University of Utah Undergraduate Research Abstracts, Volume 2, Spring 2002

Assessment of Prescribing Paters for Chest Physical Therapy at the University Hospital

Assessment of Prescribing Patterns for Chest Physical Therapy at the University Hospital Chest Physical Therapy is a procedure to increase clearance of sections by vibration or percussion of the chest. In order to optimize patient care and utilization of resources, an analysis of Chest Physical Therapy ordering patterns was done. During our thorough chart review of Chest Physical Therapy Patients, we discovered that there was possibly over-prescription of this procedure. In the chart review of twenty-seven cases, we additionally discovered that all cases did have at least one correct indication for Chest Physical Therapy and had an average of two indications. However, we have additionally discovered that in a majority of the cases that were reviewed, there was at least one and as many as seven contraindications for Chest Physical Therapy. The contraindications are broken into two categories: the absolute contraindications and the relative contraindications. In the chart review, we came across only seven cases that had absolute contraindications. However, in all of these cases, they also had several additional relative contraindications. The case average was four relative contraindications. The investigative strategy for this research was based on the files of four months of Chest Physical Therapy Patients from January to April of 2001. The cases that were selected for review during this time frame had multiple orders for Chest Physical Therapy. We then took the current indications and contraindications in the Chest Physical Therapy protocols of the University Hospital and compared them to the cases during this time frame. This included looking at: respiratory therapy notes, physician dictation, x-ray results, operating room notes, emergency room sheets, lab values, daily vitals, daily medication sheets and nurses notes. In conclusion, this has shown that the ordering practices reviewed at the University Hospital for Chest Physical Therapy need to be revised to better meet the needs of patients. This is because there are safer and more effective therapies that are available and are not being fully utilized. With the aid of this new information, the Respiratory Therapy Department at the University Hospital has started an increased education program on Chest Physical Therapy. Nic Branscomb Class Standing: Junior Major: Biology E-mail: [e-mail] Faculty Sponsor: Holly Carveth, MD Internal Medicine, Pulmonary Division E-mail: [e-mail] PM, Karen Hillier, RRT, Internal Medicine, Pulmonary Division