As a respiratory therapist, delivering evidence-based respiratory care should be the ultimate goal. This is important for patients with respiratory conditions because it can improve their quality of life and decrease mortality rates.
This topic is usually covered in the curriculum of most respiratory therapy programs, so we created this study guide to help make the learning process easier for you.
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What Does it Mean to Deliver Evidence-Based Respiratory Care?
In order to provide high-quality respiratory care, it must be backed by studies and evidence that support the most relevant underlying goals.
Evidence-based studies have shown that there are certain systems that are better than others when it comes to treating patients at the highest level. It takes into consideration the following:
- Medical direction
- Technical direction
Respiratory care protocols and systems help improve patient outcomes while ensuring that the highest quality of care is delivered to the patient.
To learn more about this topic, you can read through the practice questions that are listed below. Also, you can consider reading the chapter inside of the Egan’s Textbook on this topic.
Communicating with Patients Who Have Respiratory Conditions
One of the most important aspects of providing evidence-based respiratory care is communicating effectively with patients. Healthcare providers should take the time to listen to the patient’s concerns and ask questions to gain a better understanding of their condition.
This can help providers to develop an individualized treatment plan that meets the patient’s specific needs.
It is also important to be aware of the patient’s body language and use appropriate communication techniques. For example, it is generally recommended that healthcare providers avoid using medical jargon when communicating with patients.
Additionally, it is important to take the time to explain the treatment plan to the patient. This can help to ensure that the patient has a clear understanding of their condition and how they can best manage it.
The Egan's book is known as the "Bible of Respiratory" and is highly recommended.
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Evidence-Based Respiratory Care Practice Questions:
1. What are respiratory care protocols?
They are guidelines for delivering appropriate respiratory care treatments and services.
2. What are the skills needed to implement protocols?
(1) Assess patients for indications of therapy and the most appropriate method, (2) Be cognizant of age-related issues and how they affect the patient, (3) Adapt hospital policies and procedures to other care sites, (4) Conduct and participate in research activities, and (5) Communicate effectively with all members of the healthcare team and contribute to the body of literature concerning the field of respiratory care
3. What are the nine steps of a quality assurance plan?
(1) Identify the problem, (2) Determine the cause of the problem, (3) Rank the problem, (4) Develop a strategy for solving the problem, (5) Develop appropriate measurement techniques, (6) Implement strategies, (7) Analyze and compile results, (8) Report to appropriate personnel, and (9) Evaluate the outcome
4. What are the professional characteristics of a respiratory therapist?
They must complete an accredited respiratory therapy program. They must obtain professional credentials. They must participate in continuing education activities. They must adhere to the code of ethics put forth by the state or institution. They must join professional organizations.
5. What does CQI stand for?
Continuous Quality Improvement
6. What is evidence-based medicine?
It is an approach that relies on the following practices: A rigorous and systematic review of evidence, critical analysis of available evidence, and a disciplined approach to incorporating the literature with personal experience and practice.
7. What is quality?
In healthcare, quality reflects a high degree of excellence, fineness, or grade.
8. Who is usually professionally responsible for the clinical function of the respiratory department?
A medical director is typically responsible for the respiratory department. They are often either a pulmonologist or anesthesiologist.
9. What are the three elements of quality care?
Personnel, equipment, and the method/manner in which care is provided
10. What are the four essential components of disease management?
(1) An integrated health care system that can provide coordinated care across the full range of patients’ needs, (2) A comprehensive knowledge base regarding the prevention, diagnosis, and treatment of disease that guides the plan of care, (3) Sophisticated clinical and administrative information systems that can help assess patterns of clinical practice; and (4) A commitment to continuous quality improvement
11. What is the CoARC responsible for?
It is responsible for the quality of schools’ programs.
12. What are cohort studies?
They compare the clinical outcomes in two compared groups. They generally have greater scientific rigor than case studies or case series and consist of two broad types of study designs: (1) Observational cohort studies and (2) Randomized controlled trials.
13. What are competencies?
Having a suitable or sufficient skill, knowledge, and experience for the purposes of a specific task
14. The crucial elements for quality respiratory care include what?
(1) Energetic and competent medical direction, (2) Methods for providing indicated and appropriate respiratory care, (3) Educated, competent respiratory care personnel, (4) Adequate, well-maintained equipment, and (5) Intelligent system for monitoring performance improvement
15. What is disease management?
An organized strategy of delivering care to a large group of individuals with chronic disease to improve outcomes and reduce cost
16. What are protocols?
Guidelines for delivering appropriate respiratory care services that can improve the allocation of respiratory care services
17. What does evidence-based medicine use to find the best care?
It uses meta-analyses to find the best care.
18. What is the “licensing” process for respiratory therapists?
After completion of an approved respiratory care educational program, a graduate may become credentialed by taking the TMC examination and passing with the high-cut score to obtain the CRT credential. A CRT may be eligible to sit for the CSE examination to become a credentialed RRT.
19. What is an important part of evidence-based respiratory care?
20. What is the Joint Commission (TJC)?
A private, not-for-profit organization that evaluates and accredits hospitals and other healthcare organizations on the basis of predefined performance standards; formerly known as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
21. What are the primary credentials for respiratory therapists?
RRT (Registered Respiratory Therapist, which is the highest credential); and CRT (Certified Respiratory Therapist)
22. What are the four organizations that sponsor the Committee on Accreditation for Respiratory Care (CoARC)?
(1) AARC, (2) American College of Chest Physicians (ACCP), (3) American Society of Anesthesiologists (ASA), and (4) American Thoracic Society (ATS)
23. What is the medical director?
They are professionally responsible for the clinical function of the respiratory care department, and they provide oversight of the clinical care that is delivered. They are typically a pulmonary/critical care physician or an anesthesiologist.
