nishisaki A, Napolitano N. Utilizing Competence-Based Simulation to Improve Orientation Outcomes. Respir Care 2022; 67:respcare.09870. [PMID: 35853704 PMCID: PMC9994020 DOI: 10.4187/respcare.09870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND New graduate respiratory therapists (RTs), regardless of the degree program, receive limited preparation in neonatal/pediatric diseases and management. Experienced RTs typically have adult knowledge but limited exposure to pediatrics. We developed a program that included competence-based simulation to improve orientation success. METHODS A 9-week orientation program curriculum with simulation-based competence assessment was developed to ensure all new hires gained knowledge and skills to perform pediatric clinical tasks. Each new hire individually completed the same simulation scenarios during the first week and last week of orientation. Curriculum changes were made over time based on performance in simulations and on-the-job knowledge and skills during and after orientation. Paired and unpaired t tests were used with P < .05 as significant. RESULTS From January 2017-February 2020, the program had 3 updates. Noninvasive ventilation and decompensating patient scenarios were completed for all periods. Ninety-two new staff were oriented in period 1 = 29 (new graduate RTs 20, experienced RTs 9); period 2 = 17 (new graduate RTs 10, experienced RTs 7); period 3 = 24 (new graduate RTs 21, experienced RTs 3), and period 4 = 22 (new graduate RTs = 22). Remediation during orientation occurred in 15% of the staff. Seventy-one percent successfully advanced to ICU orientation after completion of the program. All staff improved scores between pre- versus post-simulations in all periods: mean difference ± SD period 1: new graduate RTs 32.0 ± 17.0, P < .001; experienced RTs 28.0 ± 18.9, P < .001; period 2: new graduate RTs 23.0 ± 15.2, P < .001; experienced RTs 29.0 ± 12.1, P < .001; period 3: new graduate RTs 26.0 ± 15.8, P < .001; experienced RTs 27.0 ± 15.1, P = .007; and period 4: new graduate RTs 19.0 ± 14.5, P < .001, paired t test. The scores between new graduate RTs and experienced RTs during post-simulation were not significantly different for period 1 (P = .35) but were significantly different for periods 2-4 (P = .040, unpaired t test). CONCLUSIONS The use of a competence-based orientation program showed educational advancements and helped determine successful orientation completion.
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Affiliation(s)
- Honey L Pezzimenti
- Department of Respiratory Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
| | - Patricia A Achuff
- Department of Respiratory Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Roberta L Hales
- Center for Simulation, Advanced Education and Innovation, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Cheryl L Dominick
- Department of Respiratory Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Akira Nishisaki
- Center for Simulation, Advanced Education and Innovation, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Anesthesiology, Critical Care Medicine, and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Natalie Napolitano
- Department of Respiratory Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Mehta AB, Lockhart S, Reed K, Griesmer C, Glasgow RE, Moss M, Douglas IS, Morris MA. Drivers of Burnout Among Critical Care Providers: A Multicenter Mixed-Methods Study. Chest 2022; 161:1263-1274. [PMID: 34896094 PMCID: PMC9131031 DOI: 10.1016/j.chest.2021.11.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/11/2021] [Accepted: 11/28/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Critical care practitioners have some of the highest levels of burnout in health care. RESEARCH QUESTION What are key drivers of burnout across the multidisciplinary ICU team? STUDY DESIGN AND METHODS We conducted a multicenter mixed-methods cohort study in ICUs at three diverse hospitals. We recruited physicians, nurses, respiratory therapists, and other staff members who worked primarily in an ICU. Participants completed the Maslach Burnout Inventory for Human Services Survey for Medical Personnel (MBI) and a qualitative focus group or interview using a phenomenologic approach. MBI subscales for emotional exhaustion, depersonalization, and lack of personal accomplishment were calculated. Emergent shared themes contributing to burnout were identified from qualitative interviews. RESULTS Fifty-eight providers (26 physicians, 22 nurses, six respiratory therapists, three pharmacists, and one case manager) participated. Ten participants (17.9%) described their burnout as moderate to high. However, participants scored moderate or high levels across the three MBI subscales (emotional exhaustion, 71.4%; depersonalization, 53.6%; and lack of personal achievement, 53.6%). Drivers of burnout aligned with three core themes: patient factors, team dynamics, and hospital culture. Individual drivers included medically futile cases, difficult families, contagiousness of burnout, lack of respect between team members, the increasing burden of administrative or regulatory requirements at the cost of time with patients, lack of recognition from hospital leadership, and technology. All were highly interconnected across the three larger domains. Despite differences in MBI scores, most provider types described very similar drivers of burnout. INTERPRETATION High levels of burnout were identified through the MBI, but participants did not self-report high levels of burnout, suggesting a lack of awareness. Drivers of burnout were highly interconnected, but factors related to team dynamics and hospital culture were most prominent and shared across provider types. The shared drivers of burnout across multiple provider types highlights the need for interventions focused on team- and system-level drivers.
