Implementation and Evaluation of a Continuous Respiratory Monitoring Curriculum

Implementation and Evaluation of a Continuous Respiratory Monitoring Curriculum

Bibliography

Name: Wendy Choate

Rank: LT

Presenter/Poster: Poster

Year: 2017

Abstract

Respiratory depression is a life-threatening condition that may develop in hospitalized patients, and its incidence has been associated with a multitude of other medical comorbidities. Continuous respiratory monitoring (CRM) technologies such as pulse oximetry and waveform capnography are commonly used to monitor patients at risk for respiratory depression on the medical ward. However, the utilization and interpretation of these monitoring modalities requires further education and training.
Data from Naval Medical Center San Diego (NMCSD) indicated 40% of Rapid Response Team (RRT) activations were related to patients experiencing respiratory depression events. A longitudinal project based on findings and recommendations from the Anesthesia Patient Safety Foundation and the Joint Commission was initiated and divided over two cohorts. First developed was a comprehensive electronic-based CRM educational curriculum with assistance and input from NMCSD nursing leadership and subject matter experts. The curriculum included five modules: respiratory physiology, respiratory depression, capnography and pulse oximetry, monitoring equipment, and nursing interventions. The second phase involved implementing the CRM curriculum, targeting ward staff caring for patients at risk for respiratory depression. Also developed was a survey to evaluate whether the completion of the curriculum would increase levels of knowledge and confidence among ward staff.
Results from pre-assessment survey data showed a relatively low level of knowledge and confidence among ward staff, pertaining to respiratory physiology and monitoring equipment (m=67.5%). After viewing the CRM curriculum, results indicated that knowledge levels increased by 22.78%, and confidence levels increased by 31.28%.
This project demonstrated a significant increase in baseline knowledge and confidence among ward staff caring for patients at risk for respiratory depression. Results will be presented to the leadership and evidence-based practice committee at NMCSD as an effort to foster and sustain the CRM curriculum, and ultimately decrease respiratory depression incidence among hospitalized patients. Other military MTFs may benefit from similar projects addressing their specific educational needs.