Question
What is the role of a respiratory therapist in a skilled nursing facility?
Answer
- Education for staff, patients, and family/caregivers
- Initial respiratory assessment
- Care plan development and execution
- Collaborative care
- Follow risk-stratification tool
- Pulmonary rehabilitation
Working at a skilled nursing facility (SNF) gives you the most autonomy. You are the sole respiratory therapist on-site to educate staff, patients, and family/caregivers on disease management, equipment, and medication. The RT provides an initial respiratory assessment, dictates the care plan, works with the physician to get the necessary orders, and provides bedside care during the patient's stay. Like in the hospital setting, the RT attends rounds to communicate the patient's current condition and care plan.
- Discharge planning
- Insurance coverage
- Coordinate with DME
- Medication
- Patient, family, caregiver education
- Proper handoff to home RT
The main goal of the RT is to provide quality care to ensure the patient is safe to be discharged home to avoid readmission to the hospital. Building a discharge plan is key to attain this goal. The RT can aid in the effort to confirm insurance coverage for respiratory equipment. They can coordinate with the DME company to discharge the equipment from the facility to be taken home (or delivered to the patient home within six hours of discharge from the hospital). They can also provide few days worth of medication or partner with the pharmacy to get the home delivery of medication. Education before discharge is essential for these patients and family members who may have never had to manage equipment at home. RTs play a key role in setting the patient up for success and giving them confidence that they can self-manage their chronic disease. Lastly, like in the hospital setting, a proper handoff can help decrease the gap in care. The RT should explain the patient's stay in the SNF, any difficulties, challenges, and safety concerns, so the home RT is prepared before entering the patient's home. We found that patients and their families have a better experience with more confidence in their caregivers when there is a proper transition from one setting to another.
This Ask the Expert is an edited excerpt from the course, The Importance of Respiratory Therapists in Post Acute Care, presented by Vrati Doshi, MSc, RRT.
