Integrating Central Venous and Arterial Line Placement Training for Respiratory Therapists: A Sustainable Strategic Approach to Enhance Patient Care.

Abstract

Background: This manuscript examines the use of respiratory therapists (RTs) to perform central venous and arterial line placements to address the lack of available staff to perform these procedures. To address these concerns, researchers implemented a program to provide further education to RTs to advance their skills to perform these procedures. Our facility sought to create a train-the-trainer formatted vascular access program utilizing RTs to relieve procedure burdens for critical care providers and maintain safe patient care with CLABSI rates better than the National Database of Nursing Quality Indicators (NDNQI) 95th percentile. Methods: A quality improvement project using the IOWA model was performed at the mixed ICU/CCU at a West Texas tertiary care hospital. All patients admitted from May 2017 through December 2023 to the mixed ICU/CCU for arterial catheters (ACs) and all inpatient units for central venous catheters (CVCs) were included. A training program using formal evidence-based protocols was created by the critical care medical director, who implemented the program and provided the original training with the goal of educating facility RTs on proper insertion of venous and ACs. Simple descriptive statistics were used to analyze the results of the program. Results: Over the 5-year retrospective review of RTs placing vascular access lines, only two negative events occurred. Our RTs performed 3878 ACs with zero complications. They also performed 6471 CVCs with only two complications (both pneumothoraces). Overall, the RT team had a success rate of 94.45% There was a minimal complication rate of 0.03%. Conclusions: We found the integration of RTs to the vascular access role to be highly successful in meeting both facility and patient needs.