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Hospital Programs for Respiratory Management during Acute SCI

Respiratory management for SCI patients is thought to be most effective when the care extends beyond the individual to incorporate entire specialized hospital programs (Parker et al. 2010). The following three articles examine the effect of respiratory management programs on enhancing patient recovery and decreasing hospital stay compared to regular hospital treatment that may differ for each individual. Hospital programs may include clinical practice pathways that allow for simple, objective decisions (Vitaz et al. 2001). In essence, all medications, tests, and treatments to be delivered to a patient are laid out in a framework on a daily basis and this care is standardized for all acute SCI patients. These programs may also require the introduction of an interdisciplinary team that can fulfill all the needs of the patient (Cameron et al. 2009).

Effectiveness of Hospital Programs for Respiratory Management

Discussion

Overall, hospital programs for respiratory management have been shown to benefit individuals more so than traditional hospital care. These programs reduce length of hospital stay (Cameron et al. 2009; Vitaz et al. 2001), help individuals gain independence by initiating speaking valves sooner (Wong et al. 2012) and reduce the incidence of pulmonary complications (Vitaz et al. 2001). Although Wong et al. (2012) did not perform statistical analyses to compare the efficacy of their program, the proportion of patients who received respiratory management therapies was more than before the program was initiated, emphasizing the notion that hospital programs are developed to ensure that every patient receives the highest quality of care and treatments at the appropriate time.

Conclusion

There is level 3 evidence (from one pre-post test; Wong et al. 2012) that the implementation of specialized respiratory management results in stabilization and improvement of respiratory status in acute SCI patients.

There is level 2 evidence (from one cohort study; Cameron et al. 2009) that the tracheostomy review and management service reduces length of hospital stay and duration of cannulation while increasing speech valve usage in acute SCI patients.

There is level 3 evidence (from one cohort; Vitaz et al. 2001) that the use of a clinical care pathway reduces length of hospital stay and results in fewer complications in acute SCI patients.

  • Respiratory management hospital programs may lead to improved patient care during the acute phase post SCI.