24. What is misallocation?
Misallocation refers to ordering therapy that is not indicated, ordering therapy to be delivered by an inappropriate method, or failing to provide therapy that is indicated.
25. What is the NBRC responsible for?
They are responsible for the quality of credentialing exams.
26. What is the most rigorous type of study to prove the efficacy of treatment?
Randomized controlled clinical trial
27. What are the tactics for implementing Respiratory Care Protocols?
Select a planning team with diverse membership, conduct an audit to assess the occurrence of misallocation of therapy to justify departure from usual care, identify sources of resistance (e.g., physicians, nurses, administrators, RTs), design a protocol program that fits the individual hospital, develop a training program for RTs, and develop an evaluation and quality monitoring system.
28. What are the two levels of general practice credentialing in respiratory care?
(1) Certified Respiratory Therapists (CRTs) and (2) Registered Respiratory Therapists (RRTs)
29. What are two ways to monitor quality care?
(1) Institutional and (2) Governmental
30. What is the mission of the CoARC?
To promote quality respiratory therapy education through accreditation services
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31. What is the responsibility of CoARC?
To ensure that respiratory therapy educational programs follow accrediting standards or essentials as endorsed by the American Medical Association (AMA)
32. Who sponsors the NBRC?
The AARC, ACCP, ASA, ATS, and the National Society for Pulmonary Technology
34. What three things does quality respiratory care depend on?
Experience, education, and professionalism
35. What three things encompass respiratory care?
The people who administer care, the equipment used, and the manner in which care is provided.
36. What two things determine the quality of services provided by respiratory therapists?
Intelligent efforts to establish guidelines and a method for monitoring the care
37. What is the responsibility of the medical director?
They are responsible for the clinical functions of the program and provide oversight of the clinical care provided.
38. What is the most essential aspect of providing high-quality respiratory care?
To ensure the care being delivered is appropriate and delivered competently
39. What are the four elements one should have for delivering high-quality respiratory care?
Training, education, experience, and professionalism
40. Who is responsible for preparing the budget for the respiratory department?
The medical director
41. Who is responsible for ensuring that respiratory therapy educational programs follow accrediting standards?
42. What does CoARC promote?
They promote high-quality respiratory therapy education through accreditation services
43. What is the process in which a government agency gives an individual permission to practice an occupation?
The licensure process
44. What is a term that refers to recognizing individuals in a particular profession or occupation?
45. What is the primary method for ensuring quality in respiratory care?
Voluntary certification or registration
46. Who conducts voluntary credentialing or registration?
47. Who continually monitors the quality inside hospitals and has the ability to shut them down at the same time if standards are not met?
The Joint Commission
48. How do respiratory therapists demonstrate their professionalism?
By maintaining high practice standards, engaging in ongoing learning, conducting research to advance the quality of respiratory care, and participating in organized activities or events
49. What does the P in HIPAA stand for?
50. Who ensures that the equipment and the associated protocols and procedures have sufficient quality in the department?
The technical director
51. What are the guidelines for delivering appropriate respiratory care treatments and services?
Respiratory care protocols
52. What do protocols reduce?
They reduce the over-ordering of respiratory services
53. What are the two things that are essential for a comprehensive protocol program?
An assessment tool and care plan
54. How is competency tested?
By the use of simulations
55. What is an approach to determining optimal clinical management based on aspects of care?
56. What three things make up evidence-based medicine?
(1) Systematic review of available evidence, (2) Critical analysis of available evidence, and (3) A disciplined approach to incorporating literature
57. What compares the clinical outcomes of two groups?
58. What is the most rigorous type of study designed to prove the efficiency of a treatment?
A randomized control trial
59. What does the quality of a respiratory therapist depend on?
Training, experience, education, and professionalism
60. What are the two levels of general practice in respiratory care?
Certified respiratory therapist and registered respiratory therapist
61. How can people become eligible for credentials?
They must have graduated from a CoARC approved education program.
62. What are the two forms of credentialing?
State licensure and voluntary certification
63. What does technical direction depend on?
64. What does the manager of the department usually do?
They oversee policies, procedures, and equipment used to provide safe and efficient patient care
65. Why are respiratory care protocols put in place?
They are put in place to enhance the appropriate allocation of respiratory care services.
66. What are the four types of studies that evidence comes from?
Single case studies, case series, cohort studies, and randomized controlled trials
67. What are single case studies?
The simplest and least rigorous
68. What are case series?
A collection of patients with similar clinical features
69. What are cohort studies?
They work by comparing two groups of people and provide greater scientific rigor.
70. What are randomized controlled trials?
They provide the most rigorous evidence and are the ideal choice of study.
So, there you have it. That wraps up our study guide on how to deliver evidence-based respiratory care. Hopefully, you can use this material to develop a better understanding of this topic.
We have a similar guide that covers quality, patient safety, communication, and record-keeping that I think you will find useful. Thanks for reading and, as always, breathe easy, my friend.
John Landry, BS, RRT
John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.
- Faarc, Kacmarek Robert PhD Rrt, et al. Egan’s Fundamentals of Respiratory Care. 12th ed., Mosby, 2020.
- “An Evidence-Based Approach to Acute Respiratory Distress Syndrome.” National Center for Biotechnology Information, 2001, www.ncbi.nlm.nih.gov/books/NBK68565.
- “Making a Difference: More than Just Respiratory Care.” PubMed Central (PMC), 1 Sept. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC6073514.
- “Evidence Based Medicine – New Approaches and Challenges.” PubMed Central (PMC), 25 Sept. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC3789163.