BS Respiratory Care Assessment Report 2007 - Marshall University

ANNUAL REPORT I.

ASSESSMENT ACTIVITIES:

A. Program Goals The goals of the St. Mary‘s/Marshall University Cooperative Bachelor of Science in Respiratory Care are congruent with the mission of Marshall University. Our goals must also be congruent with St. Mary's Medical Center. Our goals were therefore revised and approved by the Faculty Organization in its May 2006 meeting. The revised goals also included objectives which are sealed in measurable terms. (See Appendix A for the evaluation of the BSRT program goals for the 2005-2006 academic goals.) A formal Systematic Evaluation Plan is in place for the St. Mary's/ Marshall University Cooperative BSRT Program. The components being evaluated include: Mission and Governance Faculty Student Curriculum and Instruction Resources Integrity Educational Effectiveness The assessment plan is implemented by ad hoc committees out of the St. Mary's Center for Education Faculty Organization. The program is scheduled to be evaluated by site visitors from the Committee on Accreditation for Respiratory Care (CoARC) during the fall of 2009. A ―letter of intent‖ to start a BSRT program was submitted to CoARC and approved in September of 2004. A thorough self-study was submitted to CoARC in May of 2005. CoARC reviewed the self study issued and approved the program to begin following a few revisions. The school will have an on site visit by CoARC within six months following the graduation of the first class. There were three standards that CoARC sought revision of and those have been addressed. (See Appendix B for letter from CoARC) The faculty reviews the evaluation data to be used for program development, maintenance and revision. Therefore, the faculty members of St. Mary's/Marshall University Cooperative BSRT Program have reviewed the revision of the standards and criteria and are in the process of updating the program's systematic plan. The faculty approved a calendar for reviewing each component at the May 2006 meeting of the Faculty Organization. A revised template was also approved at this same meeting. (A copy of the schedule and the Systematic Evaluation Plan is included in Appendix C.)

B./C.

LEARNING OUTCOMES/DATA COLLECTION/RESULTS

The Committee for Accreditation for Respiratory Care (CoARC) is the recognized accrediting body for Respiratory Care and has specific guidelines in the standards that a Respiratory Care program must demonstrate to be in compliance with the program outcome criteria. These specific standards and goals of the Bachelor of Science Degree in Respiratory Care are incorporated into the courses. The course and clinical objectives reflect these competencies. See Appendix D for course and clinical syllabi. The program outcomes used to evaluate the Cooperative BSRT Program are performance on licensure examination, job placement rates, program satisfaction, and graduation rates. Our outcomes and definitions were changed to reflect the CoARC outcomes. Criteria for each of the required and selected outcomes are measured at the end of the program during the students' final semester. In addition course evaluations are administered at the end of each semester. The results of these course evaluations are reviewed by the faculty and any deficiencies are corrected and implemented int o the appropriate course instruction. Definition of Outcomes: 1. Clinical Assessment: Assessment is evaluated each semester for application of procedures that have or are presently being instructed. If a negative review has been noted by a faculty member then the student is re-instructed in the procedure and reevaluated by another faculty member. If the student is again found to be deficient the student is re-instructed by the faculty member. A final review is done with the student by the director of the respiratory care program. If it is determined the student is in fact deficient in the competency a failing grade will be recorded. 2. Licensure Pass Rate: Performance on licensing examination (NBRC) is the percentage of graduates passing the NBRC entry level examination on the first attempt. Defined Level of Achievement: The BSRT program has not graduated any students at this point. At this time there is no information to submit. The currently enrolled class will not be eligible to sit for their examination until January 2010. Our goal is for each class that sits for the NBRC entry level licensure examination that we will meet or exceed the national pass rate on their first attempt.

This data is collected from reports submitted to each school by the Committee on Accreditation for Respiratory Care. Table 1: Licensure Pass Rate CLASS 2009 2010 2011 2012 2013 2014 2015 2016 2017

# OF GRADS N/A N/A

% PASSING N/A N/A

NBRC PASS RATE N/A N/A

NBRC NATIONAL N/A RATE N/A

Job Placement Rates: The first class will not graduate until December of 2008. There is no information to report at this time. Defined Level of Achievement: 90% or greater of graduates seeking employment as a CRT or RRT will be employed within 6 months of graduation. This data is collected by the faculty. The employment data does indicate that the graduates who are seeking employment do work as graduate CRT or RRT‘s. Table 2, Job Placement Rates reflects this data. Table 2: Job Placement Rates

1.

CLASS

# GRADUATES

# EMPLOYED & %

2009 2010 2011 2012 2013 2014 2015 2016 2017

N/A N/A

N/A N/A

NO INFORMATION AVAILABLE N/A N/A

# NOT SEEKING EMPLOYMENT N/A N/A

Program Satisfaction: Program satisfaction is the degree to which the current students rate the effectiveness and quality of the Respiratory Care program. The students evaluate each course of instruction at the completion of the

semester and assigned a rating of 1-5 on a Likert scale.

Program satisfaction is the degree to which the graduates rate the effectiveness and quality of The Respiratory Care program.

Defined Level of Achievement: Current students enrolled in the program evaluate each course of instruction at the completion of the semester and assigned a rating of 1-5 on a Likert scale. Current students will indicate satisfaction with the program with 2.5 or higher on a Likert scale of 1-5. To assess satisfaction with the class progression and the program, the St. Mary's School of Respiratory Care course evaluations is considered one of the primary sources of data. Graduates will indicate satisfaction with the program with 2.5 or higher on a Likert scale of 1-5. To assess graduate satisfaction with the program, the St. Mary's School of Respiratory Care Graduate Survey Questionnaire is one of the primary sources of data. At this time there are no graduates from the school of respiratory care. The first survey is to be conducted in the summer of 2009. The data collected will be trended and will indicate overall graduate satisfaction. Table 3, Program Satisfaction illustrates the data. Table 3: Program Satisfaction CLASS 2009 2010 2011 2012 2013 2014 2015

STUDENT SURVEY N/A N/A

Likert Scale:

1 = Highest;

5 = Lowest

*Likert Scale:

5 = Highest;

1 = Lowest

ALUMNI QUESTIONNAIRE N/A N/A

MU GRADUATING SENIOR N/A QUESTIONNAIRE N/A

**Percent of those responding to agree/valuable or higher ***Alumni Questionnaire results compiled for Classes of (N/A) 1.

Graduation Rates: Graduation rates are defined as the percentage of students successfully completing the program within four years. Defined Level of Achievement:

75% or greater of students who enter the program will graduate within four years of the start of the program. No graduation rates have been calculated since the first graduating class will not be complete all course requirements until December 2008 but will be based on criteria that the students must graduate in the specified time of four years. Table 4 demonstrates the admission/retention/graduation rates. This data is collected on a continual basis by the Director. This attrition report is filed annually with CoARC. See Appendix E for annual report filed with CoARC. The faculty of St. Mary‘s School of Respiratory Care is committed to be available to all students. Each student is assigned an advisor at the beginning of each year of the program. The faculty member meets during the year with each advisee. The faculty also makes every effort to contact their respective advisees who are experiencing difficulty in the program to assess the problems and problem solve for solutions. It is a requirement that any student scoring below a 75% on any unit exam meet with the assigned advisor to review the exam.

Table 4: Admission/Retention/Graduation Rates CLASS 2009

ADMISSI ONS 14 Admitted - 2 Withdrawals

GRADUATED N/A

RETENTION RATE 86%

12 currently enrolled 2010

13 Admitted - 5 Failure to Maintain ―C‖ Average

8 currently enrolled 2011 2012 2013

N/A

61%

2014

Academic difficulty is not the only reason a student may withdraw from the program. It is important to look at the number of students who withdraw for other reasons. Table 5 demonstrates reasons for withdrawal over the past 3 years. Table 5: Reason for Withdrawal CLASS 2009 2010 2011 2012 2013 2014 2015 2016 2017

ACADEMIC 0 4 N/A N/A N/A N/A N/A N/A N/A

HEALTH 0 N/A N/A N/A N/A N/A N/A N/A N/A

PERSONAL 2 1 N/A N/A N/A N/A N/A N/A N/A

OTHER 0 N/A N/A N/A N/A N/A N/A N/A N/A

St. Mary‘s/Marshall University will make graduation comparison rates with the ACT news release (www.act.org) once the first class has graduated Class 2012 2011 2010 2009

Public Institutions N/A N/A N/A N/A

Private Institutions N/A N/A N/A N/A

All Institutions N/A N/A N/A N/A

Table 6 Retention Rates for NCAA At the end of each semester, the St. Mary's Bachelor of Science Academic Planning and Standards Committee reviews course and clinical syllabi for activities and evaluation criteria related to the learning outcomes. Copies of course syllabi are submitted with this report. See Appendix F In order to successfully complete the required courses, students must demonstrate the satisfactory achievement of the following learning outcomes from the RRT NBRC Job Matrix:

See Appendix G Table 7 illustrates the data that will be obtained from St. Mary's/Marshall University Graduate Questionnaire. Table 7: Learning Outcomes

Respiratory Process Therapeutic Respiratory Interventions Managing Care Teaching/ Learning Critical Thinking

Class of 2014 Class of 2013 Class of 2012 Class of 2011 N/A N/A N/A N/A

Class of 2010 Class of 2009 N/A N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A N/A

N/A N/A

N/A N/A

N/A N/A

N/A N/A

N/A N/A

N/A

N/A

N/A

N/A

N/A

N/A

Likert Scale: 1 = Excellent; 5 = Poor At the end of each course, students complete evaluations of the course. The required learning outcomes are a part of these evaluations. See Appendix - Course Evaluations Prior to graduation, students complete a written evaluation of the BSRT program. This evaluation also includes the learning outcomes. Graduating students also complete the Marshall University Graduating Student Outcomes Questionnaire. This survey was not available at the time this report was completed. Performance on NBRC Entry Level Examination is described in Section II, Senate Bill 653 Compliance, and also in Table 1 in Section I.

II. SENATE BILL 653 COMPLIANCE: St. Mary's/Marshall University Cooperative BSRT Program meets the requirements of Senate Bill 653. The program implements a Systematic Evaluation and evaluates achievement of goals annually. Both the Systematic evaluation and the goals are attached to this report in the appendices. The national standard for assessing the knowledge and skills of graduates of respiratory care programs in the

licensing examination (NBRC Entry Level). The benchmark established by the faculty of the St. Mary's/Marshall University Cooperative BSRT Program is: To meet or exceed the cut score established by the NBRC on their first attempt. This cut score changes from examination to examination based on national pass rates for all candidates. See Table 1 in Section I. III.

PLANS FOR THE CURRENT YEAR:

The plans for the 2007 — 2008 academic year include the implementation of the Systematic Program Evaluation Plan in the areas of Mission and Governance, Curriculum, and Evaluation. This will be done during the Fall of 2008 semester. A comprehensive standardized testing package will begin with the Class of 2009. The tests are produced by the National Board for Respiratory Care (NBRC). Beginning in the Fall of 2008, prior to the first day of class, every respiratory student will be required to take three tests: 1.

Test of Essential Academic Skills (TEAS)

2.

Critical thinking

3.

Self Assessment Inventory.

Students who do not achieve pre-determined scores on these tests will be required to attend Strive for Success classes weekly for 10 weeks. Strive for Success classes were developed by two nursing faculty members from the St. Mary‘s Center for Education. The classes will focus on study skills, learning styles, etc. Also, each student who does not pass a unit exam with a 76% or above will be required to meet with the instructors who developed the test and complete a remediation assignment. The Goals for 2007 – 2008 academic years are included in Appendix F. IV. ASSISTANCE NEEDED: The continued timely return of course and graduate evaluation data is greatly appreciated. V. IMPORTANT THING LEARNED: As with any assessment, the faculty members always find that program strengths and weaknesses are identified. Therefore, the faculty can try to correct weaknesses and continue to build upon strengths. The faculty members continue to work diligently to assist students who are having academic difficulty. We did revise our criteria for admission to the school for the next pool of applicants. It will be interesting to see if that assists in increasing our retention rate. The chart titled "Assessment of Student Outcomes: Component/Course/Program Level" is completed and may be reviewed below.

Marshall University Assessment of Student Outcomes: Component/Course/Program Level Component Area/Program/Discipline: St Mary's/Marshall University School of Respiratory Care Student Outcomes as Required by CoARC

Job Placement Rates

Person or Office Responsible

Chuck Zuhars, Director, And Brent Blevins, Clinical Director

Assessment Tool or Approach

Standards/ Benchmark

Results

Action Taken

Analysis

Graduate/Employer Survey 80% or greater of respiratory Roster with names graduates seeking and places of employment as a employment CRT or RRT will be employed within 6 months of graduation

N/A

N/A

Data from National St. ent. Board of Respiratory Care (NBRC) Mary’s/Marshall University School of Respiratory graduates will meet or exceed the cut score as set by the NBRC student pass the on the first attempt.

N/A

N/A

& Faculty Performance on Licensure Examinations

Chuck Zuhars, Director, And Brent Blevins, Clinical Director &

Faculty

Graduation Rates

Chuck Zuhars, Director,

Roster of names with data.

And Brent Blevins, Clinical Director

Program Satisfaction

Chuck Zuhars, Director And Brent Blevins, Clinical Director

St Mary's Graduate Questionnaire.

75% or greater of students who enter the program will graduate within four years.

Graduates will indicate satisfaction with the program with an average of 2.5 or greater on scale of 1-5. (Liked Scale: 1 = highest;5 = lowest)

N/A

N/A

N/A

N/A

Appendix A

St. Mary's/Marshall University Cooperative School of Respiratory BSRT Program Goals and Objectives: Service 1.

Maintain a satisfactory graduation rate. a.

Achieve a graduation rate of 80% or greater. The first class does not graduate until December 2008. There are no statistics to report.

2.

Provide academic support to students at risk of academic failure. a.

Continue enhancing the existing services and resources for the students. Goal Met: Various computer instructed cd roms are provided to the student to

enhance their learning experience. The Center for Education has purchased various manikins to enhance the students experience and training level prior to practice in the clinical area. The Center for Education has purchased periodicals to enhance and support their learning experience. This information is located in the student library. b.

Identify at risk students and assist them with a remediation plan that will assist them in achieving success in the respiratory program . Goal Met: The faculty of the School of Respiratory Care has a mandatory conference with the students at mid term. Weaknesses are identified at this point and discussed with the student. A remediation plan is designed and available for the student and assistance is rendered by the faculty to enhance the students learning experience.

Quality 1.

Faculty will maintain membership in professional organizations. a.

All faculty will be a member of a professional organization. Goal Met: All faculty members are members of the American Association of Respiratory Care and the National Board for Respiratory Care.

b.

Fifty percent (50%) of faculty will serve in a leadership role (officer, board member, committee member) in a professional organization. Goal Not Met: 2 faculty members have had the opportunity to be nominated for a leadership role in the West Virginia Society for Respiratory Care. The formal election has not been held as of this report.

