Patient-Ventilator asynchrony: Surveying the Knowledge of respiratory therapists in Saudi Arabia

Abstract

Objective: Patient-ventilator asynchrony (PVA) commonly occurs in critically ill patients, and it is connected with poor health outcomes. To prevent PVA, respiratory therapists (RTs) must have sufficient knowledge regarding respiratory physiology and mechanics and have the ability to understand ventilator graphics and patient signs and symptoms. However, little is known of the respiratory care practitioner's knowledge about PVA. The aim of this study is to assess the ability of RTs to identify and manage PVAs based on their years of experience, previous training, and characteristics of their clinical setting. Methodology: A study questionnaire was developed to examine the knowledge of RTs to identify PVA. This pilot survey was reviewed and tested by selected experts in the respiratory care field for appropriateness of questions and accuracy of the content. The final survey consisted of 33 items. This include six items on the respondent's demographic information, four on the previous PVA education, eight on the workplace policy and five ventilator screenshot to measure RTs' knowledge on waveform interpretation. Each screenshot had two open text questions asking about the possible causes and solutions for the identified asynchrony. Data were collected and managed using Qualtrics. Exploratory analysis using descriptive statistics was used to analyze the data. Results: A total of 118 recorded responses were received, and 79 participants completed the full survey. Overall, the ability to identify asynchronies on ventilator graph screenshots was poor. Only two RTs (1.7%) correctly detected all five types of asynchrony, whereas 14 (11.8%) identified four asynchronies, 31 (26.1%) recognized three asynchronies, 24 (20.2%) detected two asynchronies, 12 (10.1%) identified only one asynchrony, and 36 (30.3%) did not recognize any asynchronies. No statistically significant differences regarding previous training, years of experience, and work characteristics were observed. Conclusions: The overall knowledge regarding the identification of PVA among RTs is poor. Previous training, years of experience, and work characteristics were not an indicator to correctly identify PVAs.