Description of the Practice of Respiratory Therapists in the State of Pennsylvania

Background: The Pennsylvania Respiratory Research Collaborative (PRRC) formed in January 2017 for the purpose of providing mentorship and opportunities to participate in statewide research, quality improvement, and evidence-based practice projects. The inaugural project was designed to investigate and describe the practice of respiratory therapists in Pennsylvania. Methods: A survey related to the practice and business of inpatient respiratory therapy departments was developed and sent to managers/directors of every hospital within the state of Pennsylvania. Survey period was October 2017 — April 2018. Survey committee members connected with Pennsylvania hospitals to determine contacts for the respiratory therapy department and to ask the manager/director to complete the electronic survey. A total of 188 hospitals with inpatient Respiratory Therapy departments were contacted and we were unable to obtain contacts for the manager/director 29 of the hospitals. Results: Out of 188 hospitals in the state, 101 (53.7%) responded. Of the hospitals that responded, 52% were academic centers. Clinical ladders are utilized in 29% of hospitals, 72% of which are academic centers. For staff positions, 50% prefer BS degree and 78% prefer RRT. Protocols are utilized in 74% of hospitals with the most common being: ventilator (92%), bronchodilator (79%), airway clearance (56%), hyperinflation (41%), and disease-specific (23%). Nontraditional procedures are performed by respiratory therapists in 84% of the hospitals. The most common being: EKG9s (35%) and advanced procedures including intubation (20%), arterial lines (14%), blind BAL9s (14%), and EEG9s (12%). Respiratory therapists are utilized in 42% of hospitals. The most common alternative roles are: patient educator (29%), outpatient clinics (21%), patient navigators (19%), transport (14%), ECMO (6%), case managers (5%), research (5%), and telehealth (2%). Conclusions: The practice of respiratory therapists in the state of Pennsylvania varies greatly with a small number of hospitals practicing at the apex of the profession. Additional research is needed to understand variations in practice.