Evaluation of Respiratory Therapist Extender Comfort With Mechanical Ventilation During COVID-19 Pandemic

Burnout Among Respiratory Therapists Amid the COVID-19 Pandemic

BACKGROUND

Burnout is a major challenge in health care and is associated with poor overall well-being, increased medical errors, worse patient outcomes, and low job satisfaction. There is scant literature focused on the respiratory therapist's (RT) experience of burnout, and a thorough exploration of RTs' perception of factors associated with burnout has not been reported. The aim of this qualitative study was to understand the factors associated with burnout as experienced by RTs amid the COVID-19 pandemic.

METHODS

We performed a post hoc, qualitative analysis of free-text responses from a survey of burnout prevalence in RTs.

RESULTS

There were 1,114 total and 220 free-text responses. Five overarching themes emerged from the analysis: staffing, workload, physical/emotional consequences, lack of effective leadership, and lack of respect. Respondents discussed feelings of anxiety, depression, and compassion fatigue as well as concerns that lack of adequate staffing, high workload assignments, and inadequate support from leadership contributed to feelings of burnout. Specific instances of higher patient acuity, surge in critically ill patients, rapidly evolving changes in treatment recommendations, and minimal training and preparation for an extended scope of practice were reported as stressors that led to burnout. Some respondents stated that they felt a lack of respect for both the RT profession and the contribution of RTs to patient care.

CONCLUSIONS

Themes associated with burnout in RTs included staffing, workload, physical and emotional exhaustion, lack of effective leadership, and lack of respect. These results provide potential targets for interventions to combat burnout among RTs.

Adoption and Safety Evaluation of Comfortable Nursing by Mobile Internet of Things in Pediatric Outpatient Sedation

The aim of study was to explore the application effect and safety of comfortable nursing based on optimized mobile Internet of Things (MIoT) in the clinical sedation and diagnosis of mycoplasma pneumoniae pneumonia (MPP) in children. A total of 70 children with MPP admitted to the respiratory clinic of hospital were randomly selected and divided into a control group (comfortable nursing mode) and an observation group (comfortable nursing mode based on optimized MIoT), with 35 cases in each. The nursing effects and safety were compared between groups. The results showed that the node jitter rate, delivery success rate, and congestion times of the multilayered sensing algorithm were better than those of the mobile relay area segmentation algorithm and the wedge merge-energy hole elimination area segmentation algorithm. The CD-RISC resilience score of the observation group ((94.72 ± 1.58) points), the proportion of children with Frankl-3 and 4 points (90%), and the comfort level ((95.01 ± 5.68) points) were higher than those of the control group ((64.12 ± 1.62) points, (33.33%), and (55.23 ± 6.18) points) (P < 0.05). After treatment, the proportion of children with HRCT image lesions in the observation group was lower than that in the control group (P < 0.05). After treatment, the FEV1 ((85.71 ± 5.23) % vs. (68.26 ± 5.90) %) and FEV1/FVC ((74.22 ± 2.12) % vs (64.38 ± 2.34) %) of the observation group were significantly better than those of the control group (P < 0.05). The results showed that the incidence of adverse reactions in the observation group (14%) was significantly lower than that in the control group (46%) (P < 0.05). MIoT-assisted comfort nursing based on multilayer perception region segmentation algorithm can more effectively relieve the emotions of children in MPP outpatient department during sedation and diagnosis and treatment, improve the therapeutic effect and safety, and is worthy of clinical promotion.

Pediatric Intensive Care Hybrid-Style Clinical Round During COVID-19 Pandemic: A Pilot Study

Objectives: With the evolving COVID-19 pandemic and the emphasis on social distancing to decrease the spread of SARS-CoV-2 among healthcare workers (HCWs), our pediatric intensive care unit (PICU) piloted the integration of Zoom meetings into clinical rounds. We aimed to explore the feasibility of these hybrid virtual and physical clinical rounds for PICU patients. Design: Mixed quantitative and qualitative deductive thematic content analysis of narrative responses. Setting: PICU, single tertiary-care academic center. Participants: Multidisciplinary PICU HCWs. Interventions: Integration of Zoom meeting into clinical daily PICU rounds. Measurements: For the quantitative part, we gathered the details of daily PICU hybrid rounds in terms of times, number of HCWs, and type of files shared through Zoom. For the qualitative part, open-ended questions were used. Main Results: The physical round took statistically significantly less time (34.68 ± 14.842 min) as compared with the Zoom round (72.45 ± 22.59 min), p < 0.001. The most shared component in the virtual round was chest X-rays (93.5%). Thirty-one HCWs participated in focus group discussions and were included in the analysis. Some of the HCWs' perceived advantages of the hybrid rounds were enabling multidisciplinary discussions, fewer round interruptions, and practicality of virtual discussions. The perceived challenges were the difficulty of the bedside nurse attending the virtual round, decreased teaching opportunities for the trainees, and decreased interactions among the team members, especially if video streaming was not utilized. Conclusions: Multidisciplinary hybrid virtual and physical clinical rounds in the PICU were perceived as feasible by HCWs. The virtual rounds decreased the physical contact between the HCWs, which could decrease the possibility of SARS-CoV-2 spread among the treating team. Still, several components of the hybrid round should be optimized to facilitate the virtual team-members' interactions and enhance the teaching experience.

