Enhancing the Effectiveness of Chest Physical Therapy By Patients' Personal Care Assistants in a Respiratory Care Ward

Enhancing the effectiveness of chest physical therapy by patients’ personal care assistants in a respiratory care ward.

Purpose:

In the respiratory care ward, there are many patients with prolonged ventilator dependence. As a consequent, nurses give health care education in chest respiratory care to patients’ personal-care assistants (PCAs) and its correct execution to PCAs, and both influence the quality of respiratory care. This project was designed to evaluate and enhance the accuracy of chest physical therapy by patients’ PCAs in a respiratory care ward.

Methods:

Data collection and status analysis 

A Table for Chest Physical Therapy was designed to evaluate the status before and after chest physical therapy by patients’ PCAs in a respiratory care ward. In a sample of 52 transactions, only 11.3% accuracy was achieved. Based on the questionnaire results from 30 patients’ PCAs, 24 (80%) identified instructions from nursing staff, 10 (33.3%) recognized their regular instructions, and another 10 (33.3%) neither realized the importance of chest physical therapy nor that the lack of this therapy might cause complications. The data also showed that 85% of the patient’s PCAs were foreigners who might have had communication problems.

Setting measurements and improvement

We established a Team for Standardizing Nursing Instructions in order to conduct a documentary survey and to issue health education pamphlets like “ Chest Physical Therapy” and “Chest Physical Therapy Standards” to ensure the consistency of nursing instructions to major PCAs. The CD-ROM “Multi-language Demonstrations of Chest Physical Therapy” was produced to provide a learning model for foreign PCAs.

Results:

An on-site survey of the execution of chest physical therapy conducted by patient’s PCAs in the respiraoty care ward was carried out. Twenty-seven (86%) patients’ PCAs indicated the importance of chest physical therapy and the possibility of ignorance causing complications. Use of the Table for Chest Physical Therapy increased the accuracy from 11.3% to 77.1%. Based on a paired t-test analysis of the two sets of scores, the recognition increase was statistically significant (p <0.001).

Conclusion:

This project was designed to provide learning opportunities for patient’s personal-care assistants by providing nursing instruction standards and learning aids. Multi-media learning aids are highly recommended for the provision of complete nursing care through clinical demonstrations.

Key words: respiratory care ward, chest physical therapy, multi-media instructions