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Affiliation(s)
- Anuj B Mehta
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Denver Health & Hospital Association, Denver, CO; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO; Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO.
| | - Steven Lockhart
- Adult and Child Consortium for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO
| | - Kathryne Reed
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Denver Health & Hospital Association, Denver, CO
| | - Christine Griesmer
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO
| | - Russell E Glasgow
- Adult and Child Consortium for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Marc Moss
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Ivor S Douglas
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Denver Health & Hospital Association, Denver, CO; Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Megan A Morris
- Adult and Child Consortium for Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO; Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
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Karthika M, Sureshkumar VK, Bennett A, Noorshe AH, Mallat J, Praveen BM. Quality Management in Respiratory Care. Respir Care 2021; 66:1485-1494. [PMID: 34408082 PMCID: PMC9993877 DOI: 10.4187/respcare.08820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The word "quality" refers to the features of a product or service to which a certain value is ascribed. When it comes to hospital-based practices, quality has often been considered to be specific to the care provided. However, this specific perspective is transitioning toward a broader concept after the evolution of quality-improvement projects and quality frameworks at the organizational level. Respiratory therapy departments have been identified as an essential part of any hospital because the key nature of discipline for respiratory therapists is widely understood. Due to their professional accountability and professional values, respiratory therapists often have administrative roles in infection control practices and quality-improvement projects. Therefore, it would be ideal to have a core team of respiratory therapists trained in quality management and to initiate quality-improvement processes at the departmental level. Every respiratory therapy department should have its own quality-improvement team to assist with the process of training, implementation, and analysis. Thus, this article aimed to discuss the role of respiratory therapists and respiratory therapy departments in quality-improvement processes and projects to set benchmarks and enhance outcomes.
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Affiliation(s)
- Manjush Karthika
- Department of Health and Medical Sciences, Khawarizmi International College, Abu Dhabi, United Arab Emirates.
- Srinivas Institute of Medical Sciences and Research Centre, Srinivas University, Mangalore, India
| | - Vanajakshy Kumaran Sureshkumar
- Department of Healthcare Management, Tata Institute of Social Sciences, Mumbai, India
- Department Critical Care, Quality and Patient Safety, IQRAA Hospital, Calicut, Kerala, India
| | - Adam Bennett
- Respiratory Care, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | | | - Jihad Mallat
- Critical Care Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Ohio
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Smith CR, Gravenstein N, LeMaster TE, Borde CM, Fahy BG. A Flexible Enclosure to Protect Respiratory Therapists During Aerosol-Generating Procedures. Respir Care 2021; 65:1923-1932. [PMID: 33229369 DOI: 10.4187/respcare.08568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Exposure of respiratory therapists (RTs) during aerosol-generating procedures such as endotracheal intubation is an occupational hazard. Depending on the hospital, RTs may serve as laryngoscopist or in a role providing ventilation support and initiating mechanical ventilation. This study aimed to evaluate the potential exposure of RTs serving in either of these roles. METHODS We set up a simulated patient with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in an ICU setting requiring endotracheal intubation involving a laryngoscopist, a nurse, and an RT supporting the laryngoscopist. All participants wore appropriate personal protective equipment (PPE). A fluorescent marker was sprayed by an atomizer during the procedure using 3 different methods for endotracheal intubation. The 3 techniques included PPE alone, a polycarbonate intubating box, or a coronavirus flexible enclosure, which consisted of a Mayo stand with plastic covering. The laryngoscopist and the supporting RT were assessed with a black light for contamination with the fluorescent marker. All simulations were recorded. RESULTS When using only PPE, both the laryngoscopist and the RT were grossly contaminated. When using the intubating box, the laryngoscopist's contamination was detectable only on the gloves: the gown and face shield remained uncontaminated; the RT was still grossly contaminated on the gloves, gown, neck, and face shield. When using the coronavirus flexible enclosure system, both the laryngoscopist and the RT were better protected, with contamination detected only on the gloves of the laryngoscopist and the RT. CONCLUSIONS Of the 3 techniques, the coronavirus flexible enclosure contained the fluorescent marker more effectively during endotracheal intubation than PPE alone or the intubating box based on exposure of the laryngoscopist and supporting RT. Optimizing containment during aerosol-generating procedures like endotracheal intubation is a critical component of minimizing occupational and nosocomial spread of SARS-CoV-2 to RTs who may serve as either the laryngoscopist or a support role.