2.

Prepare graduates for entry level CRT/RRT positions as indicated on

standardized tests. a.

Meet or exceed the national mean on standardized tests. There has not been a graduating class from the School of Respiratory Care. The first class will graduate in December 2008.

3.

Graduates will be prepared for entry level CRT/RRT positions as indicated by the National Board of Respiratory Care (NBRC). a.

The graduates will meet or exceed the national pass rate as determined by the National Board of Respiratory Care (NBRC). There has not been a graduating class from the School of Respiratory Care. The first class will graduate in December 2008.

4.

Maintain graduate satisfaction with the program. a.

The graduates will rate "program satisfaction" as a 2 or below on the St. Mary's Graduate Questionnaire. There has not been a graduating class from the School of Respiratory Care. The first class will graduate in December 2008.

5.

Enhance critical thinking skills. a.

The graduates will have a group mean score on the ATI Critical Thinking EXIT EXAM that meets or exceeds the ATI Critical Thinking ENTRANCE EXAM group mean. This testing phase will begin with the class that enters in the Fall of 2007.

6. Implement the PDA bulk-buying program for all incoming Year I students. Goal Met: PDA’s were purchased and given to the students

Financial 1.

Enhance financial resources. a. In collaboration with the SMMC Foundation, submit a grant through the Center for Education Grant Committee for student or faculty use. Goal Met: The faculty members of the School of Respiratory Care have participated in several grant applications to benefit the Center for Education.

2.

Faculty will support the capital campaign for the Center for Education. Goal Met: The faculty members have participated in activities that directly support the capital campaign.

3.

Faculty will seek support of area clinical affiliates to secure donations of supplies and equipment. Goal Met: The faculty and staff have solicited and obtained donations to assist the School of Respiratory Care.

People 1.

Caring will be a concept of the curriculum. a. Students will rate the courses as enhancing the "ability to be a caring professional" as evidenced by a mean of 2.5 or less on the St. Mary's Course Evaluation. Goal Met: The students complete course evaluations at the completion of each semester. The course evaluations have a rating for understanding of students needs. The faculty rating in this area is continues to rate above the cut score.

2.

Student communication skills will be developed. a. Students will rate the courses as facilitating "the development of my communication skills" as evidenced by a mean score of 2.5 or less on the St. Mary's Course Evaluation. Goal Met: The students complete course evaluations at the completion of each semester. The course evaluations have a rating for understanding of students needs. The faculty rating in this area is continues to rate above the cut score.

Growth 1.

Demonstrate a continued need for the BSRT Program. a.

Recruit a pool of qualified applicants for each space in the program. Total space allocation for the program is 15 students. Goal Met: The School of Respiratory Care has met the number of qualified applicant for the currently enrolled class and for the class beginning in January 2007. The sophomore class had 14 students enrolled. The current enrollment is 12. 1 student dropped because she married and moved out of the state. 1 student dropped and changed her major to elementary education. The freshman class had a total enrollment of 13 students 1 student dropped due to personal reasons 4 were dropped due to failure to maintain a “C” average

b.

Ninety percent (90%) of the graduates seeking a position in respiratory care will have a job offer within 6 months of graduation. There has not been a graduating class from the School of Respiratory

Care. The first class will graduate in December 2008

2.

Demonstrate a plan to enhance the physical facilities of the School of Respiratory Care. a.

Faculty will continue to participate in the planning for the Center for Education. Goal Met: The Respiratory Care program has been moved to another section of the school and has doubled the space previously held. There is ample space provided for the classes and labs to be conducted. The faculty of the School of Respiratory Care has been actively involved with the planning committee for the new Center for Education. The faculty have provided input and assisted with the allocated space for classroom and labs for their program.

3.

Implement a plan to address the respiratory shortage. a.

Achieve and implement a plan to attract the CRT‘s employed within a 50 mile radius of the school and recruit them for enrollment into the RRT program. Goal Met: Dr. Shelia Kyle, Vice President, School of Nursing and Health Professions, and St. Mary’s Center for Education and the faculty of the School of Respiratory Care have worked diligently this academic year and have seen qualified applicants for admission increase.

Community Encourage faculty involvement in community health related activities.

a.

All faculty will participate in a community health related activities. Goal Met: The faculty members have participated in health fairs throughout the tri-state area to promote health and wellness for the population of our service area.

2.

Enhance the students' ability to provide service to the community. a.

All students will participate in a community health project. Goal Met: Students will be assisting with the community health fair conducted in December of 2007. The respiratory care students will be working in unison with the nursing and radiology students.

b.

Students will rate the courses as enhancing the "ability to provide service to the community" as evidenced by an average score of 2.5 or greater on a Likert scale of 1-5 on the St. Mary's Course Evaluation. Goal Not Met: This will be conducted in the December of 2007

Appendix

B

Sponsored By:

The American Association of Respiratory Care • The American College of Chest Physicians The American Society of Anesthesiologists • The American Thoracic Society

Executive Office

MEMORANDUM

TO:

St. Mary's Medical Center

FROM:

Richard T. Walker, MBA, RRT CoARC, Executive Director

SUBJECT:

"APPROVAL OF INTENT" TO ESTABLISH A RESPIRATORY CARE PROGRAM

Date:

September 16, 2004

This "Memorandum" serves as formal approval to begin the process of establishing an educational program in Respiratory Care. Please be advised that a qualified Program Director should be appointed and will be responsible for of the initial review process. The initial review process will consist of the following:

1.

Self-Study #1 — For Programs seeking a "Letter of Review"

2.

Self-Study #2 — For programs seeking "Initial Accreditation"

3.

The On-Site Visit, to occur after the program's first class graduates

4.

Response to the Site Visit Report following the On-Site Visit

The following items can be found on the CoARC Web Site: www.coarc.com

1.

The CoARC Standards and Guidelines for the Profession of Respiratory Care

2.

CoARC Accreditation Handbook — see "New or Re-Accreditation" section

NOTE: The Program Director should feel free to call me for any assistance needed during the remainder of the accreditation process (817-283-2835, Ext. 101).

1248 Harwood Road • Bedford, Texas 76021-4244 (817) 283-2835 • Fax (817) 252-0773 • (800) 874-5615

June 9, 2005 Chuck Zuhars, RRT, MS Program Director Respiratory Care Program St. Mary's School of Respiratory Care/ Marshall University 2900 is! Avenue Huntington, West Virginia 25755 Dear Mr. Zuhars:

RE: 200506

I have completed my review of your self study and will be contacting you by telephone to discuss my findings. In

preparation for your next self study and your annual program evaluation, please re-address the following Standards. Standard V. A. 2. Fair Practices Program accreditation status must be stated in the college catalog. Note the following statement which should be in the college catalog. Any information that you send prospective students must also include program accreditation status. Program Statement: The Respiratory Care program is accredited by the Commission on Accreditation of the Allied Health Education Programs (CAAHEP), in collaboration with the Committee on Accreditation for Respiratory Care (CoARC), 1248 Harwood Road Bedford, TX 76021, 1-817-283-2835, http://www.coarc.com/. Standard III. A. Resources, Type & Amount and B. 1Key Administrative Personnel I am concerned with the limited administrative hours for the program director and director of clinical education as well as the very high (10:1) lab and clinical teaching ratios. Please consult with your administrative officers regarding adjustments in both these areas. Standard III, D Resource Assessment I wish to advise you to include the advisory committee members in your surveying. Please refer to the CoARC evaluation instruments Web page which states that the Personnel-Program Resource Survey, edition 3-2003, is to be administered annually at the program advisory Board meeting. This survey instrument is to be completed by program faculty, the Medical Director, and advisory board members. I also recommend revising your purposes statements for the library to include computer resources and electronic reference materials and financial resources to include fiscal support for the retention of personnel and the acquisition and maintenance of equipment and supplies. Please call me at (727) 341-3627 or reply via email should you require further assistance. Send your documents electronically or in hard copy form to the CoARC Executive Office and to me. Sincerely, Stephen Mikles, EdS, RRT Referee

Appendix C

Standardized Progress Report Questions - Program Attrition % Success Directions to the Program: The following questions have been developed by CoARC to guide your analysis and action plan, directed toward improving your outcomes on Program Attrition. Your Threshold Level of Success results on this outcome have triggered an accreditation dialogue consisting of assigning a referee and requiring this progress report. The referee is available to assist

you with your preparation of this report and the identification of possible changes to improve your attrition results. REMINDER: Upon completion of these questions, please forward a copy electronically to the Executive Office and Referee. Each program is encouraged to utilize the NBRC electronic filing system. Program Name: St. Mary's/Marshall University School of Respiratory Care CoARC Program Number: 200506 Your referee is: Stephen Mikles The progress report is due by: September 2009 For those Students leaving for non-academic reasons: 1. Could the attrition have been predicted at the time of the student's admission? For example, did the student expect to work part-time or full time during the program? Did the student have inadequate language skills to complete the program? If the answer is yes to any of the above, was the student adequately counseled about the rigors and time requirements of the program? The attrition of students could not be predicted at the time of admission. 1 student in the class of 2008 entered the program with aspirations of being in respiratory therapy. After attending the introductory classes she made the decision that respiratory care was not what she wanted to do as a career. The student in the class of 2009 dropped because of personal reasons that she stated was not due to anything or anyone in the program. She stated it was purely for personal reasons she did not feel free to discuss. The 2nd student was engaged to be married when accepted in the respiratory class. During the summer 2006 session her fiancé accepted employment in another state and she withdrew to move out of state with him. The other 4 students in the class of 2009 were forced to leave the program for academic reasons. All 4 students stated they did not realize the complexity of the program and due to other commitments this greatly decreased their performance. All the students had the appropriate language skills to be successful in this program. All the students were counseled prior to admission to the respiratory care program as to the time commitment required to be successful in this program. Revised November, 2002

2. Did the student know what he/she was getting into? For example, does the program require prospective students to `shadow' a Respiratory Th erapist at one of its clinical sites before acceptance into program? Were potential or alleged health hazards explained to the student prior to acceptance? Does the program require a prospective student to speak with current students to get a feel for the physical and academic rigors of the program and profession? If some of the mandatory clinical sites are extremely distant, was this made clear to the student prior to admission? It is the opinion of both the Program Director and the Director of Clinical Education that all the students were explained the processes and commitment required to be successful in the respiratory program. It is a requirement of our program that prior to entry they must attend a shadowing experience at a local hospital. The potential hazards of the respiratory care field were explained in depth prior to acceptance into the program as well as information presented in the class room. At this time it is not required for the prospective student to speak with previous classes . We did strongly recommend that they contact respiratory therapists at local hospitals to further explore the field. Due to our program being located in rural Appalachia, we did address the issue of travel distance required to attend some of our distant clinical sit es.

3. Was adequate and timely financial aid and personal counseling available to students? Did students have a clear understanding of all financial requirements of the Program prior to admission? Do students in the program have access to all services avai lable to students in other programs? The students did have available to them a financial aid counselor. Our financial aid counselor does assist the students through the whole process to insure their process is done correctly and is not an unpleasant experience The financial requirements are explained in depth by our financial aid counselor prior to admission to the program. This process is a very important commitment for our students and is necessary for the student to understand. The students in the respiratory program have the same privileges and availability of services as any other student in any of our other allied health programs.

4. Were students apprised of professional behavioral expectations prior to admission? Were students adequately counseled as to the significance and importance of these behaviors as problems occurred? The professional behaviors expectations were explained to each student prior to entry tom the

program. This was reinforced in the introductory academic classes as well. The students did not exhibit any behavioral problems

For students who leave for Academic reasons: 1.

Could this have been predicted prior to admission based upon the student's prior academic performance? If so, was the student counseled that such an outcome was likely? The admissions director does a very thorough job screening applicants that may have difficulty in progressing in this program. Once the admissions director screens the applicants for all admissions criteria, the Vice President for the Center for Education, the Program Director and the Director of Clinical Education also review the applicants for admission.

2.

If the program has data demonstrating that a certain level of academic competence (e.g., GPA, aptitude tests) is required to succeed in the program, is this information used to set entrance requirements? In institutions with an "open admissions" policy, do all programs have the same academic entrance requirements? The Nursing program and the Respiratory Program do have the same admissions requirements.

3.

Does the program use non-respiratory prerequisite courses as a predictor of success? Yes

4.

Are students regularly informed and counseled about their academic progress? Is academic counseling and systematic remediation (e.g., tutoring) available for students who are having difficulties? Yes, all students not successfully passing an examination are remediated and retested to ensure academic success.

5.

Can academic difficulties be traced to a particular instructor (didactic, laborato ry, or clinical rotations)? Does the program regularly evaluate all of its instructors (e.g., Resource Assessment, course evaluations) and address any problems identified?

No. All students are given a course evaluation to complete at the end of the seme ster. The instructors are rated on a Likert scale of 1-5. No deficiencies have been noted as of this date. 6.

Can the students' academic difficulties be traced to a particular instructor or course (regardless of instructor)? No

S T A N D A R D

P R O G R E S S R E P O R T A T T R I T I O N

Program Name: Marshall University/St. Mary's Medical Center - School of Respiratory Care Was attrition due to: x X

General Education Courses Non-Academic

F O R M

CoARC Program # 200506 x RT Core Courses

Analysis: The Program Director and the Director of Clinical Education feel that adequate pre admission qualifications are in place. There is no way to predict family situations (marriage)that occur in an individuals life and the subsequent timing of this. The student that left for a change of major, we did see some indicators after class began that maybe this was not the appropriate career for this student. The student who left for personal reasons would not reveal the circumstances that forced her to leave. The students that were unable to advance for academic reasons did not realize the time commitment required for this course of study. Action Plan: The faculty are going to reevaluate the form used for shadowing and see if it adequately covers what is required for a therapist to perform their functions. This will be reviewed by the advisory committee for their input as well.

Date Expected to Re-evaluate: Fall 2008

Revised November, 2002

2007 PROGRAM RESOURCE ASSESSMENT RESOURCE: ADVISORY COMMITTEE PURPOSE(S): To actively develop, promote, support and evaluate the goals of the respiratory therapy program.

MEASUREMENT SYSTEM(S): 1. Program Personnel Program Resource Survey 2. Advisory Committee Minutes and Actions.

DATE(S) OF MEASUREMENT:

1. May of each year. 2. May of each year.

RESULTS: 2007 The advisory Committee felt like the goals and objectives were met for the academic school year.

ACTION PLAN(S): No actions were noted to be taken

2007 PROGRAM RESOURCE ASSESSMENT RESOURCE:

MEDICAL DIRECTOR

PURPOSE(S): 1. To provide input into curriculum including review of appropriateness of medical content. 2. To provide review of selected respiratory care topics in a format that encourages student interaction with a physician. 3. To assist in the development of physician "communication skills‖ and to assist in

the evaluation of student attainment of these skills.

MEASUREMENT SYSTEM(s): Program Course and Resource Survey(s) completed by the students. Program Resource Survey completed by the faculty and advisory committee. Medical Director written evaluation(s) of student communication skills.

