RCP 720 - Resp Therapy Practicum V

1. Perform routine respiratory care procedures unsupervised.
   1. Achieve Intermittent Positive Pressure Breathing therapy.
   2. Execute Postural Drainage and percussion.
   3. Achieve hand held aerosol therapy.
   4. Supervise use of metered dose inhalers.
   5. Administer medical gas therapy.
   6. Perform arterial puncture and analysis of blood specimens.
   7. Perform pulse oximetry.
2. Plan respiratory care based on individual patient needs.
   1. Review patient medical records.
   2. Assess persons receiving respiratory care.
   3. Determine therapeutic goals for care.
   4. Estimate consistency of therapeutic goals with indications for ordered care.
   5. Develop plan of care designed to accomplish therapeutic goals.
3. Complete assigned duties according to departmental priorities
   1. Demonstrate an understanding of departmental policies which impact on completion of assigned duties.
   2. Integrate additional duties assigned throughout shift.
   3. Enlist assistance as needed to complete assigned duties.
   4. Revise scheduled duties as needed.
   5. Organize assigned duties at beginning of shift.
4. Demonstrate proper application of transcutaneous monitoring.
   1. Describe the rationale for transcutaneous monitoring.
   2. Correlate transcutaneous PO2 and PCO2 to arterial values.
   3. Document transcutaneous PO2and PCO2 according to departmental policy.
   4. Calibrate transcutaneous monitors.
   5. Change TCM electrode sites according to protocol.
   6. Perform routine maintenance and troubleshooting on monitors which are in use.
5. Apply mechanical ventilation to adult and pediatric patients to accomplish therapeutic goals.
   1. Describe indications for mechanical ventilation.
   2. Explain each parameter which will alter PaO2and PaCO2.
   3. Utilize patient medical records to determine ventilation goals.
   4. Correlate ventilation goals to patient condition and effects of ventilators.
   5. Evaluate effectiveness of ventilation in achieving goals.
   6. Recommend changes in mode, parameters or ventilators to best achieve therapeutic goals.
   7. Provide adequate humidification to persons receiving mechanical ventilation.
   8. Wean persons from mechanical ventilation.
   9. Provide adequate protection from infection to persons receiving mechanical ventilation.
6. Monitor persons receiving mechanical ventilation.
   1. Assess patient response to mechanical ventilation using noninvasive clinical assessments.
   2. Utilize capnometry to evaluate patient response to mechanical ventilation.
   3. Utilize pulse oximetry to evaluate patient response to mechanical ventilation.
   4. Utilize hemodynamic monitoring to evaluate patient response to mechanical ventilation.
   5. Evaluate patient ability to be weaned from mechanical ventilation.
   6. Perform studies to determine optimum PEEP.
7. Suggest modifications to care based on patient needs.
   1. Identify persons who would benefit from modes of respiratory care.
   2. Determine if therapeutic goals are being met by currently ordered respiratory care.
   3. Identify modifications to therapy which could benefit patients.
   4. Contact physicians to discuss proposed modifications to care.
   5. Recommend modifications, discontinuation or addition of therapies which will benefit persons with pulmonary problems.
   6. Initiate ordered changes to therapy.
   7. Evaluate appropriateness of changes made.
8. Evaluate effectiveness of therapies based on assessment of patient responses.
   1. Identify therapeutic goals of ordered therapies.
   2. Assess patient progress toward therapeutic goals over course of time therapies have been administered.
   3. Determine if current therapies are meeting therapeutic goals.
9. Perform routine maintenance on blood gas analyzers.
   1. Evaluate function of analyzer(s) to determine presence or absence of problems.
   2. Change membranes and electrodes as needed.
   3. Replace solutions, reagents and gases as needed.
   4. Analyze quality control standards according to laboratory protocol.
   5. Document values obtained from quality control samples.
   6. Identify problems with analyzers based on data from quality control samples.
   7. Identify problems based on comparisons of values from the same sample on various machines.
   8. Correct problems identified from quality control and duplicate sample analysis.
   9. Maintain clean and safe working environment in laboratory.
   10. Practice safety with regard to blood borne pathogens in the laboratory.
10. Perform pulmonary function testing on adults and children.
    1. Describe the indications for pulmonary function testing.
    2. Describe equipment necessary to test pulmonary function.
    3. Follow CDC guidelines for infection control in the laboratory.
    4. Follow ATS standards for equipment and protocols in the laboratory.
    5. Test persons according to physician orders and patient situation.
    6. Interpret results of testing.
11. Maintain airway patency.
    1. Utilize noninvasive techniques to maintain a patent airway.
    2. Insert artificial airways to maintain airway patency.
    3. Change artificial airways as needed.
    4. Utilize proper humidification of artificial airways.
    5. Suction artificial and natural airways.
12. Perform basic and advanced cardiopulmonary resuscitation.
    1. Identify situations in which CPR is needed.
    2. State the proper sequence of CPR.
    3. Demonstrate proper application of CPR to persons requiring it.
    4. Function as either a ventilator or compressor during advanced life support.
    5. Perform in any needed role in life support.
13. Perform noninvasive cardiac diagnostic tests under supervision.
    1. Perform 12 Lead electrocardiography.
    2. Perform peripheral vascular studies.
    3. Connect electrodes and equipment for Holter monitoring.
    4. Perform exercise testing.