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Affiliation(s)
- Cameron R Smith
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida
| | - Nikolaus Gravenstein
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida
| | - Thomas E LeMaster
- Center for Experiential Learning and Simulation, University of Florida College of Medicine, Gainesville, Florida
| | - Ceri M Borde
- Center for Experiential Learning and Simulation, University of Florida College of Medicine, Gainesville, Florida
| | - Brenda G Fahy
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida.
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Abstract
BACKGROUND Respiratory therapy was introduced to India in 1995. Respiratory therapists (RTs) work alongside doctors in hospitals. Of the 993 universities in India, a few have bachelor's or master's programs in respiratory therapy, but no studies have examined the demographics, geographical spread, or skills used by these RTs. This study assessed the demographics and services offered by RTs in India. METHODS This was a cross-sectional study based on a survey administered on paper, by telephone, or online. RTs were selected by convenience sampling from institutional databases and from WhatsApp groups of RTs in India, as well through snowball sampling of co-workers. A link to the online survey was shared on the author's personal social media channels. Of the invited RTs, 465 consented and participated; of those, 237 answered all questions. RESULTS Of the 237 respondents completing the survey, 73% had bachelor's degree, 16.5% had a master's degree, 4.6% had a diploma, 2.5% had mixed qualifications, 1.7% had post graduate diploma, 0.8% had a certificate, 0.4% had a master of business administration degree, and 0.4% had a PhD degree. Almost all (96.6%) worked as an RT or in a job that required respiratory therapy knowledge. Although individuals may have had multiple job roles, 77.6% worked as a hospital staff RT. The least frequently performed competencies were recommending diagnostic procedures, using evidence-based principles, initiating and conducting patient and family education, and administering home care and pulmonary rehabilitation; the most frequently performed competencies were support oxygenation and ventilation, ensuring infection control, and maintaining a patent airway. CONCLUSIONS Most subjects were employed in south India and had a bachelor's degree. They worked as staff RTs with a focus on the acute care environment. Pneumonia, asthma, COPD, and ARDS were the most commonly managed diseases. Competencies such as recommending procedures, planning and providing pulmonary rehabilitation, and administering home-based care were the least frequently performed.
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Affiliation(s)
- Madhuragauri S Shevade
- Training Programs Division, Chest Research Foundation, Marigold Premises, Pune, Maharashtra, India.
- Faculty of Health and Biological Sciences, Symbiosis International Deemed University, Pune, Maharashtra, India
| | - Rajiv C Yeravdekar
- Faculty of Health and Biological Sciences, Symbiosis International Deemed University, Pune, Maharashtra, India
| | - Sundeep S Salvi
- Training Programs Division, Chest Research Foundation, Marigold Premises, Pune, Maharashtra, India
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Abstract
Lung ultrasound is a point-of-care imaging tool that is routinely used in acute care medicine. Traditionally, radiology physicians were the primary practitioners of diagnostic ultrasound, but with the recognition of its importance in intensive care medicine, critical care physicians have also adopted this practice. Within the intensive care unit inter-professional team is the respiratory therapist, who participates actively in the care of ventilated patients. Their scope of responsibility is expanding with newer technologies being brought into clinical use on a regular basis. This review focuses on the scope and benefits of ultrasound training within respiratory care-related areas.