DATE(S) OF MEASUREMENT: Program Resource Surveys are completed annually at the end of the spring semester. Course Surveys are completed at the end of each semester. Medical Director evaluation of student "communication skills"-Minimum of once per semester.

RESULTS: 200 1. No deficiencies were noted in the medical direction of the program.

ACTION PLAN(S): It was the consensus of the Program full-time personnel that no specific changes in medical director activities were indicated based on the 2007 assessments.

2007 PROGRAM RESOURCE ASSESSMENT RESOURCE: PURPOSE(S):

FACULTY

Program Director: To provide classroom, lab, and clinical instruction and to coordinate the overall program activities. Director of Clinical Education: To provide classroom, lab, and clinical instruction and to coordinate the clinical education of the students. Additional Full-time Faculty: To teach selected classroom and labs and to supervise the clinical rotation at various clinical sites. Adjunct Clinical Faculty: to provide focused review on specific procedures and provide "formative evaluations" in the clinical setting. Medical Director: See Medical Director Resource Assessment.

MEASUREMENT SYSTEM(S): Program Resource Survey(s) completed by the students. Program Personnel Resource Surveys completed by the faculty, Note: Starting in 2006, also by: advisory committee, and Medical Director.

DATE(S) OF MEASUREMENT: Student Exit/Resource Survey: End of each academic year (May) Advisory Committee and Medical Director Survey: Spring Advisory meeting.

RESULTS: 2007 No deficiencies were noted.

ACTION PLAN(S): 1. Will monitor feedback on faculty performance by students. 2. Implement newest CoARC Program resource surveys this academic year, that include feedback from advisory committee and Medical director.

2007 PROGRAM RESOURCE ASSESSMENT

RESOURCE:

Support Personnel

PURPOSE(S): To provide adequate secretarial support for primary program faculty.

MEASUREMENT SYSTEM: Faculty Resource survey

DATE(S) OF MEASUREMENT: Program Resource Surveys are completed annually at the end of the spring semester.

RESULTS: 2007 Faculty felt there was not enough secretarial support for the program.

ACTION PLAN(S): Next years budget will ask for a secretary for the respiratory care division.

2007 PROGRAM RESOURCE ASSESSMENT

RESOURCE:

PHYSICAL RESOURCES / LABORATORY

PURPOSE(S): 1. To provide adequate physical resources (classroom and lab) for effective delivery of the program curriculum. 2. To provide each student an opportunity to practice with equipment and procedures prior to being responsible for the equipment or skill in the clinical environment.

MEASUREMENT SYSTEM(s): Program Resource Survey(s) completed by the students. Program Resource Survey completed by the faculty.

DATE(S) OF MEASUREMENT: Program Resource Surveys are completed annually at the end of the spring semester.

RESULTS: 2007 The students there was not adequate space for classrooms and lab.

ACTION PLAN(S): The respiratory care department was moved to a larger area on the 3rd floor of the center for education.

2007 PROGRAM RESOURCE ASSESSMENT

RESOURCE:

LABORATORY – EQUIPMENT & SUPPLIES

PURPOSE(S): 1. To provide adequate laboratory resources (equipment and supplies) for effective delivery of laboratory exercises. 2. To provide each student an opportunity to practice with equipment and procedures prior to being responsible for the equipment or skill in the clinical environment.

MEASUREMENT SYSTEM(s): Program Resource Survey(s) completed by the students. Program Resource Survey completed by the faculty.

DATE(S) OF MEASUREMENT: Program Resource Surveys are completed annually at the end of the spring semester.

RESULTS: 2007 The respiratory students felt there was not adequate space allocated for the laboratory exercises.

ACTION PLAN(S): The respiratory class room and lab was moved to a larger area on the 3 rd floor for the center of education.

2007 PROGRAM RESOURCE ASSESSMENT RESOURCE:

LEARNING RESOURCES

PURPOSE(S): 1. To provide a quiet place to study (Library). 2. To provide reference material when required to complete class assignments. 3. To provide sufficient computer support for students to complete assignments (computer lab).

MEASUREMENT SYSTEM(S): Program Resource Survey(s) completed by the students. Program Resource Survey completed by the faculty.

DATE(S) OF MEASUREMENT: Program Resource Surveys are completed annually at the end of the spring semester.

RESULTS: 2005 The students felt the library area was adequate for their learning experience.

ACTION PLAN(S): No action necessary

2007 PROGRAM RESOURCE ASSESSMENT RESOURCE:

FINANCIAL RESOURCES

PURPOSE(S): To provide adequate financial support to support program needs as identified during the various outcome (product) assessments.

MEASUREMENT SYSTEM: Faculty Resource survey

DATE(S) OF MEASUREMENT:

Program Resource Surveys are completed annually at the end of the spring semester.

RESULTS: 2005 The faculty felt more money should be allocated to capital purchases for the laboratory.

ACTION PLAN(S): A proposed increase in the budget for fiscal year 2009 will be submitted.

2007 PROGRAM RESOURCE ASSESSMENT RESOURCE:

CLINICAL RESOURCES

PURPOSE(S): St. Mary’s Medical Center: To provide sufficient clinical experience at a large teaching medical university in

order to:

(1) develop the student's ability to perform respiratory critical care procedures as identified in the program's clinical activities summary log. (2) facilitate the student's development of patient assessment skills. (3) develop students "physician interaction" skills (4) provide clinical instruction with periodic "formative evaluations" to assist the student and the program in identifying progress in clinical skills development.

All other clinical affiliates (except Neonatal Intensive Care Units): To provide sufficient clinical experience at teaching and community hospitals in order to: (1) develop the student's ability to perform respiratory care procedures as identified in the program's clinical activities summary log. (2) facilitate the student's development of patient assessment skills. (3) develop students "physician interaction" skills Neonatal Intensive Care Units: To provide sufficient clinical experience in Neonatal Intensive Care in order to: (1) familarize the student with neonatal respiratory care. (2) develop students "physician interaction" skills

MEASUREMENT SYSTEM(s): Program Resource Survey(s) completed by the students. Program Resource Survey completed by the faculty. Faculty Review of student Clinical Summary Logs.

DATE(S) OF MEASUREMENT: Program Resource Surveys are completed annually at the end of the spring semester. Clinical Summary logs are reviewed on an on-going basis as well as being formally reviewed twice each semester

RESULTS: The students did not feel their pediatric/neonatal rotation was adequate for their educational goals

ACTION PLAN: CAMC has been added for the pediatric/neonatal rotation.

2007 PROGRAM RESOURCE ASSESSMENT RESOURCE:

PHYSICAIN INPUT - INSTRUCTIONAL

PURPOSE(S): 1. The primary purpose of physician interaction in the clinical setting is to assist the students in developing their "professional communication" skills to facilitate their

effective interaction in the clinical setting. 2. Physician input by the Medical Director is to assist in the development and evaluation of practitioner/physician "communication skills".

MEASUREMENT SYSTEM(s): 1. Program Resource Survey(s) completed by the students. 2. Program Resource Survey completed by the faculty. 3. Physician Interaction documentation forms. 4. Daily clinical log documentation of physician interaction. 5. Medical Director written evaluation(s) of student communication skills. 6. Pulmonologist written assessment of student assessment and communication skills.

DATE(S) OF MEASUREMENT: 1. 2. 3. 4. 5.

Exit survey conducted at end of academic year (May). May each year. 6 per semester required / reviewed and approved by program faculty. Clinical Activity logs are reviewed weekly by program faculty. Medical Director evaluation of student "communication skills" performed a minimum of once each semester based on bedside clinical rounds. 6. Written evaluations are performed by Dr. Pete Ottavanio twice during Fall and Spring semesters based on clinical interaction during "patient assessment" and "Ventilator rounds" activities at St. Mary’s Medical Center.

RESULTS: 2007 The students felt physician interaction was good and beneficial in both their classroom and clinical experience.

ACTION PLAN(S): No action necessary

Appendix D

RESPIRATORY CARE PROGRAM Statement of Philosophy The Respiratory Care faculty believe: that all people have dignity and worth. that these programs should serve people regardless of race, creed, sex, disadvantage, or handicap. that the cognitive base, psychomotor skills, and effective domain are of equal importance in the training of respiratory care practitioners. that the graduates of these programs should possess competence in the technical phases of respiratory care and a sound understanding of the scientific principles of respiratory care. that graduates should have developed the ability to make independent clinical judgments within the limits of the respiratory therapy technician‘s responsibilities. that graduates should exhibit strong ethical behavior and attitudes. that competent respiratory care technicians are significant participants on the health care team.

RESPIRATORY CARE PROGRAM

Goals: 1.

Provide instruction necessary to enable individuals to function as competent entry level respiratory care practitioners.

2.

To help satisfy the need in local and regional communities for competent respiratory care practitioners.

The Respiratory Care Program prepare graduates to: 1.

Recognize the role of the respiratory care practitioner as a member of the health care team.

2.

Develop a caring ethical behavior.

3.

Develop a respect for the dignity and worth of the patient.

4.

Develop effective communication skills.

5.

Utilize a knowledge base in the sciences and technologies for the practice of respiratory care at the technician level.

6.

Demonstrate an ability to practice independent clinical judgment under the direction of a physician.

7.

Assume responsibility for continued learning following graduation.

RESPIRATORY CARE PROGRAM TASK LIST

A.

Administering Medical Gas Therapy 1. 2. 3. 4. 5. 6. 7. 8. 9.

B.

Identify, transport, and store medical gas cylinders Select, attach, and use regulating devices Operate, and perform general maintenance of air compressors and oxygen concentrators Select, obtain, and assemble oxygen delivery devices appropriate to the respiratory care plan Administer oxygen via low flow systems Administer oxygen via high flow systems Administer oxygen utilizing precision metering devices] Perform oxygen analysis Evaluate patient response to oxygen therapy, and recommend modification as indicated

Administering Humidity and Aerosol Therapy 1. 2.

Select, obtain, and assemble humidifying devices appropriate to the respiratory care plan Administer humidity therapy

3. 4. 5. 6. 7.

C.

Administering Therapeutic Procedures 1. 2. 3. 4. 5. 6.

D.

Select, obtain, and assemble therapeutic equipment appropriate to the respiratory care plan Administer incentive spirometry Administer intermittent positive pressure breathing (IPPB) therapy Administer mask CPAP (continuous positive airway pressure) therapy Administer chest physiotherapy Evaluate patient response to therapeutic procedures and recommend modification as indicated

Administering Pulmonary Medications 1. 2. 3.

E.

Select, obtain, and assemble nebulizing devices appropriate to the respiratory care plan Administer aerosol therapy via pneumatic nebulizers Administer aerosol therapy via ultrasonic nebulizers Administer aerosol therapy via tents Evaluate patient response to humidity or aerosol therapy and recommend modifications as indicated

Obtain and prepare prescribed dosage of medication Administer prescribed agents via aerosol, inhalation, or metered dose inhaler Monitor and evaluate patient response to the medications administered, and recommend modification as indicated

Providing Airway Management 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

Select, obtain, and assemble airway management equipment Position the patient to assure a patent airway Insert appropriate oral and nasal pharyngeal airways Perform oral endotracheal intubation Change tracheostomy tubes Maintain proper cuff inflation and position of endotracheal and tracheostomy tubes Extubate patients Remove esophageal obturator airways Suction artificial airways Perform naso-tracheal suctioning Perform tracheal suctioning for specimen collection Monitor and evaluate patient response to airway management procedures

and recommend modification as indicated F.

Select, Reviewing, Obtaining, and Interpreting Patient Data 1. 2. 3. 4. 5. 6. 7. 8.

G.

Cardiopulmonary Testing and Evaluation 1. 2. 3. 4.

I.

Measure and interpret tidal volume, respiratory rate, and minute volume Calculate I:E (inspiratory to expiratory) ratio Measure and evaluate the negative inspiratory force Measure and evaluate peak flow

Providing Respiratory Care in Special Settings 1. 2. 3. 4.

J.

Review existing data in the patient record, and recommend diagnostic procedures Assess patient‘s respiratory status by inspection Assess patient‘s respiratory status by palpation Assess patient‘s respiratory status by auscultation Inspect the chest x-ray for gross abnormalities Interview the patient Measure and assess the patient‘s vital signs Recommend procedures for obtaining additional data

Provides respiratory care to pediatric and neonatal patients Provide respiratory care in the home environment Provide respiratory care in emergency situations Provide respiratory care to pulmonary rehabilitation patients

Maintaining Infection Control 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.

Utilize aseptic techniques while providing respiratory care Practice isolation techniques Disinfect respiratory care equipment Sterilize respiratory care equipment Measure and evaluate the vital capacity Measure and evaluate timed forced expiratory volumes Perform and evaluate spirometry pre- and post- bronchodilator Measure and evaluate lung volumes Evaluate the results of closing volume determination Evaluate the results of diffusion studies Evaluate the results of volume of isoflow measurement Evaluate flow volume curves Obtain samples for arterial blood gas measurement Measure arterial blood gases Interpret arterial blood gases Perform and interpret oximetry

17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. H.

