Disparity in Injury Awareness Between Nurses and Respiratory Therapists: Are Respiratory Therapy Device Injuries Under-Reported?

Background: Institutional cultures promote nurses as the primary skilled providers for recognizing and preventing injuries. However, ETT management is primarily the responsibility of the respiratory therapist (RT) at many institutions. The purpose of this study is to determine the disparity in injury awareness between nurses and RTs. Methods: A process assessment was created to determine the value of trained RTs in the early detection, prevention, and management pertaining to medical device-related injuries (MDRI) in the Department of Respiratory Care Services at Emory Midtown Hospital. During a 27-month period, RT and nursing documentation of 191 ETT device-related injuries, cheeks, lips, gums, nose, nares, and skin irritation of mechanically ventilated patients (n = 145) were reviewed. Quantitative indicators represented the number of monthly ETT-associated MDRI. Data from chart audits were performed regarding incidences, injury locations, and provider documentation adherence for RT device-related injury. Results: The results reveal a large disparity in the awareness of ETT device-related injuries among the providers which was reflected in their documentation. RTs were 98% more likely aware of injuries discovered than their nursing counterparts 57%. The likelihood of RTs and nurses both being aware of injuries was 43%, suggesting provider collaboration for patient safety. The lack of documentation alignment between providers can be associated with the underreporting of injuries, if nursing reports and documentation are the only provider sources utilized. Conclusions: This assessment exposes the value of knowledgeable and trained RTs as partners to assist in early detection, prevention, management, and quality improvements of MDRI in respiratory care.