Policy 1.4.1
Page 1 of 4
UTMB RESPIRATORY CARE SERVICES
POLICY - Scope of Care
Scope of Care
Formulated: 04/91
Effective:
Revised:
06/01/97
07/24/03
Scope of Care
Purpose
To define the scope of respiratory care and delineate the areas of service
provided by Respiratory Care Service (RCS).
Policy
It is the policy of the University of Texas Medical Branch that Respiratory
Care Service exists for the purpose of providing a high level of patient care
for those suffering from acute and chronic respiratory problems. These
range from neonatal practice, adult, and geriatric populations.
Definition
Respiratory Therapy is an allied health specialty employed in the treatment,
management, control, and care of patients with deficiencies and
abnormalities associated with respiration and ventilation.
Scope of
Services
Respiratory care is a life-supporting, life enhancing health care profession
practiced under qualified medical direction. Respiratory Care Services
provided to neonatal, pediatric, adult, and geriatric patients with acute and
chronic disorders of the cardiopulmonary system include diagnostic testing,
therapeutics, monitoring, and rehabilitation. Patient and family are central
to the mission of the profession. The department/service offers respiratory
care services twenty-four (24) hours a day to inpatients and outpatients.
Therapeutic
 Oxygen Therapy
 Humidified Gas Therapy
 Aerosolized Medication Therapy
 IPPB
 Metered Dose Inhaler
 Chest Physical Therapy
 Postural Drainage
 Cough and Deep Breath
 Incentive Spirometry
 PEP Therapy
 Invasive Ventilatory Management
 Cardiopulmonary Resuscitation
 Endotracheal and Nasotracheal Suctioning
 Airway Management and Care
 Oxygen Transport
 Surfactant Administration
 Nitric Oxide Administration
Continued next page
Policy 1.4.1
Page 2 of 4
UTMB RESPIRATORY CARE SERVICES
POLICY - Scope of Care
Scope of Care
Formulated: 04/91
Scope of
Services
Continued
Effective:
Revised:
06/01/97
07/24/03
Diagnostic Services
Provided in the Adult, Pediatric, and Neonatal areas:
 Suctioning for laboratory analysis of sputum Blood Gas Sampling
 Oximetry
 Electrocardiograph
 Spirometry
 Peak Flow Assessment
 Clinical and Physiologic Assessment
 Pulmonary Mechanics
Educational Services
Provided for Adult and Pediatric inpatients, outpatients, significant others
and community shall be provided in a way that all who are educated
demonstrate or verbalize a level of functional comprehension. These
services include:
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Information of disease processes
Information of diagnostic procedures
Education of therapeutic procedures used to treat disease processes
Education on preventative procedures
Recruitment of qualified respiratory care practitioners.
Assisting departmental personnel in research activities and coordinating
departmental professional publications.
Supervision/Leadership
 Supervision and leadership will be given for Respiratory Care Service
personnel in all patient care and employee activities.
 Supervisors and Respiratory Care Practitioners will function in this role.
Management
 Management of patient care and employee activities will be provided by
the Department of Respiratory Care Service.
 Management of patient care activities includes, but is not limited to,
monitoring of quality assurance activities, departmental performance
appraisal plans, coordination of appropriate Respiratory Care Service
charges and patient care audits. Development and implementation of
departmental and hospital Strategic Plan. Development and
implementation of new patient care programs. Research and
development of new/experimental equipment and procedures.
 The Program Manager will provide this function.
Continued next page
Policy 1.4.1
Page 3 of 4
UTMB RESPIRATORY CARE SERVICES
POLICY - Scope of Care
Scope of Care
Formulated: 04/91
Scope of
Services
Continued
Effective:
Revised:
06/01/97
07/24/03
Support Services - Equipment and Supply
 Cleaning and sterilization of all equipment to proper departmental
procedures.
 Routine equipment maintenance to insure proper functioning at all
times.
 Insure proper manufacture's preventive maintenance on all equipment
when required.
 Electrical safety through electrical checks by biomedical technician.
 Inventory control of all respiratory care equipment.
 Insure proper stocking of all supplies, non-disposable, disposable, and
equipment repairs.
 Keep accurate and up-to-date records of all purchasing and equipment
repairs.
 Keep abreast of current equipment market.
 Coordination of department's purchasing activities with hospital
university system.
 Evaluation of respiratory care equipment.
Support Services - Clerical Section
 General clerical duties including charge/billing, typing, answering
phones, and inter/intra hospital correspondence.
 Personnel record keeping, payroll, and data management.
 Facility management.
 Development and maintenance of Departmental Information System.
Other services related or concomitant to respiratory care include
cardiopulmonary resuscitation, quality performance monitoring and
evaluation, quality control, transporting critically ill patients to or from the
hospital, maintaining and repairing equipment, charting and record filing,
patient charging/billing, marketing, equipment purchasing, and continuing
education.
Staffing
All individuals who provide diagnostic or therapeutic respiratory care have
appropriate qualifications and training. Practitioners and staff include a
physician director, and appropriately qualified designee to share medical
direction responsibility or assume it in the director's absence. The
departmental Program Manager, and supervisors are all registered
respiratory therapists. The clinical staff consists of registered respiratory
therapists, certified respiratory therapists, respiratory care practitioners, and
students. All have age specific training in the areas for which therapy are
assigned. Ancillary staff includes a senior secretary, and equipment
Respiratory Care Assistants.
Continued next page
Policy 1.4.1
Page 4 of 4
UTMB RESPIRATORY CARE SERVICES
POLICY - Scope of Care
Scope of Care
Formulated: 04/91
Standards/
Guidelines


Effective:
Revised:
06/01/97
07/24/03
All Respiratory Care Practitioners are licensed by the State of Texas
under the Respiratory Care Practice Act and have been continuously
assessed for competency through the department's competency based
assessment program.
Teamwork among the above practitioners under the supervision and
guidance of the physician director is critical. A therapist is available
twenty-four (24) hours a day; the medical director is available to the
respiratory therapy staff; and the administrative director or designee is
"on call" for emergencies. Respiratory Care services are provided to
patients in accordance with a written prescription by the physician
responsible for the patient and are documented in the patient's medical
record. The prescription for respiratory care will specify the type,
frequency, and duration of treatment, as appropriate, the type and dose
of medication, the type of diluent, and the oxygen concentration. The
director and respiratory therapists are consultants responsible for
advising referring physicians on which therapies and diagnostic
procedures to order when consulted.