Perform and interpret capnography Calculate and evaluate A-aDO2 Calculate and evaluate shunt Calculate and evaluate VD/VT Perform electrocardiography Recognize basic cardiac arrhythmias Measure and evaluate blood pressure Interpret arterial pressure tracings Interpret central venous pressure measurements Evaluate (basic) hemodynamic patterns from pulmonary artery catheters Inspect the chest x-ray to find gross abnormalities

Providing ventilatory Support 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Assess the patient‘s need for ventilatory support Select, assemble and prepare appropriate ventilators Select appropriate ventilatory parameters Adjust the mechanical ventilator to comply with physician orders or established protocol Recommend modification of ventilatory parameters based on patient data Initiate, adjust, and monitor effects of CPAP and PEEP Replace ventilator circuits as needed Institutes modifications of ventilator circuitry following established protocol Institute and modify weaning procedures Monitor, record, and react to changing conditions related to mechanical ventilation

RSP 100 – Respiratory Pharmacology

This 3 credit hour will introduce the student to the basic principles of pharmacology. This will include regulatory agencies, dosage calculations, and the physiology of the autonomic nervous system as it is related to respiratory care pharmacology. Major topics of discussion include; sympathomimetics, parasympolytics, xanthines, prostaglandins, Mucokinetics, cortiocosteriods, cromlyn sodium, other broncho-active agents, and neuromuscular blockers. Additionally, central nervous system agents, cardiovascular and diuretic agents, and antimicrobials are included. RSP 101 – Introduction to Respiratory Care This 2 credit hour course will introduce the student to the History of Respiratory Care and Professional Organization. Emphasis is on exploring the role of the respiratory therapist or technician as a member of the health care team. Ethical and medicolegal dimensions of health care are presented. Basic techniques of patient evaluation are covered. Included are: Chest physical examination, measurement of the vital signs, patient interview and history, evaluation of the chest x-ray, and spirometry. Pre- requisites Admission into the Respiratory Care Program RSP 102 – Introduction to Respiratory Care Procedures This introduction course is 3 credit hours in length. The administration of medical gases, humidity and aerosol therapy is covered. Emphasis is placed on the safe handling of medical gases and safety in administration. Principles and techniques of therapeutic procedures used in basic respiratory care are covered. Also included are: Techniques of chest inflation therapy, chest physical therapy, breathing exercises, bronchial hygiene. The physiologic effects, indications, and contraindications of each therapy are stressed. Detailed study of isolation, equipment and supplies used in these therapies is included. Pre-requisites – Admission into the Respiratory Care Program. RSP 102L - Respiratory Care Procedures Lab This 1 hour laboratory class will give the student the opportunity to practice techniques and use of technology covered in Respiratory Care Procedures and Introduction to Respiratory Care. Lab exercises will be given for the student to complete. Pre-requisites – Successful completion of program sequence. RSP 201 – Pulmonary Pathophysiology This 3 credit hour course is designed to supplement the information presented in Introduction to Respiratory Care. The most frequently encountered diseases and syndromes are presented in detail. Emphasis is placed on the etiology, signs and symptoms, pathology, clinical manifestations, sequellae, and treatment. The respiratory therapists role in the recognition and treatment of pulmonary diseases is given special emphasis. The student completing the course is expected to have a firm understanding of the diseases covered. Pre-requisites – Successful completion of program sequence

RSP 202 – Mechanical Ventilation Technology & Management This 3 credit hour course provides an introduction to the fundamentals of mechanical ventilation techniques and terminology is presented. Various classes of mechanical ventilators are discussed and compared, emphasizing the differences required in their uses. The technology of adult continuous mechanical ventilation is covered. The design, function, and operation of representative mechanical ventilators of the various classifications are examined in detail. Management of continuous adult mechanical ventilation is covered with emphasis on the physiologic effects of various techniques and selection of optimal methods. Monitoring, quality control, and the ability to solve clinical problems relating to mechanical ventilation are emphasized. Pre-requisites – Successful completion of program sequence RSP 202L - Mechanical Ventilation Technology & Management Lab This 1 hour laboratory class will give the student the opportunity to practice techniques and use of technology covered in Mechanical Ventilation & Management. Lab exercises will be given for the student to complete. Pre-requisites – Successful completion of program sequence RSP 203 – Respiratory Internship 1 This 4 credit hour course is designed to introduce the student to the clinical facility and to clinical education. Opportunity is given for observation of the various aspects of respiratory care. Practice in gathering information from the patient record, patient evaluation, oxygen administration, and record keeping is provided. Techniques of cardiopulmonary resuscitation are covered with laboratory practice and evaluation. Pre-requisites – Successful completion of program sequence. RSP 204 – Cardiopulmonary Diagnostics This 3 credit hour course will cover advanced techniques of pulmonary function testing. Topics include lung volume determination, tests of small airways, diffusion, and distribution of ventilation. Invasive and non-invasive methods of arterial blood gas sampling, analysis, and interpretation are also covered. The technology and methodology of invasive and non-invasive cardiovascular testing including electrocardiography and hemodynamic monitoring are presented. Fundamental interpretation of these tests is covered. Pre-requisites – Successful completion of program sequence. RSP 205 – Neonatal/Pediatric Respiratory Care This introductory course is 3 credit hours. It is designed to provide the student with detailed knowledge to the needs of neonatal and pediatric patients. Fetal cardiopulmonary development and changes at birth are covered. Equipment, procedures and methods used in the care and evaluation of neonatal and pediatric patients are also covered (Neonatal Vents). Also included are cardiopulmonary conditions and diseases particular to neonate and pediatric patients.

Pre-requisites – Successful completion of program sequence. RSP 206 – Introduction to Critical Care Management This introductory course is 3 credit hours and is designed to provide the student with detailed knowledge to the principles and techniques of therapeutic procedures used in Respiratory Care as covered: Airway management, transtracheal oxygen therapy and aspiration, bronchoscopy, thoracentisis and pleural chest tubes, arterial lines, ABG interpretation and analysis, transports, and electrocardiogram interpretation. Pre-requisites – Successful completion of program sequence.

RSP 207 – Pulmonary Rehabilitation/Home Care This 1 credit hour course will cover care of the patient with long term pulmonary disability. Psychosocial and physical needs of the patient are addressed with emphasis on motivating and conditioning the patient with the goal of improving both quality of life and cardiopulmonary reserve. Special requirements for the patient in the home who requires respiratory care are covered. Pre-requisites – Successful completion of program sequence. RSP 208 – Seminar in Respiratory Care This 1 credit hour course introduces the student to NBRC exam taking skills, mock examinations of the NBRC matrix, and self-evaluation studies. Study methods and application are also covered. A study of realistic clinical problems and situations, with emphasis on analyzing and evaluating these problems to formulate acceptable respiratory care modalities. Practice will be provided in the necessary techniques to take the NBRC clinical simulation examination. Computer simulations are an integral part of this course. Pre-requisites – Successful completion of program sequence. RSP 209 – Respiratory Internship 2 This course is 4 credit hour course is designed to introduce the student to aspects of Respiratory Care learned in RSP 102 and RSP 101. Emphasis is on the supervised practice of basic respiratory care techniques covered in Introduction to Respiratory Care Procedures and in Introduction to Respiratory Care. Opportunity for respiratory care techniques such as oxygen therapy, humidity and aerosol therapy, aerosol drug therapy, lung inflation therapy is provided. Also, observation and supervised practice in the techniques used in electrocardiography. Pre-requisites – Successful completion of program sequence. RSP 210 – Respiratory Internship 3 This course is 4 credit hour course is designed to provide the student with additional experience in the practice of fundamental respiratory care techniques. Emphasis is given to the development of efficiency in the practice of these techniques. Opportunities for observation and strictly supervised practice in the techniques of arterial blood gas sampling and analysis, arterial line management and chest tube management. are also provided. Also, included is critical care observation, supervised practice of techniques used in electrocardiography and observation of hemodynamic measurement and monitoring. Additional experiences in the application of all previously covered respiratory care techniques are also provided.

Neonatal/Pediatric assessment and care will be provided in addition to mechanical ventilation, airway management, critical care respiratory therapy, pulmonary function testing and sleep studies. Emphasis will be placed in pulmonary rehab/home care and neonatal/pediatric respiratory care. The student of this course will maintain daily records of all activities. The student will submit and present a detailed case study. Pre-requisites – Successful completion of program sequence. RSP 211 – ACLS/PALS This 1 credit hour course is designed to provide the student, upon successful completion, the Advanced Cardiac Life Support and Pediatric Advanced Life Support certification. This course will cover topics required by the American Heart Association for certification. Pre-requisites – Successful completion of program sequence. RSP 212 – Cardiopulmonary/Renal Anatomy & Physiology This 3 credit hour course will cover the anatomy and physiology of the respiratory systems in detail. Emphasis is placed on the interaction of systems in gas exchange renal and acid base balance. The structure and function of the chest cage, mechanics of breathing, and control of respiration are also included. Pre-requisites – Successful completion of program sequence. RSP 301 – Introduction to Management Introduction to basic principles of management and their application in the current healthcare environment. Course content includes: management theory, scope of management, quality issues, budgeting, personnel issues, and evaluation and application of management concepts. RSP 302 –Directed Reading/Seminar Critical Care This course affords the senior respiratory care student with the opportunity to practice advanced evaluative and procedural skills in the intensive care setting. Emphasis is placed on cardiopulmonary assessment and treatment of trauma, post-surgical, cardiac and renal patients, quantitative assessment techniques, refinement of monitoring procedures, and interpretation of data. RSP 303 - Respiratory Education This 3 credit hour course is designed as an introduction to clinical teaching in a respiratory care program. The course includes self-directed study in instructional and evaluation strategies and development of performance objectives. The student performs functions required of a clinical instructor in a respiratory care program. The student will be required to set up Prerequisite: RSP 304 - Respiratory Cost Management & Solutions This 3 credit hour course introduces the student to management decision making and providing costs solutions for a respiratory department. Topics covered will be annual budgets, purchasing decisions, effective staffing, inventory and supply controls as well as searching for other methods to contain costs in the healthcare environment. Prerequisite: RSP 305 – Respiratory Care Performance Improvement

Provides basic principles associated with Total Quality Management (TQM) and Continuous Quality Improvement (CQI). Aids identification and quality problem-solving found in all healthcare organizations utilizing continuous quality improvement (CQI) tools and techniques. Through the use of case studies, current events, and textbook materials, students will learn how to identify problems, recommend improvements, and collect data to demonstrate process improvement. RSP 306 – Advanced Neonatal & Pediatrics This 3 credit hour course provides an in-depth study of neonatal/pediatric anatomy, physiology, growth and development; physical, radiological, laboratory, and risk assessment; general principles of management of the sick neonate and child; and special considerations in neonatal/pediatric pharmacology as each applies to respiratory care of the neonatal/pediatric patient. An in-depth study of neonatal/pediatric pathophysiology including parenchymal disease, obstructive airway disease, lesions of the lungs and airways, congenital abnormalities, respiratory distress syndrome, apnea disorders, neurological disorders, and trauma as each applies to respiratory care of the neonatal/pediatric patient will also be covered in detail . RSP 307 Advanced Techniques in Adult Critical Care This 3 hour credit course introduces the student to current respiratory care procedures for the critically ill adult patient along with an exploration into newer and experimental techniques. Topics include independent lung ventilation, ECMO, high frequency ventilation, inverse ratio, and disease specific ventilatory support. Attendance at clinical sites is required. Prerequisite:

RSP 402 Introduction to Sleep Disorders Course Description: This 3 credit hour course is designed to teach the student the process of procuring an effective sleep history and physical examination relevant to a sleep disorders patient, identify the more common relevant sleep disorders, have a general understanding of how a polysomnogram is performed, know the major categories of sleep disorders, and have a good sense of the presenting symptoms of sleep apnea, narcolepsy, psychophysiological insomnia, and sleep disturbance due to depression. The student will also be able to recognize a typical example of obstructive sleep apnea on a polysomnogram upon successful completion of this course. Prerequisites: RSP 403 - Respiratory Management Course Description: This 3 credit hour course is designed to examine the healthcare delivery system in the Appalachian region. The course examines the entire health care delivery system in general. This course will assist in the development of recommendations for future developments. This course will address the key issues confronting healthcare today, examine the causes, and develop reasonable solutions to the current set of problems.

Prerequisites: RSP 404 –Respiratory Care Research This course is 3 semester credit hours and is designed to provide the student knowledge about survey of research problems, methods, and designs utilized in respiratory care, with emphasis on data presentation and analysis. RSP 405 –Advanced Respiratory Care Diagnosis A method of instruction providing detailed education, training and work- based experience and direct patient/client care, generally at a clinical site. Specific detailed learning objectives are developed for each course by the faculty. On-site clinical instruction, supervision, evaluation and placement is the responsibility of the College faculty. Clinical experiences are unpaid external learning experiences. RSP 420 – Capstone in Respiratory Care

Course Goals: Introduction to Respiratory Care A.

To identify appropriate behavior in promoting and practicing effective human relationships in health care settings and recognize patient well-being as the ultimate concern of the respiratory technician.

B.

To make necessary communication with patients and health team members, using appropriate methods and terminology and practice ethical behavior in health care situations.

C.

Recognize the significance of respiratory therapy education – its evolution, growth and contributions in providing manpower in the health care system.

D.

Identify the legal factors that affect his/her functions as a student and practitioner in respiratory therapy and as a member of the health care team.

E.

Develop a concept of future opportunities in the health field and his/her responsibility for self improvement through continuing education programs.

F.

To develop and practice good study habits.

TOPICAL OUTLINE: RSP 101 INTRODUCTION TO RESPIRATORY CARE I.

Study Skills

II.

Respiratory Care Profession A.

Roles and Responsibilities

B. C. III.

Team Medicine A. B.

IV.

Negligence Malpractice Patient Rights

Record Keeping and Hospital Communication A. B. C. D. E.

VII.

Patient Practitioner

Medicolegal Aspects A. B. C.

VI.

Benefits of Patient Benefits to Health Care Professionals

Grief Responses and Resolutions A. B.

V.

Professional and Credentialing Organizations Code of Ethics

Medical Terminology Charting Incident Reports Verbal Reporting Communication with Physicians

Continuing Education A. B.

Need Benefits

INSTRUCTIONAL OBJECTIVES RSP 101 INTRODUCTION TO RESPIRATORY CARE

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

Describe the role of the respiratory therapy technician in providing health care.

2.

Relate the role of the technician to that of the therapist, physician, patient, nurse, and the remainder of the health care team.

3.

Explain the concept and advantages of team medicine.

4.

Describe the history of respiratory care.

5.

Explain the role of the American Association for Respiratory Care and the National Board for Respiratory Care.

6.

Describe the levels of employment in respiratory care and the necessary examination procedures for the various credentials.

7.

Explain the effect of licensure.

8.

Describe the mechanisms of grief resolution.

9.

Identify the stages of grief resolution.

10.

Outline methods of avoiding and relieving stress.

11.

Recognize and apply current standards of ethical practice of respiratory care.

12.

Given common respiratory care situations, identify those meeting current standards of ethical practice.

13.

Recognize and avoid common causes of negligence and malpractice in the practice of respiratory care.

14.

Given common respiratory care situations, identify those which illustrate negligence and malpractice.

15.

Identify the criteria of proper charting and discuss their importance.

16.

Given examples of charting, identify incorrect records and explain why there are incorrect.

17.

Explain the use and results of the incident report.

18.

Identify situations requiring an incident report.

19.

Correctly use and define standard medical terms and abbreviations.

20.

Explain why respiratory care practitioners must continue their education beyond credentialing.

21.

Discuss the need for continuing education of all allied health practitioners.

RSP 101 INTRODUCTION TO RESPIRATORY CARE ORIENTATION TO HEALTH CARE

TOPICS

ASSIGNMENTS

Introduction Respiratory Care Profession

Burton, pp. 3-51 Handouts

Team Medicine

Burton, pp. 82-90 Burton, pp. 91-101 Ross, pp. 88-114

Examination #1 Grief Responses and Resolution Medicolegal Aspects Record Keeping and Hospital Communication

Ross, pp. 117-153 Burton, pp. 90-122

Handout Burton, pp. 128-157

Examination #2 Continuing Education Comprehensive Final

Burton, pp. 157-165

TOPICAL OUTLINE: RSP 102 - INTRODUCTION TO RESPIRATORY CARE PROCEDURES I. Chest Physical Examination A. B. C. D. E. F. II.

Vital Signs A. B. C.

III.

Normal Findings Placement of Tubes Gross Abnormalities

Pulmonary Measuring and Monitoring Devices A. B. C. D.

VI.

History Present Illness Activities and Exercise Tolerance

Chest Radiograph A. B. C.

V.

