Respiratory Therapists’ role in caring for ventilator assisted individuals in the community: A scoping review

Optimal patient flow, which frees critical care beds for those most in need, is improved when ventilator-assisted individuals (VAIs) can efficiently transition to safe environments such as complex continuing care or the community. In Canada, clinicians work with respiratory therapists (RTs) to care for VAIs outside acute care, but information on their role and contributions in these settings is limited. The aims of this study were to describe the role and impact of RTs in caring for VAIs outside the acute care environment. A scoping review was conducted to identify sources describing the RT role in managing VAIs outside acute care. The Respiratory Therapy Practice-Based Outcome Initiative (RT-PBOI) model with 5-domains was used to describe RT contributions to patient care and healthcare utilization. A total of 14 peer-reviewed studies and 6 grey literature sources were included. Reported RT roles were in the care of VAIs requiring prolonged-, long-term- and home mechanical ventilation. Of the included studies, 12 reported Technical Skills, 11 Approaches to Practice, 3 Leveraging Capacity, 7 Strategic Expertise, and 1 Future Value. None of the grey literature addressed Strategic Expertise. Airway and mechanical ventilation management, patient education and discharge coordination were identified as key RT skills within the interprofessional team. RTs are key facilitators in support of both VAIs and caregivers in the community, providing airway and mechanical ventilation, education and transition facilitation. Ongoing assessments of their role and contributions will enhance the needs of VAIs and their caregivers outside of acute care.