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Affiliation(s)
- Manjush Karthika
- Department of Respiratory Services, Sidra Medicine, Doha, Qatar.
| | - Duane Wong
- Department of Respiratory Services, Sidra Medicine, Doha, Qatar
| | - Suresh G Nair
- Department of Anesthesia and Critical Care Medicine, Aster Medcity Hospital, Kochi, Kerala, India
| | - Lalitha V Pillai
- Department of Critical Care Medicine, Aundh Institute of Medical Sciences, Pune, Maharashtra, India
| | - Chris Sara Mathew
- College of Health Sciences, Srinivas University, Mangalore, Karnataka, India
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AlAhmari MD, Al-Otaibi H, Qutub H, AlBalawi I, Alqahtani A, Almasoudi B. Noninvasive ventilation utilization in the Kingdom of Saudi Arabia: Results of a national survey. Ann Thorac Med 2018; 13:237-242. [PMID: 30416596 PMCID: PMC6196671 DOI: 10.4103/atm.atm_116_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Noninvasive ventilation (NIV) has been extensively used globally and is often administered as the first-line treatment. Currently, data regarding the utilization of NIV in the Kingdom of Saudi Arabia (KSA) is scarce. The present study aimed to assess and quantify the utilization of NIV in clinical practice across the KSA and investigate obstacles that may cause NIV underutilization. METHODS A web-based survey composed of a 31-item, self-administered questionnaire was developed and validated. The questionnaire was designed to obtain general information about each hospital, availability of NIV practice, use of NIV, and obstacles that can hinder NIV use in clinical settings; the survey was sent to senior respiratory therapists (RTs) of 76 hospitals. Descriptive statistics were used to analyze the data. RESULTS Sixty-one hospitals (80.3%) responded to the survey (47 governmental and 14 private). NIV was available in all hospitals and all the Intensive Care Units. The majority of RTs (85%) reported having a good experience with NIV, with a confidence rate of 60%; however, only 22% of the RTs had received formal training. Although NIV setup was the sole responsibility of RTs, only 69% participated in NIV management. Moreover, 72% of hospitals had an NIV setup protocol in place. However, 50% of them lacked a protocol for NIV failure. NIV protocols for specific indications were present in 64% of the hospitals: 47.2% for monitoring and 42% for weaning. The perceived efficiency of NIV practice was low in the medical wards, with a <49% success rate in 39% of the hospitals. Shortage of staff and lack of formal training were the most common reasons for NIV underutilization. CONCLUSION The efficiency of NIV in the KSA was low. The RTs expressed moderate confidence in administering NIV. Lack of appropriate exposure and formal training could have negative impacts on NIV practice.