Pulse Assessment Respiration Assessment Blood Pressure Assessment

Patient Interview A. B. C.

IV.

Reference Landmarks Observation/Inspection Palpation Percussion Auscultation Causes of Abnormal Findings

Respirometers Spirometers Peak Flow Meters Body Plethysmograph

Basic Pulmonary Measurements

A. B. C. D. E. VII.

Minute Ventilation Tidal Volume Vital Capacity Peak Flow Inspiratory Force

Routine Pulmonary Function A. B. C. D.

Lung Volumes – Definition Spirometry MVV Pre-/Post- Bronchodilator Studies

INSTRUCTIONAL OBJECTIVES RSP 102 - INTRODUCTION TO RESPIRATORY CARE PROCEDURES

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

Describe the anatomic landmarks which will be used to localize findings of chest physical examination.

2.

Summarize the process of inspecting the patient to determine: respiratory rate, use of accessory muscles, symmetry of chest expansion, presence of retractions, rhythmicity of breathing, general appearance, peripheral edema, diaphoresis, digital clubbing, cyanosis, chest configuration, nasal flaring, character of cough, amount and character of sputum.

3.

List the findings expected when palpating the thorax to determine: symmetry of chest expansion, presence of fremitus, pulse (rate, rhythm, force), tracheal deviation.

4.

Explain the process of auscultation.

5.

Describe the character of normal and abnormal breath sounds and adventitious sounds.

6.

List the physical findings expected with common pathologic conditions including: atelectasis, hyperinflation, pneumothorax, pleural effusion, subcutaneous emphysema, and consolidation.

7.

List the steps of measuring the blood pressure using the sphygmomanometer.

8.

Recognize normal range for the vital signs.

9.

Outline the process of interviewing the patient to determine: level of consciousness, orientation, emotional state, ability to cooperate, presence of dyspnea and orthopnea, sputum production, exercise tolerance, and activities of daily living.

10.

Describe the process used in making chest x-ray.

11.

Describe normal anatomic structures in a chest x-ray.

12.

Explain the process of evaluating the chest x-ray to determine: position of endotracheal or tracheostomy tubes, presence of pneumothorax, segmental or lobar atelectasis or consolidation, hyperinflation, pulmonary edema, large pleural effusions.

13.

Calculate the patient‘s minute volume using the tidal volume and respiratory rate.

14.

Explain the mechanism of common volumetric devices.

15.

Describe the process of measuring the negative inspiratory force.

16. 17.

List factors which influence the maximum inspiratory and expiratory pressures. Describe the significance of peak flow measurements.

18.

Describe the mechanisms of common devices used in pulmonary function testing.

19.

List, define, and give normal values for the various lung volumes and capacities.

20.

List factors which influence the successful measurement of pulmonary function.

21.

Provide a rationale for performing pulmonary function tests.

22.

Summarize the process of administering a spirometry test.

23.

Use a spirometry tracing to measure and calculate Vt, IRV, ERV, IV, FVC, FEV1, FEV2, FEV3, FEVT%s, FEF 200-1200, FEF 25-75%.

24.

Describe the maximum voluntary ventilation test.

25.

Describe the equipment used for flow volume testing.

26.

Given a flow volume curve, identify: inspiratory and expiratory flow, vital capacity, peak flow, FEF 25-50-75%.

27.

Determine whether a flow volume curve represents fixed or variable large or small airway obstruction.

28.

Evaluate pre/post bronchodilator spirometry results.

TOPICAL OUTLINE: RSP 102 - INTRODUCTION TO RESPIRATORY CARE PROCEDURES I.

Gas Storage A. B. C. D.

Atmospheric and Medical Gases Cylinders Bulk Systems Liquid Systems

II.

Gas Delivery A. B. C. D.

III.

Medical Gas Administration A. B. C. D. E. F. G. H.

IV.

Basic Concepts Humidifier Mechanisms Methods of Administration

Aerosol Therapy A. B. C. D. E. F.

VII.

Electrical Physical Electrochemical

Humidity Therapy A. B. C.

VI.

Regulators Flow Meters Blenders Low Flow Administration Devices High Flow Administration Devices Treatment of Hypoxia Carbogen Therapy Helium Therapy

Oxygen Analyzers A. B. C.

V.

Hospital Piping Systems Medical Gas Piping Systems Compressors Oxygen Concentrators

Penetration and Deposition Pneumatic Nebulizers Ultrasonic Nebulizers Hydronamic nebulizers Administration Devices Methods of Administration

Chest Physical Therapy (Indications, Goals, Methods, Hazards) A. B.

Postural Drainage Percussion

C. D. E.

VIII.

Vibration Cough Assistance Breathing Exercises

Lung Inflation Therapies (Indications, Goals, Methods, Hazards) A. B. C.

Intermittent Positive Pressure Breathing Incentive Spirometry Mask CPAP

INSTRUCTIONAL OBJECTIVES RSP 102 - INTRODUCTION TO RESPIRATORY CARE PROCEDURES MEDICAL GAS THERAPY

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

List the gases composing the atmosphere and relate these to Dalton‘s Law.

2.

Describe the methods of manufacturing oxygen.

3.

Identify the color code, size, capacity, and construction of various medical gas cylinders.

4.

Categorize various medical gases as to use and flammability.

5.

List the steps in gas cylinder testing.

6.

Identify and explain gas cylinder markings.

7.

Calculate the duration of flow for a gas cylinder.

8.

Describe the requirements of a hospital bulb oxygen storage and delivery system.

9.

Compare the use of liquid and gaseous bulk oxygen.

10.

Define the roles of the various regulatory agencies in manufacture, transport, and storage of medical gases.

11.

List safety standards for handling compressed gases.

12.

Define, compare, and contrast the compressed gas connector safety systems.

13.

Explain the basic design and function of the various types of gas pressure regulators to include: preset, adjustable, single, and multistage.

14.

Given a diagram of a regulator, identify its components.

INSTRUCTIONAL OBJECTIVES RSP 102 - INTRODUCTION TO RESPIRATORY CARE PROCEDURES HUMIDITY AND AEROSOL THERAPY Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

Describe the pathophysiology of retained secretions.

2.

List and explain the etiologies of retained secretions.

3.

Describe how to prevent or correct retained secretions.

4.

Describe the concept of humidity and its thermodynamics.

5.

Calculate relative humidity or absolute humidity.

6.

Calculate the humidity deficit.

7.

Describe the design and function of Passover, bubble diffusion, cascade, hygroscopic, and room humidifiers.

8.

List the factors which influence the effectiveness of humidifiers.

9.

Given an illustration, identify the components of a humidifier.

10.

Describe the clinical uses and appropriate applications of the various humidifiers.

11.

Explain the safety factors involved in the use of heaters used for humidity and aerosol therapy.

12.

Define aerosol and describe the uses of aerosol in medicine.

13.

Describe the factors which influence the penetration, deposition, and stability of aerosols.

14.

List methods for optimizing deposition of therapeutic aerosols.

15.

List and recognize the hazards of aerosol therapy.

16.

Describe the mechanisms of aerosol clearance from the pulmonary system.

17.

Describe the design and function of jet, hydronamic, and ultrasonic nebulizers.

18.

Given illustrations, identify the type of a nebulizer and its components.

19.

List the goals of aerosol therapy and methods of achieving these goals.

20.

Describe the use of aerosol masks, face tents, t-pieces, tracheotomy masks, and patient enclosures.

21.

List the advantages and disadvantages of the various devices used to administer aerosol therapy.

22.

Given illustrations or described situations, identify correct and incorrect methods of administration of aerosol therapy and give reasons for your selection.

INSTRUCTIONAL OBJECTIVES: RSP 102 - INTRODUCTION TO RESPIRATORY CARE PROCEDURES BRONCHIAL HYGIENE & LUNG INFLATION THERAPIES Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

List the indications, contraindications, hazards, the therapeutic goals of the various techniques of chest physical therapy.

2.

List the postural drainage position and the anatomical landmarks for each lung segment.

3.

Describe the proper techniques of therapeutic percussion, vibration, and postural drainage.

4.

Explain the rationale for diaphragmatic and pursed lip breathing.

5.

Describe the techniques of diaphragmatic and pursed lip breathing.

6.

Describe the techniques for localized expansion exercises.

7.

List the factors to be monitored during chest physiotherapy.

8.

List the indications, contraindications, hazards, physiologic effects, and clinical goals of intermittent positive pressure breathing therapy.

9.

Describe the adjustment of the equipment used for IPPB therapy to achieve the goals of the therapy.

10.

List and explain the instructions given to a patient during IPPB to achieve maximal lung volume.

11.

List the patient parameters to be monitored during IPPB therapy for safety and effectiveness.

12.

Summarize the rational for the use of incentive breathing devices.

13.

Describe the technique for incentive spirometry.

14.

Explain the methods of coaching the patient during incentive spirometry (sustained maximal inspiration).

15. 16.

List parameters to be monitored with the patient during incentive spirometry therapy for safety and effectiveness. Describe the cough mechanism.

17.

Outline the methods for instructing and assisting the patient in effective coughing.

18.

List the indications, contraindications, physiologic effects, hazards, and clinical goals of mask CPAP therapy.

19.

Describe the method of administering mask CPAP for lung inflation therapy.

20.

Explain the function of a mask CPAP system.

21.

List the parameters to be monitored in a patient receiving mask CPAP for safety and effectiveness.

TOPICAL OUTLINE: CARDIOPULMONARY ANATOMY AND PHYSIOLOGY

I.

Respiratory System A. B. C. D. E. F. G. H. I.

General Structure and Function Upper Airways Lower Airways Defense Mechanisms Acinus Histology Thoracic Cage Mechanics of Breathing Ventilation – Perfusion Matching & Mismatch

II.

Cardiovascular System A. B. C.

III.

Blood Gas Transport A. B. C. D.

IV.

Organization Electrophysiology Mechanics

Oxygen Transport CO2 Transport Acid Base Regulation Evaluation

Control of Respiration A. B. C. D.

Central Peripheral Reflexes Breathing Patterns

INSTRUCTIONAL OBJECTIVES CARDIOPULMONARY ANATOMY AND PHYSIOLOGY

Upon completion of appropriate units of instruction, the student will on examination demonstrate the ability to: 1.

List the functions of the respiratory system.

2.

Differentiate between breathing, ventilation, internal, and external respiration.

3.

On a illustration, identify the structures of the upper airway and describe their function in detail.

4.

List the cartilages of the larynx and describe its structure and function.

5.

On an illustration, identify the structures of the tracheobronchial tree and describe their functions.

6.

Describe the histology of the airways and changes found in the various airway generations.

7.

Identify the various defense mechanisms of the pulmonary system and explain their importance.

8.

Describe the structure and function of the acinus.

9.

State the cell types of the alveolar epithelium and describe their functions.

10.

List the origin, composition, function and explain the significance of the surfactant.

11.

On an illustration, identify the various lung lobes and segments.

12.

Describe the structure and function of the components of the thoracic cavity.

13.

List the major and minor muscles of respiration and describe their role in breathing.

14.

Explain the physiology of ventilation and state the effects of compliance, resistance, and pressure gradients.

15.

Describe the elastic forces of the lung and chest wall and explain their effect on lung volume.

16.

Summarize the effects of resistance on breathing.

17.

Define work of breathing and delineate factors which change it.

18.

Describe the normal breathing cycle and calculate the I;E ratio.

19.

Relate ventilation perfusion matching and the effects of shunt and dead space.

20.

Describe regional differences in ventilation, perfusion, and ventilation perfusion matching.

21.

Explain the process of diffusion relating factors which influence the efficiency of diffusion.

22.

On an illustration, identify the structures of the heart and describe their function.

23.

On an illustration, trace the flow of blood through the pulmonary and systemic circulatory systems.

24.

Describe the electrophysiology of the heart and relate the events of cardiac conduction to the electrocardiogram.

25.

Relate the events of myocardial contraction to Starling‘s Law.

26.

Draw, label, and define the components of the normal electrocardiogram.

27.

Explain, compare, and contrast the mechanisms of oxygen transport in the erythrocyte and in plasma.

28.

Describe the structure and function of hemoglobin and relate the differences in major abnormal forms.

29.

Draw the oxyhemoglobin dissociation curve.

30.

Describe the effects of temperature, pH, PCO2, and 2,3-DPG on the binding of oxyhemoglobin.

31.

Describe the Bohr effect.

32.

List the normal values of arterial and venous oxygen tensions and saturations.

33.

Give PaO2 calculate the oxygen content when the hemoglobin concentration is known.

34.

Define hypoxia and hypoxemia, list common causes, and determine the severity when given PaO2 values.

35.

Describe the various mechanisms of carbon dioxide transport.

36.

Summarize the Haldane effect.

37.

Describe the effect of carbon dioxide on the acid base status of the patient.

38.

Classify the acid base status of blood when given pH and PaCO 2 values.

39.

Describe the identify the mechanism of compensation for acid base derangements.

40.

Given levels of VO2 and VCO2 calculate the respiratory quotient.

41.

Explain how the respiratory quotient affects the need for ventilation.

42.

Calculate the A-aDO2 and relate its value to impairment of the cardiopulmonary systems.

43.

Compare the use of A-aDO2 to the FiO2 / PaO2 ratio and Pa/aO2 ratios.

44.

List the components of the medullary and pontine respiratory centers and describe their interaction in controlling ventilatory drive.

45.

Describe the mechanism of the central chemoreceptors and relate their function in normal and abnormal breathing patterns.

46.

Describe the influence of the cerebrum over ventilation.

47.

Locate and describe the function of the peripheral chemoreceptors.

48.

Describe the effects of the various reflexes on breathing.

49.

Recognize common abnormal breathing patterns.

TOPICAL OUTLINE: Pulmonary Pathophysiology

I.

Infectious Pneumonias A. B. C. D. E. F.

II.

Asthma A. B. C. D. E. F.

III.

Etiology Pathology Biochemical reactions Clinical manifestations Prognosis Treatments

Chronic Obstructive Pulmonary Diseases A. B. C. D. E. F. G.

IV.

Etiologies Susceptibilities Diagnostic techniques Clinical manifestations Pathology Treatment

Definitions Etiologies Pathology Clinical manifestations Prognosis Treatment Rehabilitation

Adult Respiratory Distress Syndrome

A. B. C. D. E. F. G. H. V.

Pulmonary Embolism A. B. C. D. E.

VI.

Definition Etiologies Clinical manifestations Treatment Prognosis

Hypersensitivity Pneumonitis A. B. C. D. E. F.

VIII.

Etiologies Clinical manifestations Diagnostic techniques Treatment Prognosis

Pulmonary Hypertension A. B. C. D. E.

VII.

Definition Etiologies Pathogenesis Clinical manifestations Diagnostic techniques Treatment Sequellae Prognosis

Hypersensitivity reaction types Etiologies Clinical manifestations Treatment Pathology Prognosis

Pulmonary Tuberculosis A. B. C. D. E. F. G. H.

