The Effects of Respiratory Therapist-Driven Bronchodilator Protocol Compared to Physician-Ordered Bronchodilator

The evolving respiratory care landscape experienced a fundamental change toward evidence-based practices and protocol-based techniques for optimized resource utilization and improved patient outcomes. This research aims to contribute to a paradigm shift by examining the impact of a respiratory therapist-driven bronchodilator protocol compared to the conventional physician-ordered bronchodilator approach. Investigating the specific area of bronchodilator therapy is crucial as protocol-based health care gains prominence in the industry. Different scholars examined various respiratory care services in the protocol-driven care context (1). However, a discernible gap is evident in the literature concerning the distinct details related to bronchodilator protocols conducted by respiratory therapists. In that regard, the research focuses on this uncharted territory, aiming to elaborate on the impact of therapist-driven bronchodilator protocols on patient outcomes and resource utilization. This undertaking would contribute to the ongoing debate about evidence-based practices in respiratory care.

Extensive research in the broader respiratory care context has investigated the application of protocol-driven care and evidence-based practices in various respiratory services. Notably, various studies highlighted the effectiveness of protocol-driven techniques in services, including oxygen administration, bronchopulmonary hygiene, and lung expansion therapy (3). However, there needs to be more literature concerning the specific examination of respiratory therapist-based bronchodilator standards. Indeed, previous studies demonstrated the efficacy of protocol-based care in reducing the cost and frequency of respiratory services. For example, Fleming et al. and Kallam et al. demonstrated significant reductions in the use of specific treatments and staffing following protocol implementation (4) (3). Nevertheless, there has been a limited focus on bronchodilator therapy, which is a common and critical element of respiratory care. Thus, the current research aims to cover this gap by refining the unique dynamics of therapist-based bronchodilator practices. This honing would provide a broad examination of the protocols’ impact on patient outcomes and resource utilization in the context of evidence-based respiratory care.

The gap in existing literature underscores the significance of researching respiratory therapist-driven bronchodilator protocols. Although protocol-driven care and evidence-based practices have been extensively studied (1), the specific focus of therapist-driven bronchodilator protocols is markedly limited. This research aims to fill this gap by highlighting the essential aspect of respiratory care, covering the knowledge void on the effects of therapist-driven bronchodilator standards. This study’s significance lies in its potential to guide healthcare professionals and policymakers in optimizing bronchodilator therapy. This treatment is crucial in respiratory care as it aims to enhance patient care efficiency. The research findings could influence clinical decision-making, healthcare practices, and protocol development. This contribution would lead to a more nuanced and evidence-based approach to bronchodilator treatment.

The main research question aims to address the identified gap in the current knowledge of respiratory care practices. It covers details of whether implementing a respiratory therapist-driven bronchodilator protocol would significantly impact resource utilization without negatively affecting patient outcomes. The question is pivotal in revealing the effectiveness of protocol-driven care tailored for bronchodilator treatment, which is a key part of respiratory care. Delving into this investigation, the research intends to contribute valuable insights into whether respiratory therapists’ decision-making autonomy regarding bronchodilator therapies leads to a noticeable decrease in resource utilization while ensuring high-quality patient care (2). The hypothesis, envisaging a reduction in resource utilization without affecting patient outcomes negatively, underscores the transformative potential of therapist-driven bronchodilator standards on healthcare practices. This warrants a comprehensive investigation to guide evidence-based techniques in respiratory care.

References

1. Rycroft‐Malone J, Seers K, Titchen A, Harvey G, Kitson A, McCormack B. What counts as evidence in evidence‐based practice?. Journal of advanced nursing. 2004 Jul;47(1):81-90.
2. Rycroft‐Malone J, Fontenla M, Seers K, Bick D. Protocol‐based care: The standardization of decision‐making?. Journal of Clinical Nursing. 2009 May;18(10):1490-500.
3. Kallam A, Meyerink K, Modrykamien AM. Physician-ordered aerosol therapy versus respiratory therapist-driven aerosol protocol: the effect on resource utilization. Respiratory Care. 2013 Mar 1;58(3):431-7.
4. Fleming K, George JL, Bazelak SJ, Roeske JA, Biggs AD, Landry CM, Lipchik RJ, Truwit JD. Optimizing respiratory therapy resources by de-implementing low-value care. Respiratory Care. 2023 May 1;68(5):559-64.