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Affiliation(s)
- Mohammed Dhafer AlAhmari
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Hajed Al-Otaibi
- Department of Respiratory Care, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hatem Qutub
- Department of Medicine, Imam Abdulrahman Alfaisal University, Dammam, Saudi Arabia
| | - Ibrahim AlBalawi
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Abdullah Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Bandar Almasoudi
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
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Tsai RJ, Boiano JM, Steege AL, Sweeney MH. Precautionary Practices of Respiratory Therapists and Other Health-Care Practitioners Who Administer Aerosolized Medications. Respir Care 2015; 60:1409-17. [PMID: 26152473 PMCID: PMC4583800 DOI: 10.4187/respcare.03817] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Respiratory therapists (RTs) and other health-care workers are potentially exposed to a variety of aerosolized medications. The National Institute for Occupational Safety and Health (NIOSH) Health and Safety Practices Survey of Healthcare Workers describes current exposure control practices and barriers to using personal protective equipment during administration of selected aerosolized medications. METHODS An anonymous, multi-module, web-based survey was conducted among members of health-care professional practice organizations representing RTs, nurses, and other health-care practitioners. A module on aerosolized medications included submodules for antibiotics (amikacin, colistin, and tobramycin), pentamidine, and ribavirin. RESULTS The submodules on antibiotics, pentamidine, and ribavirin were completed by 321, 227, and 50 respondents, respectively, most of whom were RTs. The relatively low number of ribavirin respondents precluded meaningful interpretation of these data and may reflect the rare use of this drug. Consequently, analysis focused on pentamidine, classified by NIOSH as a hazardous drug, and the antibiotics amikacin, colistin, and tobramycin, which currently lack authoritative safe handling guidelines. Respondents who administered pentamidine were more likely to adhere to good work practices compared with those who administered the antibiotics. Examples included training received on safe handling procedures (75% vs 52%), availability of employer standard procedures (82% vs 55%), use of aerosol delivery devices equipped with an expiratory filter (96% vs 53%) or negative-pressure rooms (61% vs 20%), and always using respiratory protection (51% vs 13%). CONCLUSIONS Despite the availability of safe handling guidelines for pentamidine, implementation was not universal, placing workers, co-workers, and even family members at risk of exposure. Although the antibiotics included in this study lack authoritative safe handling guidelines, prudence dictates that appropriate exposure controls be used to minimize exposure to the antibiotics and other aerosolized medications. Employers and employees share responsibility for ensuring that precautionary measures are taken to keep exposures to all aerosolized medications as low as practicable.
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Affiliation(s)
- Rebecca J Tsai
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio.
| | - James M Boiano
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio
| | - Andrea L Steege
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio
| | - Marie H Sweeney
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio
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Stoller JK, Strange C, Schwarz L, Kallstrom TJ, Chatburn RL. Detection of alpha-1 antitrypsin deficiency by respiratory therapists: experience with an educational program. Respir Care 2013; 59:667-72. [PMID: 24106322 DOI: 10.4187/respcare.02817] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Alpha-1 antitrypsin deficiency is under-recognized. We hypothesized that respiratory therapists (RTs) could help improve the detection rate of individuals with alpha-1 antitrypsin deficiency. The American Association for Respiratory Care (AARC) and Alpha-1 Foundation recently collaborated to create an online alpha-1 antitrypsin deficiency training program for RTs. This study aimed to determine (1) the rate of RT enrollment in the training program, (2) the rates of detecting individuals with alpha-1 antitrypsin deficiency referred for testing by RTs who took the online course ("trained RTs"), and (3) the genotype distribution of referred individuals found to have alpha-1 antitrypsin deficiency. METHODS Patients referred by trained RTs submitted blood samples for alpha-1 antitrypsin deficiency testing through the existing Alpha-1 Coded Testing (ACT) Study. The AARC sent the first 3 digits of trained RTs' zip codes to the study data center. Investigators there matched those zip codes with those of patients in the ACT Study who reported being referred to the study by an RT. The data center determined the number of these patients with alpha-1 antitrypsin deficiency and their genotypes. Investigators then aggregated the data and calculated the RT enrollment rate, the rate of detecting individuals with alpha-1 antitrypsin deficiency, and the distribution of genotype results. RESULTS Between July 1, 2012, and June 30, 2013, 378 RTs took the online program (mean 21/mo), and 326 patients reported that they were referred for testing by an RT. Thirty-four percent (111/326) of these referrals were by trained RTs (6.2/mo). Sixty-two test blood kits were returned by these 111 referred patients and analyzed (4/mo). Two of these specimens (3.2%) were from patients identified as having severe alpha-1 antitrypsin deficiency (PI*ZZ) and one from a patient with PI*SZ (serum level 14 μM). Twenty-four percent were from PI*MZ heterozygotes. CONCLUSIONS A program to educate RTs about alpha-1 antitrypsin deficiency was associated with referral of patients for alpha-1 antitrypsin deficiency testing and high rates of detecting individuals with severe alpha-1 antitrypsin deficiency.
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Affiliation(s)
- James K Stoller
- Education Institute and the Departments of Pulmonary Medicine and Critical Care Medicine, Cleveland Clinic
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