Etiology Pathology Clinical manifestations Diagnostic techniques Chemotherapy Control Complications Prognosis

IX.

Pulmonary Fungus Diseases A. B. C. D.

X.

Bronchiectasis A. B. C. D. E.

XI.

Etiologies Pathology Clinical manifestations Treatment

Pleural Effusions A. B. C.

XIII.

Etiology Diagnostic techniques Pathology Clinical manifestations Treatment

Lung Abscess A. B. C. D.

XII.

Etiologies Pathology Clinical manifestations Treatments

Etiologies Treatment Clinical manifestations

Pneumothorax and Pneumomediastinum A. B. C. D.

Pathogenesis Clinical manifestations Treatment Precautions

XIV. Pulmonary Neoplasms A. B. C. D. E. F.

Types Incidence Clinical manifestations Treatments Prognosis Post-operative care

XV.

Interstitial Pneumonias A. B. C. D. E.

Types Etiologies Pathology Treatment Clinical manifestations

XVI. Pneumoconioses A. B. C. D. E.

Types Etiologies Diagnostic techniques Treatment Rehabilitation

XVII. Connective Tissue Diseases A. B. C. D.

Types Etiologies Treatment Clinical manifestations

XVIII. Myasthenia Gravis A. B. C. D.

Etiology Clinical manifestations Monitoring Treatment

XIX. Diseases Affecting Control of Ventilation A. B. C. XX.

Etiologies Clinical manifestations Treatments

Myocardial Infarction and Congestive Heart Failure A. B. C. D.

Etiologies Clinical manifestations Treatments Prognosis

TOPICAL OUTLINE: CARDIOPULMONARY PATHOPHYSIOLOGY

I.

Cardiovascular Pathology A. B.

II.

Myocardial Infarction Congestive Heart Failure

Obstructive Pulmonary Disease A. B. C. D. E.

Bronchitis Emphysema Asthma Cystic Fibrosis Bronchiectasis

III.

Infectious Diseases A. B. C. D.

IV.

Restrictive Lung Diseases A. B. C. D.

V.

Primary Metastatic

Environmental Lung Diseases A. B.

IX.

Pneumothorax Pleural Effusion Kyphoscoliosis

Lung cancer A. B.

VIII.

Pulmonary Emboli Pulmonary Hypertension Cor Pulmonale

Conditions of Thoracic Cage and Pleura A. B. C.

VII.

Sarcoidosis Pneumonitis Rheumatoid Lung Diseases Lung Abcess

Pulmonary Vascular Diseases A. B. C.

VI.

Pneumonia Pulmonary Fungus Disease Tuberculosis Lung Abcess

Pneumoconiosis Noxious Gas Inhalation

Neuromuscular Diseases and Disorders of Respiratory Control A. B. C. D. E.

Guillian Barre' Myasthenia Gravis Polio Sleep Apnea and Hypoventilation Paralysis

F. X.

Intracranial Pressure

Trauma and Surgery of the Chest A. B. C. D. E.

Thoracic Surgery Abdominal Surgery Atelectasis Flair chest Lung contusion

INSTRUCTIONAL OBJECTIVES CARDIOPULMONARY PATHOPHYSIOLOGY

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to:

1.

Outline the factors which pre-dispose a patient to the development of myocardial infarction.

2.

List the etiologies of myocardial infarction.

3.

Describe the clinical manifestations of myocardial infarction.

4.

Describe the pathogenesis and manifestations of congestive heart failure.

5.

List the common treatments of MI and CHF.

6.

Recognize the signs and symptoms of cardiopulmonary arrest.

7.

recognize the signs and symptoms of cardiovascular decompensation.

8.

List the diseases commonly associated with COPD.

9.

List the pre-disposing factors for COPD.

10.

Differentiate the pathology and clinical symptomatology of patients with predominately chronic bronchitis versus emphysema.

11.

Compare and contrast centrilobular versus panlobular emphysema.

12.

Outline and justify the treatments of COPD.

13.

Describe the impact of COPD on the patient, family and society.

14.

Describe the pathogenesis and prognosis of COPD.

15.

Describe the etiology and pathophysiology of bronchiectasis.

16.

Describe the treatment and prognosis of bronchiectasis.

17.

Describe the pathogenesis of cystic fibrosis and differentiate its treatment compared to other chronic obstructive diseases.

18. 19.

Recognize and delineate the special needs of the patient with cystic fibrosis. Explain the role of pulmonary rehabilitation in chronic obstructive pulmonary diseases.

20.

Outline the etiology and pathophysiology of asthma.

21.

Describe the cellular events that take place during an asthma attack and list the chemical mediators of bronchospasm.

22.

Justify the treatments of asthma.

23.

Differentiate between the various common infectious pneumonias with regard to: causative organism, clinical manifestations, pathogenesis, and prognosis.

24.

Outline the various treatments for pneumonia.

25.

List the most common pulmonary fungus diseases and their causative organism, differentiating their likely sources to include: histoplasmosis, coccidioidomycosis, blastomycosis, and candidiasis.

26.

Describe the pathophysiology of pulmonary fungus diseases.

27.

List the treatments of pulmonary fungus diseases.

28.

Outline the pathogenesis and manifestations of tuberculosis.

29.

List the treatments of tuberculosis.

30.

Describe the special requirements of infection control with tuberculosis patients in the hospital or in the community.

31.

Describe the special requirements for treatment of lung abscess.

32.

List factors pre-disposing to lung abscess formation and its prognosis.

33.

Summarize the pathophysiology of sarcoidosis.

34.

Describe the clinical manifestations of sarcoidosis and its management.

35.

List the causes of hypersensitivity pneumonitis.

36.

Describe the pathology and clinical manifestations of hypersensitivity pneumonitis.

37.

List the treatments of hypersensitivity pneumonitis.

38.

Describe the pathophysiology and clinical manifestations of common rheumatoid lung diseases.

39.

List major etiologies of the Adult Respiratory Distress Syndrome.

40.

Describe the clinical manifestations of ARDS.

41.

Outline the treatment of ARDS and its prognosis.

42.

List factors which pre-dispose a patient to pulmonary embolic disease.

43.

Describe the clinical manifestations of pulmonary emboli.

44.

Outline the treatment of pulmonary emboli.

45.

Describe the etiologies, manifestations, and treatment of pleural effusions.

46.

List common etiologies of pleural effusions.

47.

List the clinical manifestations and treatment of pleural effusions.

48.

List the common causes of pneumothorax and describe its treatment.

49.

Describe the components and function of common chest drainage systems.

50.

Recognize the signs and symptoms and special treatment considerations of a patient with pneumothorax.

51.

Outline the occurrence etiology, treatment, and prognosis of common pulmonary neoplasms.

52.

Describe the techniques used in the treatment and diagnosis of pulmonary neoplasms.

53.

Describe the etiologies, clinical manifestations, and treatment of interstitial pneumonitis.

54.

Explain the etiologies and pathogenesis of the more common pneumoconiosis.

55.

Define black lung and coal workers pneumoconiosis.

56.

Describe the methods of decreasing the incidence of pneumoconiosis.

57.

Outline the treatment of pneumoconiosis.

58.

Describe the etiology and clinical manifestations of Myasthenia Gravis.

59.

Summarize the special requirements of respiratory monitoring for the patient with Myasthenia Gravis.

60.

Outline the pharmacologic and respiratory treatment of Myasthenia Gravis.

61.

Explain the pharmacologic treatment of muscarinic crisis.

62.

Describe the monitoring and necessary support for patients with Guillain Barre' Syndrome.

63.

Describe the pathophysiology of Guillain Barre' Syndrome.

64.

List the pre-disposing and complicating factors associated with the various forms of sleep apnea and hypoventilation.

65.

Summarize the methods of diagnosis and treatment for the sleep apnea syndromes.

66.

Describe the pathophysiology and treatment of polio.

67.

Explain the special complications and needs of patients with respiratory muscle paralysis.

68.

Relate the role of ventilation in control of intracranial pressure.

69.

Describe the special considerations of providing respiratory care to neurosurgical patients.

70.

Summarize the effects of thoracic and abdominal surgery on the patient‘s pulmonary status.

71.

Outline the effects of the various modes of respiratory care in preventing and treating postoperative pulmonary complications.

72.

List the clinical signs and symptoms of atelectasis.

73.

Describe the pathophysiology, clinical manifestations, and treatment of pulmonary aspiration, including foreign body, gastric contents, and hydrocarbons.

74.

Define the terms: flail chest and lung contusion. Outline the pathophysiology and treatment of these conditions.

TOPICAL OUTLINE RSP 202 - MECHANICAL VENTILATION TECHNOLOGY & MANAGEMENT I.

TERMINOLOGY A. B. C.

II.

VENTILATOR CLASSIFICATION SYSTEM A. B.

IV.

Bennett Bird

TIME CYCLED VENTILATORS A. B.

V.

Modes Cycling Mechanisms Drive Mechanisms

Rotary Drive Pneumatically Powdered Electrically Controlled

VOLUME CYCLED VENTILATORS

A. B. C. D.

VI.

Bellows Type Fluidic Microprocessor Controlled Portable Home Care Type

MANUAL RESUSCITATORS A. B.

Types Use

TOPICAL OUTLINE: RSP 202 - MECHANICAL VENTILATION TECHNOLOGY & MANAGEMENT I.

Terminology A. B. C.

II.

Ventilator Classification System A. B.

III.

Modes Cycling Mechanisms Drive Mechanisms

Bennett Bird

Time Cycles Ventilators A. B.

Rotary Drive Pneumatically Powered Electrically Controlled

IV.

Volume Cycled Ventilators A. B. C. D.

V.

Bellows Type Fluidic Microprocessor Controlled Portable Home Care Type

Manual Resuscitators A. B.

Types Uses

INSTRUCTIONAL OBJECTIVES RSP 202 - MECHANICAL VENTILATION TECHNOLOGY & MANAGEMENT

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

Describe the characteristics of the various modes of mechanical ventilation and recognize their pressure curves.

2.

Explain the different cycling mechanisms (pressure, volume, time, flow) and describe the variability of their effects in ventilating patients.

3.

Explain the classification system used to describe mechanical ventilators.

4.

Classify the Bird MK VII ventilator.

5.

Explain, in detail, the function of the Bird MK VII and its component parts.

6.

Describe the effects of each of the controls of the Bird ventilator with respect to ventilation, oxygenation, and interrelationship with other controls.

7.

Classify the Bennett PR 2 ventilator.

8.

Describe the function of the component parts of the Bennett PR 2 and the interrelationship of its controls.

9.

Classify and explain the mechanism of a representative electrically powered, time cycled, rotary drive, piston type ventilator, specified by the program (example: Emerson 3PV, IMV).

10.

Classify and explain the mechanism of at least one electrically powered, compressor driven, bellows type, double circuit ventilator, specified by the program (example: Ma-1, MA-2, Ohio CCV2).

11.

Define fluidics and describe its use in mechanical ventilators.

12.

Describe the coanda effect.

13.

Explain the function of common fluidic devices.

14.

Classify and explain the mechanism of a representative, fluidically controlled mechanical ventilator, specified by the program (example: Monaghan).

15.

Classify and explain the mechanism of at least tow pneumatically powered, electrically controlled, adult mechanical ventilators, specified by the program (example: Bear 1 & 2, Servo 900C).

16.

Classify and explain the mechanism of at least one microprocessor controlled, adult mechanical ventilator, specified by the program (example: Bear V, Bennett 7200, Hamilton, Engstrom Erica).

17.

Describe the mechanism and explain the use of a representative, electrically powered portable ventilator commonly used by home bound patients.

18.

List performance characteristics of commonly used manual resuscitators.

19.

Illustrate and explain the function of representative manual resuscitators.

20.

List criteria for verifying adequate function of manual resuscitators.

21.

Describe the proper use of manual resuscitators.

22.

Explain the importance of periodic monitoring of technical performance of mechanical ventilators.

23.

Outline a procedure for verifying function of mechanical ventilators.

24.

Given a description of a malfunctioning mechanical ventilator, recognize likely causes of the malfunction and describe the role of the technician in correcting it.

RSP 202 - MECHANICAL VENTILATION TECHNOLOGY & MANAGEMENT Ventilator Maintenance REFERENCE: Clinical Application of Respiratory Care, Shapiro, Chapter 20

PERFORMANCE OBJECTIVES: 1.

Define the terminology used in ventilator care.

2.

Recognize the ventilator used by reading pressure curves.

3.

Discuss the different cycling mechanisms of mechanical ventilators and the variability of ventilator parameters while using these.

4.

List the ventilator parameters which are used and monitored in ventilator care.

5.

When given blood gas parameters for a patient, discuss changes which should be made in the ventilator parameters.

Course Competencies: 1.

List the indications for mechanical ventilation.

2.

List and explain the causes and effects of respiratory failure.

3.

Define the terminology of mechanical ventilation.

4.

Provide a rationale for ventilator commitment.

5.

Describe the hemodynamic effects of mechanical ventilation.

6.

List the factors which must be optimized prior to weaning.

7.

Discuss the psychological impact of mechanical ventilator on the patient and the family.

8.

Knows various techniques, indications, contraindications of weaning.

9.

List the parameters which must be monitored in mechanical ventilation.

10.

Describe the various methods of mechanical ventilation, and give criteria.

11.

Recognize the ventilator mode by reading pressure and flow patterns.

12.

Discuss the different cycling mechanisms of mechanical ventilators, and the variability of ventilator parameters while using these.

TOPICAL OUTLINE: RSP 202 - MECHANICAL VENTILATION TECHNOLOGY & MANAGEMENT I.

Indications A. B. C. D.

II.

Respiratory Failure Ventilatory Failure Cardiopulmonary Reserve Parameters/Measurements

Goals of Mechanical Ventilation A. B.

Desired Parameters Effects

IV.

Complications

IV.

Methods A. B.

Modes Parameters 1. 2. 3. 4.

C.

Special Methods 1. 2.

D. V.

PEEP CPAP

Modification

Monitoring A. B. C. D. E. F. G.

VI.

Volume Flow Rate Pressures

Volume Pressures Compliance Resistance FiO2 Alarm Systems Recording and Reporting

Weaning

A. B. C.

Methods Monitoring Special Considerations

INSTRUCTIONAL OBJECTIVES RSP 202 - MECHANICAL VENTILATION TECHNOLOGY & MANAGEMENT Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

Define ―critically ill‖.

2.

Differentiate between respiratory and ventilatory failure.

3.

List common causes of respiratory and ventilatory failure.

4.

Recognize the signs and symptoms and respiratory and ventilatory failure.

5.

Outline methods of assessing cardiopulmonary reserve.

6.

List the indications for mechanical ventilation.

7.

List the goals of mechanical ventilation.

8.

Explain the importance of early ventilator commitment.

9.

Identify the moral and ethical problems associated with life support systems.

10.

Delineate the sequence of steps in ventilator commitment.

11.

Outline the use of and special considerations of the various modes of mechanical ventilation including: control, assist, assist-control, IMV, SIMV, IDV, EMMV, pressure support.

