Egan’s Chapter 2 Practice Questions: 

Question Answer
1. What are Respiratory Care Protocols? They are guidelines for delivering appropriate respiratory care treatments and services
2. What are skills needed to implement protocols?  -Assess patients for indications of therapy and the most appropriate method?
-Be cognizant of age-related issues and how they affect the patient
-Adapt hospital policies and procedures to other care sites
-Conduct and participate in research activities
-Communicate effectively with all members of the health care team and contribute to the body of literature -concerning the field of respiratory care.
3. What are the nine steps for a Quality Assurance Plan? 1.Identify the problem
2.Determine cause of the problem
3.Rank problem
4.Develop strategy for solving problem
5.Develop appropriate measurement techniques
6.Implement strategies
7.Analyze and compile results
8.Report to appropriate personnel
9.Evaluate outcome
4. What are the professional characteristics of an RT? -Completes an accredited respiratory therapy program
-Obtains Professional Credentials
-Participates in continuing education activities
-Adheres to the code of ethics put forth by the state or institution
-Joins professional organizations
5.What is CQI? 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
– A disciplined approach to incorporating the literature with personal experience and practice.
7.What is quality? Reflects a high degree of excellence, fineness, or grade.
8.Who is professionally responsible for the clinical function of the respiratory department? A Medical Director who is usually a Pulmonologist or an Anesthesiologist


Question Answer
1.3 Elements of quality care: – Personnel
– Equipment
– Method/manner in which care is provided
2.4 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
3.CoARC:  Responsible for quality of schools’ programs.
4.Cohort studies: -Compare the clinical outcomes in two compared groups
**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
5.Competencies:  Having suitable or sufficient skill, knowledge, and experience for the purposes of a specific task
6.Crucial elements for quality respiratory care include: 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
5) Intelligent system for monitoring performance improvement
7.Define Disease Management:  An organized strategy of delivering care to a large group of individuals with chronic disease to improve outcomes and reduce cost
8.Define Protocols pg. 25 of Egan’s text:  Guidelines for delivering appropriate respiratory care services that can improve allocation of respiratory care services
9.Evidence-based medicine:  Uses meta-analyses to find best care
10.Explain the “licensing” process:  After completion of an approved respiratory care educational program, a graduate may become credentialed by taking the entry-level examination to become a CRT. A CRT may be eligible to sit for the registry examinations to become a credentialed RRT.
11.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)
12.Key Elements of a Respiratory Care Protocol Program: – Strong and committed medical direction
– Capable RTs
– Active quality monitoring
– Collaborative environment among RTs, physicians, and nurses
– Responsiveness of all participants to address and correct problems
13.List of Credentials: 1) RRT Registered Respiratory Therapist (**highest credential)
2) CRT Certified Respiratory Therapist
3) NPS Neonatal-Pediatric Specialist
4) SDS
8) RCP Respiratory Care Practitioner
9) AE-C Certified Asthma Educator
14.List the 4 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)
4) American Thoracic Society (ATS)
15.Medical Director: Professionally responsible for the clinical function of the department and provides oversight of the clinical care that is delivered. Typically an pulmonary/critical care physician or an anesthesiologist
16.Misallocation: Ordering therapy that is not indicated, or ordering therapy to be delivered by an inappropriate method, or failing to provide therapy that is indicated.
17.NBRC:  Responsible for quality of credentialing exams
18.Nine Steps for a Quality Assurance Plan: 1) Identify the problem
2) Determine cause of problem
3) Rank problem
4) Develop strategy for resolving problem
5) Develop appropriate measurement techniques
6) Implement problem-resolution strategy
7) Analyze and compile results of intervention
8) Report results to appropriate personnel
9) Evaluate intervention outcome
19.Professional Characteristics of a Respiratory Therapist: – Completes an accredited respiratory therapy program
– Obtains professional credentials
– Participates in continuing education activities
– Adheres to the code of ethics put forth by the institution or state licensing board or both
– Joins professional organizations
 20.Quality:  A characteristic reflecting a high degree of excellence, fitness, or grade.
21.Sequence of Events for a Respiratory Care Consult: 1) A physician writes an order for a respiratory care protocol or consult
2) A physician order entry system or the nursing unit secretary notifies an RT evaluator
3) The evaluator assesses the patient using specific guidelines
4) The evaluator writes a care plan using designated indications and algorithms and documents the care plan in the patient’s chart for review by the physician
5) The RT covering the nursing unit delivers the care
6) The patient is assessed on a shift-by-shift basis for changes in status and indicated modifications for the care plan, which are also documented
7) The physician is notified of any deterioration in the patient’s status
8) When indications for respiratory care no longer exist, respiratory care treatment is discontinued, and notification is placed in the patient’s chart
22.Tactics for Implementing Respiratory Care Protocols: STEP 1: Select a planning team with diverse membership
STEP 2: Conduct an audit to assess the occurrence of misallocation of therapy to justify departure from usual care
STEP 3: Identify sources of resistance (e.g., physicians, nurses, administrators, RTs)
STEP 4: Design a protocol program that fits the individual hospital
STEP 5: Develop a training program for RTs
STEP 6: Develop an evaluation and quality monitoring system
23.The two levels of general practice credentialing in respiratory care: 1) Certified Respiratory Therapists (CRTs) and
2) Registered Respiratory Therapists (RRTs)
24.Ways to monitor quality care (name two): 1) Institutional: skills check-offs, classes, and competencies
2) Governmental: Monitors like CMS or the Joint Commission accredits instituions based on quality monitoring standards over 9 or more areas
25.What is the mission of CoARC: To promote quality respiratory therapy education through accreditation services
26.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)
27.Who sponsors the NBRC: 1) AARC
3) the ASA
4) the ATS
5) the National Society for Pulmonary Technology