Respiratory Care Services

Revised:
December 12, 2023 Steven J. Schweon, RN, MPH, MSN, CIC, LTC-CIP, CPHQ, FSHEA, FAPIC Infection prevention consultant

Steven J. Schweon, LLC
Saylorsburg, Pa.

Jess Danko, MSHA, RRT, LTC-CIP Program Director Quality Improvement Advisor

South Dakota Foundation for Medical Care

The University of South Dakota
Chamberlain, South Dakota

Published:
October 2, 2014
Declarations of Conflicts of Interest:
  • Jess Danko acknowledges she has no conflict of interest disclosures.
  • Steven Schweon discloses an adjunct faculty position at Drexel University. Steve works with a full-time consulting practice and is a consultant for Safety and Disaster Solutions, Inc. (SDSi) in addition to consulting for Medline and APIC Consulting. He is a committee member of the APIC Practice Guidance Council, IPAC Canada and is a Clinical Editor for the APIC Text.


Acknowledgments:

Special thanks to the 2014 chapter author, Marie Fornof, RN, BSN, CIC 

Infection Preventionist

National Jewish Health
Denver, CO

Abstract

The COVID-19 pandemic and the potential for severe pulmonary complications has highlighted how the Respiratory Care Services (RCS) department plays an integral role with the treatment team and promoting patient safety. The RCS department is managed by Respiratory Therapists (RTs). Respiratory therapy is a specialized healthcare field where practitioners are trained in pulmonary medicine in order to work therapeutically with people suffering from pulmonary illness and disease. The RCS department delivers diagnostic and therapeutic procedures to monitor and support respiratory function.

Respiratory therapy is offered in numerous clinical practice settings with a multitude of services, as exemplified in the following list:

  • Hospitals e.g., emergency resuscitation, pulmonary assessment, delivery of aerosolized breathing treatments, invasive and non-invasive ventilation management, blood gas analysis, bronchial hygiene therapies.
  • Skilled nursing facilities e.g., oxygen therapy, aerosolized breathing treatments, incentive spirometry/lung expansion therapies, invasive and non-invasive ventilation management.
  • Patient homes e.g., assessing pulmonary function to prevent hospitalization, non-invasive ventilator support, respiratory medication technique education .
  • Sleep laboratories e.g., diagnosing of sleep disorders, assistance and education with home sleep equipment set up, disease and home equipment education.
  • Ambulatory care settings e.g., pulmonary function testing, chronic disease management education, pulmonary rehabilitation and exercise, airway management.

In some practice settings, with proper education and training and following the clinical team’s direction, nursing and other healthcare disciplines may also provide respiratory therapy services.

Respiratory care service activities may include cardiopulmonary diagnostics, emergency resuscitation, the administration of medical gases and aerosolized medications, bronchial hygiene therapies, airway management procedures, lung expansion therapies, mechanical ventilation, and blood gas sampling and analysis. Each of these procedures is a potential source of infection for the patient or the healthcare practitioner (HCP) caring for the patient. The risk of infection is quite variable, depending upon the service and equipment being utilized (e.g., intubation, ventilator support, pulmonary function testing).

Specific respiratory care services involve proper equipment handling, cleaning, disinfection, and storage of equipment, as well as use of evidence-based practices that reduce the risk of infection to patients, healthcare personnel, and visitors. The infection preventionist must have a thorough understanding of A) the different equipment and devices for respiratory therapy delivery, B) non-invasive and invasive modalities, C) the correct cleaning and disinfection protocol for equipment being used, and D) the technology to provide efficient respiratory support.

Additionally, understanding how microbes are introduced into the respiratory tract (e.g., aspiration, intubation) is critical for prevention of infection. Application of evidence-based bundles to prevent healthcare and ventilator-associated events may reduce the likelihood of complications, including infection.