12.

Describe the physiologic effects and hazards of mechanical ventilation.

13.

Describe the psychological impact of mechanical ventilation.

14.

Summarize the use of PEEP including indications, contraindications, effects, and hazards.

15.

Select the optimal PEEP level for a patient based on physiologic response.

16.

List the indications, contraindications, and hazards of CPAP.

17.

Describe the application of CPAP and its monitoring.

18.

Given simulated or common clinical situations, determine changes to be made in mechanical ventilation modes or parameters to restore blood gas values or other physiologic responses to appropriate levels.

19.

List parameters that should be monitored during the course of mechanical ventilation and describe the significance of those measurements.

20.

Calculate static compliance and dynamic characteristics of a mechanical ventilation patient.

21.

Calculate and correct for lost volume due to compression in the ventilator circuitry.

22.

Determine safe limits for alarms used during mechanical ventilation.

23.

Identify the parameters to be measured in monitoring the patient‘s physiologic response to mechanical ventilation.

24.

List the indications for weaning from mechanical ventilation.

25.

List the physiologic factors which must be optimized prior to successful weaning from mechanical ventilation.

26.

Describe the procedure and special considerations for conventional weaning techniques.

27.

Summarize the use of IMV and associated techniques for weaning and describe the procedures used.

28.

Explain special considerations for weaning from PEEP and high oxygen concentrations.

29.

List the steps to be accomplished in weaning.

TOPICAL OUTLINE: RSP 202 - MECHANICAL VENTILATION TECHNOLOGY & MANAGEMENT I.

Assessment of Cardiopulmonary Reserve

II.

Respiratory Failure A. B.

Causes Effects

III.

Mechanical Ventilation Terminology

IV.

Pressure Patterns

V.

Flow Patterns

VI.

Ventilation Commitment

VII.

Effects of Mechanical Ventilation

VIII.

Weaning from the Mechanical Ventilator

PERFORMANCE OBJECTIVES: Upon completion of this unit, the student will demonstrate on examination, the ability to:

1.

Define ―critically ill‖.

2.

Describe how and why to assess mechanical pulmonary reserve.

3.

List normal and abnormal levels of: a. b. c. d. e. f.

tidal volume respiratory rate I:E ratio Vital capacity Negative inspiratory force Dead space and VD/VT

4.

Describe the methods of assessing the cardiovascular reserve.

5.

List and describe normal and abnormal limits of: a. b. c. d. e. f. g.

EKG blood pressure pre-load and after-load central venous pressure pulmonary artery pressure pulmonary capillary wedge pressure

6.

Differentiate between primary and secondary (relative) hypovolemia.

7.

List the clinical signs used to assess perfusion.

8.

Discuss the importance of blood constituents, and micro-circulation in relation to perfusion.

9.

Assess the levels of gas exchange and reserve when given blood gas parameters.

10.

List the normal and critical levels of blood gas parameters.

11.

When given a clinical description of a patient‘s status in relation to parameters of cardiopulmonary reserve, make a decision as to need for cardiovascular or mechanical pulmonary support.

RSP 202 - MECHANICAL VENTILATION TECHNOLOGY & MANAGEMENT Ventilator Commitment

PERFORMANCE OBJECTIVES: Upon completion of this unit, the student will demonstrate on examination, the ability to: 1.

Discuss the importance of early ventilator commitment.

2.

List the goals of mechanical ventilation.

3.

List the indications for mechanical ventilation.

4.

Describe moral and ethical problems associated with mechanical ventilators and life-support systems. Discuss the five steps of ventilator commitment as listed by Shapiro.

5.

INSTRUCTIONAL OBJECTIVES RSP 204 – CARDIOPULMONARY DIAGNOSTICS TRANSTRACHEAL ASPIRATION AND OXYGEN THERAPY

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

List and explain the indications for transtracheal aspiration.

2.

List the equipment needed to perform transtracheal aspiration and oxygen therapy.

3.

Explain the procedure for insertion of a transtracheal catheter.

4.

Describe the uses of a transtracheal catheter.

5.

List the hazards and complications of transtracheal catheter insertion.

INSTRUCTIONAL OBJECTIVES RSP 204 – CARDIOPULMONARY DIAGNOSTICS BRONCHOSCOPY

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

Explain the diagnostic and therapeutic uses of rigid and fiberoptic bronchoscopy.

2.

Describe the advantages and disadvantages of rigid and fiberoptic bronchoscopy.

3.

Explain the procedure of rigid and fiberoptic bronchoscopy.

4.

On an illustration, identify and label the parts of a fiberoptic bronchoscope.

5.

Identify the hazards and complications of bronchoscopy.

6.

Explain the therapeutic treatment for each of the hazards and complications of bronchoscopy.

INSTRUCTIONAL OBJECTIVES

RSP 204 – CARDIOPULMONARY DIAGNOSTICS THORACENTESIS AND PLEURAL CHEST TUBES

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

Anatomy and physiology review of the pleural space.

2.

Describe the optimal positioning of a client for a thoracentesis.

3.

Explain the procedure of a thoracentesis.

4.

List the signs and symptoms that would indicate the need for a thoracentesis.

5.

Define the following terms; empyema, chyle, loculated, purulent, mucopurulent, serosanguinous.

6.

Differentiate characteristics of transudative and exudative effusions.

7.

List the disease processes that cause transudative and exudative effusions.

8.

List abnormal conditions requiring chest tube placement.

9.

Describe the anatomical location of chest tube insertion.

10.

Describe the use of chest tube drainage systems.

11.

Describe the function of a one bottle/chamber drainage system.

12.

Identify the bottles used in a two bottle/chamber drainage system.

13.

Explain when it is recommended to use a two bottle/chamber system over a one bottle system.

14.

Identify the bottles used in a three bottle/chamber suction drainage system and describe their function.

15.

Identify and correct various problems that occur when using a one, two, and three bottle/chamber drainage system.

INSTRUCTIONAL OBJECTIVES RSP 204 – CARDIOPULMONARY DIAGNOSTICS ARTERIAL LINE MANAGEMENT Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

Explain the procedure of performing an Allen test.

2.

Explain other procedures that provide accurate assessment of ulnar collateral blood flow to the hand.

3.

Identify advantages and disadvantages associated with percutaneous cannulation of the following arterial sites; radial artery, brachial artery, axillary artery, and the femoral artery.

4.

Identify and name the anatomic locations of the arteries of the arm.

5.

Explain the procedure for percutaneous cannulation of the radial artery.

6.

Explain specific complications associated with percutaneous cannulation of arterial insertion sites.

7.

Explain what physiologic events occur and their relationship with arterial systole and arterial diastole pressures.

8.

Define and calculate stroke volume.

9.

Calculate Mean Arterial Pressure (MAP) when given cardiac output (CO) and systemic vascular resistance (SVR).

10.

Differentiate between arterial pressures being measured via a transducer vs an anaeroid manometer.

11.

Explain the procedure of setting up an arterial pressure system using a transducer and pressure IV bag.

12.

Identify and label a normal arterial pressure waveform.

13.

Identify and label an abnormal arterial pressure waveform demonstrating marked reduction in stroke volume and pulse pressure associated with a run of PVC‘s aortic stenosis, hypertrophic cardiomyopathy, aortic insufficiency.

14.

Identify problems and causes, and give prevention techniques and treatment of problems encountered with arterial catheters.

15.

Identify signs and symptoms of infection of arterial sites and list preventive techniques and treatment.

16.

Explain the steps for obtaining arterial blood from an arterial catheter. INSTRUCTIONAL OBJECTIVES RSP 207 – PULMONARY REHAB/HOME CARE SLEEP APNEA

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

Explain the physiologic effects of rapid eye movement (REM) and non-REM (NREM) sleep.

2.

Explain the physiologic changes in respiration during sleep.

3.

Explain the influence of chemical stimuli during wakefulness and sleep.

4.

Define the three classifications of sleep apnea. 1. 2. 3.

5.

central sleep apnea obstructive sleep apnea mixed disorder sleep apnea

Explain the clinical features, diagnosis, and treatment of central, obstructive, and mixed disorder sleep apnea.

INSTRUCTIONAL OBJECTIVES RSP 204 – CARDIOPULMONARY DIAGNOSTICS TRANSPORTS

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

Outline field triage criteria for trauma patients.

2.

Describe the criteria used in patient assessment using the Glascow Coma Scale.

3.

Describe the physiologic effects of altitude during aviation transport.

4.

Predict in-flight arterial oxygen tension from cabin altitude and preflight arterial oxygen tension using a nomogram.

5.

Explain the operational characteristics and features of the following transports ventilators: 1. 2. 3. 4. 5.

6.

Impact Uni-vent Hamilton MAX Pneu-Pac 2-R or HARV Auto Vent 2000 and 3000 Stein Gates Omni Vent

Define the terms capnometry, capnogram and capnography. List clinical situations in which they are useful.

7.

Describe the basic components of a nondispersive double-beam, positive-filter infrared CO2 detector.

8.

Describe the basic components of a single-beam, negative-filter infrared CO2 detector.

9.

Identify and label, on an illustration, a normal capnogram waveform.

10.

List advantages and disadvantages of capnometry.

INSTRUCTIONAL OBJECTIVES RSP 204 – CARDIOPULMONARY DIAGNOSTICS ELECTROCARDIOGRAM INTERPRETATION

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

Identify and label, on an illustration, the electro conduction system of the heart.

2.

Describe and label the electrophysiological events represented by the normal sinus electrocardiogram.

3.

Explain the ten features that should be examined in the interpretation of an electrocardiogram.

4.

Identify and label, on an illustration, the following ECG tracings: 1. 2. 3. 4.

normal sinus rhythm sinus arrhythmia sinus tachycardia sinus bradycardia

5. 6. 7. 8. 9. 10. 11. 12. 13. 14.

I.

paroxysmal atrial tachycardia atrial flutter atrial fibrillation first degree atrioventricular (AV) block second degree AV block Mobitz type I (wenckebach) second degree AV block Mobitz type II third degree (complete) AV block premature ventricular contraction (PVC) ventricular tachycardia ventricular fibrillation

5.

Explain the procedure and indications for cardiovension.

6.

Explain the procedure and indications for defibrillation.

7.

Explain the hazards and complications of cardioversion and defibrillation.

TOPICAL OUTLINE RSP 206 – INTRODUCTION TO CRITICAL CARE MANAGEMENT Airway Management

A.

Upper airway anatomy. B. Airway obstruction. C. Artificial airways. D. Endotracheal intubation/extubation E. Cuff management. F. Tracheostomy tubes and care. G. Suctioning. H. Manual resuscitators

II.

Transtracheal Aspiration and Oxygen Therapy

A.

Indications. B. Equipment needed. C. Transtracheal oxygen catheter placement.

D.

Procedure for transtracheal aspiration.

III.

Bronchoscopy

A.

Indications. B. Rigid vs Fiberoptic 1. advantages 2. disadvantages C. Bronchoscopy procedure D. Risks

IV.

Thoracentesis and Pleural Chest Tubes

A.

Indications. B. Procedures. 1. thoracentesis 2. pleural chest tube C. Pleural drainage systems. D. Three chamber vs four chamber. E. Troubleshooting complications.

V.

Arterial Lines A. B. C. D. E. F. G. H.

Arterial access. Physiologic review. Clinical applications. Intra-arterial pressure measurement. Waveforms. Complications and troubleshooting. Prevention of infection. Arterial blood sampling.

VI.

Sleep Apnea A. Physiology of sleep. B. Respiratory physiologic process during sleep. C. Obstructive sleep apnea. D. Central sleep apnea.

VII.

Transports A. B. C.

Prehospital Respiratory Care. Transport ventilation. Capnography

VIII. Electrocardiogram interpretation A. B.

Electroconduction system of the heart. EKG interpretation

C. D.

Cardioversion Defibrillation

INSTRUCTIONAL OBJECTIVES RSP 204 – CARDIOPULMONARY DIAGNOSTICS AIRWAY MANAGEMENT

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to: 1.

Define the role of the Respiratory Therapist in airway management.

2.

Locate and identify the anatomical structures of the upper airway.

3.

Explain the anatomical structures and their effects on airway maintenance.

4.

List the causes of airway obstruction.

5.

List the signs and circumstantial signs of airway obstruction.

6.

Discuss the development and use of the Heimlich maneuver.

7.

List the specific steps in performing the Heimlich maneuver with the victim standing, sitting and lying.

8.

Discuss the use of artificial airways in the prevention of airway obstruction.

9.

List the general indications for artificial airways.

10.

Name the general classifications or artificial airways.

11.

Identify the advantages and problems associated with artificial airways.

12.

Explain the proper insertion techniques of the oropharyngeal and nasopharyngeal airway.

13.

Explain the procedure in the selection of an artificial airway.

14.

Identify parts of an endotracheal tube.

15.

Identify the parts and list the indications for the double-channeled endotracheal tube.

16.

Identify the different types of endotracheal tube cuffs and explain how they are classified according to volume and pressure.

17.

Discuss and explain the techniques for performing the minimal occlusive volume (MOV), minimal leak volume (MLV) and actual measurement using a pressure manometer.

18.

List the hazards of tracheal tubes and cuffs.

19.

Discuss what measures can be done to prevent tracheal damage.

20.

Discuss the composition of tracheal tubes.

21.

Explain the steps involved in determining the correct size tracheal tube.

22.

Identify and list the equipment needed for tracheal intubation.

23.

Differentiate between the use of various laryngoscope blades.

24.

On an illustration, identify anatomical landmarks used in endotracheal intubation.

25.

Discuss the process of endotracheal intubation.

26.

List the hazards of oral and nasal intubation.

27.

List the potential results of improper airway insertion techniques during endotracheal intubation.

28.

List the methods and criteria of monitoring, securing and verifying the position of oral and nasal endotracheal tubes.

29.

Identify the hazards of excessive cuff pressure.

30.

List the rationales and hazards of a tracheotomy.

31.

Identify the parts of a tracheostomy tube.

32.

List and identify the various styles of tracheostomy tubes.

33.

Describe the techniques of tracheostomy tube care.

34.

List the indications, contraindications, and hazards of endotracheal suctioning.

35.

List and explain the different types of endotracheal suctioning techniques.

36.

List the signs and symptoms expected as a result of complications during airway suctioning.

37.

Describe the method of monitoring the patient being suctioned for safety and effectiveness.

38.

List criteria indicating that suctioning is effective.

39.

Describe the use of a sterile trap for sputum collection during airway suctioning.

40.

List the pressures and time used when suctioning adults, infants, and children.

41.

Identify appropriately sized suction catheters.

42.

List the standards for the design and construction of manual resuscitators set by the American Society for Testing and Materials (ASTM).

43.

Identify the various brands of manual resuscitators and the type of ‗patient valve‘ and pressure relief valve‘ that each incorporate into their system.

44.

List the indications for the use of manual resuscitators.

45.