Adherence to COVID-19 Appropriate Behavior Among Respiratory Therapists: A Cross-Sectional Study in the Kingdom of Saudi Arabia

Background: Adherence to novel coronavirus disease 2019 (COVID-19) appropriate behavior plays a crucial element in the management of the infections of COVID-19. Despite the importance of transmission-reducing behaviors among healthcare professionals, there is a lack of literature in this area of research explicitly relating to respiratory therapists (RTs). Therefore, it is essential to assess the adherence level to COVID-19 transmission-reducing behaviors among the RTs in Saudi Arabia. Methods: A web-based online survey was conducted using questions based on the risk assessment guidelines of WHO. A random representative sample of RTs (N = 215) residing in Saudi Arabia was recruited for the study. Descriptive and inferential statistics were computed using STATA software. Logistic regression analysis was used to identify key factors that are associated with adherence to COVID-19 appropriate behavior among the study participants. Results: Of the 215 participants, 59.5% were aged between 26 and 35 years, and 40.9% were women. Most (85.5%) participants had a bachelor's degree while 12.0% had a master's degree. About 56.2% of RTs provided direct care to a confirmed patient of COVID-19 during the study periods. The study showed 80.9% of RTs in Saudi Arabia adhered to personal protective equipment (PPE) at the workplace and 65.0% at home. Moreover, the findings of the study indicated that senior RTs (with >5 years of experience) demonstrated a higher adherence level to the guidelines than RTs with <5 years of experience. High-risk perception [aOR:2.32; 95% CI: 1.09-3.27], and work history of <5 years [aOR:2.00; 95% CI: 1.14-3.15], were found to be the strongest predictors in explaining the adherence to appropriate behavior among the RTs at the workplace. Whereas the high-risk perception [aOR:2.32; 95% CI: 1.09-3.27] and being married [aOR:1.85; 95% CI: 1.08-3.82] were found to be the strongest predictors at home. Conclusion: Adherence ("Always" or "Most times") to COVID-19 appropriate behavior was found to be high at hospital settings among the study participants. However, the same practice was found to be inconsistence in non-healthcare settings among the RTs. Considering the paramount role of COVID-19 appropriate behavior in reducing the transmissions the policy focus, therefore, needs to be on creating a well-spread behavior change communication that is curtailing the adoption of appropriate behavior in the non-healthcare settings.

Prevalence of Burnout Among Respiratory Therapists Amidst the COVID-19 Pandemic

Background: Burnout is a major challenge in health care, but its prevalence has not been evaluated in practicing respiratory therapist (RTs). The purpose of this study was to identify RT burnout prevalence and factors associated with RT burnout.Methods: An online survey was administered to 26 centers in the United States and between January and March 2021. Validated, quantitative, cross-sectional surveys were used to measure burnout and leadership domains. The survey was sent to department directors and distributed by the department directors to staff. Data analysis was descriptive and logistic regression analysis was performed to evaluate risk factors, expressed as odds ratios (OR), for burnout.Results: The survey was distributed to 3,010 RTs, and the response rate was 37%. Seventy-nine percent of respondents reported burnout, 10% with severe, 32% with moderate, and 37% with mild burnout. Univariate analysis revealed those with burnout worked more hours per week, worked more hours per week in the ICU, primarily cared for adult patients, primarily delivered care via RT protocols, reported inadequate RT staffing, reported being unable to complete assigned work, were more frequently exposed to COVID-19, had a lower leadership score, and fewer had a positive view of leadership. Logistic regression revealed burnout climate (OR 9.38, p<0.001), inadequate RT staffing (OR 2.08 to 3.19, p=0.004 to 0.05), being unable to complete all work (OR 2.14 to 5.57, p=0.003 to 0.20), and missing work for any reason were associated with increased risk of burnout (OR 1.96, p=0.007). Not providing patient care (OR 0.18, p=0.02) and a positive leadership score (0.55, p=0.02) were associated with decreased risk of burnout.Conclusion: Burnout was common among RTs in the midst of the COVID-19 pandemic. Good leadership was protective against burnout while inadequate staffing, inability to complete work, and burnout climate were associated with burnout.