Identify and correct a malfunction of a manual resuscitator when given a clinical situation.

Appendix E

ST. MARY'S/MARSHALL UNIVERSITY COOPERATIVE B.S. RESPIRATORY CARE PROGRAM

COURSE EVALUATION DATE:

COURSE:

This evaluation is designed for the student to evaluate the course and the instructors. Use a number 2 pencil for marking the appropriate circle on the computer answer sheet. If an item does not apply, leave the answer sheet blank for that item. You are also asked to provide comments for each section. Please explain your reasons for rating an item (instructor, unit, etc.), especially if you had a problem or concern. Use the space provided on this evaluation sheet for your comments. Use the following rating scale (A-E) to rate each item. A — Strongly Agree B — Agree C — Neutral D — Disagree E — Strongly Disagree EVALUATE THE FOLLOWING COURSE RELATED ITEMS, USING TIM ABOVE SCALE. PUT YOUR COMMENTS IN THE DESIGNATED AREA OF THE SCORING SHEET. 1.

This course had clearly stated course objectives.

2.

This course had achievable course objectives.

3.

Course assignments are relevant to course objectives.

4.

The grading method is appropriate for course content.

5.

There is sufficient time in class for questions and discussions.

6.

Exams accurately assess what I have learned in this course.

7.

The course content built on my previous knowledge.

8.

Lecture information is adequately supplemented by other work.

9.

The course content facilitated the development of critical thinking (questioning, reasoning, analyzing, etc.)

10.

The course facilitated the development of my communication skills (verbal, non-verbal).

11.

The course content enhanced my knowledge and skills necessary to provide patient care.

12.

The course content will assist me in providing service to the community and the profession.

13.

The syllabus provided guidance for my learning.

14.

The syllabus identified objectives, course content and teaching methods.

15.

The syllabus described evaluation methods.

16.

The course content enhanced my ability to be a caring professional.

ST. MARY'S/MARSHALL UNIVERSITY COOPERATIVE B.S. RESPIRATORY CARE PROGRAM

COURSE EVALUATION DATE:

COURSE:

This evaluation is designed for the student to evaluate the course and the instructors. Use a number 2 pencil for marking the appropriate circle on the computer answer sheet. If an item does not apply, leave the answer sheet blank for that item. You are also asked to provide comments for each section. Please explain your reasons for rating an item (instructor, unit, etc.), especially if you had a problem or concern. Use the space provided on this evaluation sheet for your comments. Use the following rating scale (A-E) to rate each item. A — Strongly Agree B — Agree C — Neutral D — Disagree E — Strongly Disagree INSTRUCTOR PERFORMANCE: Evaluate only those classroom or clinical instructors to which you were assigned. Instructor presented content in a knowledgeable manner. 17. 18.

Brent Blevins Chuck Zuhars

Instructor presented content in an organized manner. 19. 20.

Brent Blevins Chuck Zuhars

Instructor demonstrated knowledge in assigned clinical area. 21. 22.

Brent Blevins Chuck Zuhars

The instructor provided additional explanation or resource material when requested.. 23. 24.

Brent Blevins Chuck Zuhars

The instructor provided additional assistance with clinical aspects of the course as needed. 25. 26.

Brent Blevins Chuck Zuhars

Written/verbal feedback in the classroom/clinical from instructor was beneficial. 27. 28.

Brent Blevins Chuck Zuhars

Instructor promoted an environment of learning. 29. Brent Blevins 30. Chuck Zuhars Comment: Identify the instructor (by name) and provide any pertinent comments regarding any of the above topics.

ST. MARY'S/MARSHALL UNIVERSITY COOPERATIVE B.S. RESPIRATORY CARE PROGRAM

COURSE EVALUATION DATE:

COURSE:

This evaluation is designed for the student to evaluate the course and the instructors. Use a number 2 pencil for marking the appropriate circle on the computer answer sheet. If an item does not apply, leave the answer sheet blank for that item. You are also asked to provide comments for each section. Please explain your reasons for rating an item (instructor, unit, etc.), especially if you had a problem or concern. Use the space provided on this evaluation sheet for your comments. Use the following rating scale (A-E) to rate each item. A — Strongly Agree B — Agree C — Neutral D — Disagree E — Strongly Disagree CLINICAL ROTATIONS/AGENCY: Evaluate only those units to which you actually were assigned. Clinical rotations were appropriate for application of course content. 45. 46.

St. Mary‘s Medical Center Holzer Medical Center

Comment: Identify the clinical experience by number above and provide pertinent comments: 47. 48. 49.

Student was able to collaborate with staff on assigned unit in an effective manner. Staff modeled the professional respiratory therapists‘ role. Staff members on assigned units were helpful.

Comment: Please make comments regarding staff on units by first identifying the unit or agency and then provide any pertinent comments: TEXTBOOKS: 50. The textbook was useful in understanding classroom presentation and clinical situations Comment: Identify the text by number above and then provide any pertinent comments: LEARNING RESOURCES 51. When I needed additional learning resources for this course, the library, Academic Support Center, and/or the computer lab had what I needed. Comment: 52. Instructional aids, such as Power Point presentations, videos, and handouts given by the instructors were beneficial. Comment:

DATE:

ST. MARY'S/MARSHALL UNIVERSITY COOPERATIVE BSRT PROGRAM COURSE EVALUATION COURSE:

This evaluation is designed for the student to evaluate the course and the instructors. Use a number 2 pencil for marking the appropriate circle on the computer answer sheet. If an item does not apply, leave the answer sheet blank for that item. You are also asked to provide comments for each section. Please explain your reasons for rating an item (instructor, unit, etc.), especially if you had a problem or concern. Use the space provided on this evaluation sheet for your comments. Use the following rating scale (A-E) to rate each item A — Strongly Agree B — Agree C — Neutral D — Disagree E – Strongly Disagree

53. Classroom, library and laboratory facilities were adequate to meet my learning needs. Comment:

54. What was your advisor's name? ___________________________________

Did you find him/her helpful? Yes No If not, explain:

55. Identify the grade that you expected to receive in this course.

10/95 10/99 06/00 03/04 11/05 9/06

Appendix F

COURSE SYLLABI

SCHOOL OF RESPIRATORY THERAPY

ST. MARY’S/MARSHALL UNIVERSITY COURSE CURRICULUM COURSE NAME: RSP 100 - Pharmacology CLASS HOURS:

45

LAB HOURS:

0

PREREQUISITES: Successful completion of program sequence. COURSE DESCRIPTION: This two credit hour course consists of two hours of lecture each week. This course is a presentation of topics related to drug groups commonly used in respiratory therapy; their physiologic mechanisms; pharmacological mode of action; drug doses; pharmacy calculations; and related drug product review. COURSE OBJECTIVES: 1. Gain a thorough understanding of the drug groups used in respiratory therapy practice. 2. Gain a thorough understanding of the mechanism of action of various classes of drugs. 3. Become familiar with various generic and brand names of medications commonly used in respiratory therapy. 4. Become familiar with appropriate adult and pediatric respiratory medication dosages. 5. Gain a thorough understanding of the rational for drug administration. 6. Become familiar with and be able to recognize complications associated with use of various respiratory medications. 7. List contraindications of various classes of respiratory medications. METHODS OF TEACHING: Lecture/Discussion Through the Teaching/Learning Process Exercises to Assist with Problem Solving In-Class Activities Handouts Reference Readings Paper/Pen Examinations

COURSE MATERIAL: Required Textbooks: Rau: Respiratory Care Pharmacology, 6th Ed., Elsevier 2002 Reference and Resource Material: Hill, F.: Respiratory Care Drug Reference, Delmar, 1999. Kacmarek, Mack, Dimas: The Essentials of Respiratory Therapy, 4th Ed., Elsevier 2005 Physicians’ Desk Reference Wilkins, Stoller, Scanlan: Egan‘s Fundamentals of Respiratory Care, 8th Ed., Elsevier 2003 SAFETY PRACTICES: Safety is an important component of respiratory care and technical skills taught throughout the semester. Features of each unit are given below: Unit 1: General Principles of Pharmacology- A general overview of pharmacology is given. Unit 2: Calculating Drug Dosages- The students are instructed how to calculate and administer appropriate dosages for respiratory medication for the adult and pediatric patient. Unit 3: The Central and Peripheral Nervous Systems- The effects of various pharmacological agents on the central and peripheral nervous system is presented. Unit 4: Sympathomimetic Bronchodilators- The generic and trade names, indications, appropriate dosages, contraindications, proper administration, and side effects of sympathomimetic bronchodilators is presented. Unit 5: Parasympatholytic Bronchodilators- The generic and trade names, indications, appropriate dosages, contraindications, proper administration, and side effects of parasympatholytic bronchodilators is presented.

Unit 6: Xanthines- The generic and trade names, indications, appropriate dosages, contraindications, proper administration, and side effects of xanthines is presented.

Unit 7: Mucus Controlling Agents- The generic and trade names, indications, appropriate dosages, contraindications, proper administration, and side effects of mucus controlling agents is presented. Unit 8: Surfactant Agents- The generic and trade names, indications, appropriate dosages, contraindications, proper administration, and side effects of surfactant agents is presented. Unit 9: Corticosteroids in Respiratory Care- The generic and trade names, indications, appropriate dosages, contraindications, proper administration, and side effects of corticosteriods is presented. Unit 10: Antiasthmatic Aerosol Agents- The generic and trade names, indications, appropriate dosages, contraindications, proper administration, and side effects of antiasthmatic agents is presented. Unit 11: Aerosolized Anti-Infective Agents- The generic and trade names, indications, appropriate dosages, contraindications, proper administration, and side effects of aerosolized anti-infective agents is presented. Unit 12: Anti-Microbial Agents- The generic and trade names, indications, appropriate dosages, contraindications, proper administration, and side effects of anti-microbial agents is presented. Unit 13: Neuromuscular Agents- The generic and trade names, indications, appropriate dosages, contraindications, proper administration, and side effects of neuromuscular agents is presented. Unit 14: Cardiovascular Agents- The generic and trade names, indications, appropriate dosages, contraindications, proper administration, and side effects of various cardiovascular agents is presented. Unit 15: Diuretic Agents- The generic and trade names, indications, appropriate dosages, contraindications, proper administration, and side effects of diuretics is presented. .

12 SCHOOL OF RESPIRATORY THERAPY ST. MARY’S/MARSHALL UNIVERSITY EVALUATION OF THE STUDENT

EVALUATION The purpose of evaluation is to indicate, to some degree, the extent to which the student has learned the concepts presented. Frequent testing will encourage the student to study and learn at a regular and constant pace throughout the course. The teaching-learning process meets the expected outcome goal. Evaluation is also utilized as a learning tool. Questions are designed to stimulate problem solving. The examinations are reviewed to provide feedback and promote discussion. Students who require additional support outside of that given during class hours may set-up personal meetings with the instructor during office hours. Students with math difficulties will be referred to ABE or URG Learning Center for tutoring.

SPECIFIC FACTORS 1. Examinations/Quizzes A. Unit Exams 4 Exams: Each exam is worth 15% of the final grade for a total of 60%. Exams will be approximately 30 questions in length and may include multiple choice, matching, listing, labeling, short answer, and essay style questions. An hour will be given for each unit exam. B. Quizzes Quizzes: There will be a total of 15 quizzes administered after the completion of each unit. All quizzes will be averaged to consist of 10% of the final grade Quizzes will be approximately 10 questions in length and questions may include multiple choice, short answer, listing, and labeling. C. Final Examination Final Exam: The Final exam will be comprehensive and may include multiple choice, matching, listing, labeling, short answer, and essay style questions. The final exam will be worth 30% of the final grade. The final exam will be administered during Finals Week. 2. Homework/Classwork

12 It will be the student’s responsibility to complete homework/classwork assignments. There are no scheduled homework assignments in this course. However, additional assignments may be given at the instructor’s discretion. 3. Class Participation: Class participation will include discussions and workgroups. 4. Grading Scale: Theory:

Laboratory Skills

93%-100%: A –Excellent 85%-92%: B –Good 76%-84%: C –Satisfactory 0%-75%: Failing

No lab scheduled for this course.

5. Final Grade Calculation The factors below will be used to determine the final grade for the course: A. The unit exams are worth 60% of the final grade. The unit quizzes are worth 10% of the final grade. The final exam is worth 30% of the final grade.

12 RESPIRATORY THERAPY St. Mary’s/Marshall University COURSE CURRICULUM COURSE NAME:

RSP 101 - Introduction to Respiratory Care

Instructors:

Chuck Zuhars, RRT, M.S. Chris Trotter, RRT, B.A.

Contact Information:

Chuck Zuhars Phone: (304) 399-4969 E-mail: [email protected]

Chris Trotter (304) 399-4957 [email protected]

Office hours : by appointment

PREREQUISITES: Successful completion of program sequence COURSE DESCRIPTION: This 2 credit hour course will cover the history of Respiratory Care and our Professional Organization. Emphasis is on exploring the role of the respiratory therapist or technician as a member of the health care team. Ethical and medico-legal dimensions of health care are presented. Basic techniques of patient evaluation are covered. Included are: Chest physical examination, measurement of the vital signs, patient interview and history, evaluation of the chest x-ray, and electrocardiography. COURSE OBJECTIVES: Upon successful completion of this course, the student will: 1. The student will gain a basic understanding of the Respiratory Care Profession including its evolution, medical and professional ethics, and required professional interaction skills. 2. The student will demonstrate comprehension of patient assessment skills to include inspection, percussion, palpation, auscultation, chest radiology, and electrocardiogram procedure and basic interpretation. 3. The student will gain knowledge of infection control procedure, universal precautions, and proper equipment processing.

12

Methods of Evaluation:

Assignments/course book - 10% Quizzes -10% Exams (2) - 20% Final Exam 20% Lab – 20% Attendance – 20%

Methods of Teaching:

This course consists of weekly lectures and includes a variety other teaching methods (i.e., discussion, simulation, audiovisuals etc.)

Academic Progress:

Information regarding the Student's academic progress in this course will be shared with their Academic Advisor and/or Department Chair.

University Statement on Equality, Tolerance and Affirmative Action:

Please indicate by the end of the 2nd week of the course if you will need accommodations under the Americans with Disabilities Act.

Academic Integrity:

Academic dishonesty includes, but is not limited to, cheating, plagiarism, collusion, the submission for credit of any work or materials that are attributable in whole or in part to another person, taking an examination for another person, and any act designed to give unfair advantage to a student or the attempt to commit such an act.

Course Evaluations:

Students will be given the opportunity to evaluate the performance of the instructor and course near the end of the course/semester. When submitting course evaluations students must follow the guidelines provided by the course instructor or department.

MEHODS OF TEACHING: Lecture/Discussion through the Teaching/Learning Process Exercises to Assist with Problem Solving In-Class Activities Handouts Reference Readings Paper/Pen Examinations Laboratory Simulations and Exercises

Grade Scale 90-100 points 80-89 points 70-79 points 60-69 points