RC 246 - Clinical Practice IV

Credit Hours: 4

This course is a continuation of Clinical Practice III. The student will complete a series of special clinical rotations at designated clinical sites. This intensive course affords the student opportunities to practice many respiratory procedures within a hospital setting on both adult and pediatric populations. These procedures include non-invasive positive pressure breathing, incentive spirometry, manual ventilation, postural drainage and percussion, mechanical ventilation as well as the more specialized areas of pulmonary function testing, drawing and analyzing arterial blood gases, and home care.

Students are instructed and supervised by designated clinical instructors and instructed and evaluated by college faculty, all of whom are directed and supervised by the director of clinical education. Each semester, students will be assigned to a minimum of two clinical sites. More rotations may be utilized during any given semester depending on the number of students. The director of clinical education will assign students in such a way that each student receives an equal opportunity to achieve the objectives outlined in this manual. At each site, a student is assigned to a designated clinical instructor who he/she accompanies for the day. The student receives ongoing instruction in performing respiratory care procedures and practices these procedures under the supervision of the clinical instructor. An assigned college instructor visits each week to provide related instruction, observe student performance, coordinate instructors, hold clinical conferences for students, and complete formal evaluations at the end of each site rotation.

Course Outcomes
General Objectives

Upon completion of this course, the student will be able to:

demonstrate an understanding of the role of the respiratory therapist in the clinical setting;
demonstrate good working relations in functioning as a member of the health care team;
demonstrate professional behavior and judgment in terms of appearance, attitudes, and conduct with staff and patients;
demonstrate professional responsibility in terms of attendance and punctuality;
demonstrate effective communication skills in dealing with staff and patients;
demonstrate good patient care skills and rapport in establishing and maintaining therapeutic relationships with patients;
describe the structure and function of a respiratory care department;
describe the organization of patient care areas and function of equipment observed; and
follow infection control guidelines as outlined in our professional clinical guidelines as well as hospital regulations.

The student will be expected to demonstrate continued competence in all Clinical Practice I, II, and III objectives:

Performance and Knowledge Objectives for Clinical Practice I:

Upon completion of this course, the student will be able to:

demonstrate appropriate use of compressed gas cylinders including air, oxygen, heliox, nitric oxide, and any other medical gases used as therapy;
demonstrate appropriate use of oxygen delivery devices including air/oxygen blenders, regulators and flowmeters, masks, cannulas, and enclosures;
demonstrate appropriate use of liquid oxygen systems;
demonstrate appropriate use of oxygen delivery during patient transport;
demonstrate an understanding of basic assessment for the need for oxygen or other medically therapeutic gas;
demonstrate an understanding of the need and appropriate use of hyperinflation therapy;
demonstrate appropriate documentation of therapy;
maintain asepsis regarding the above-stated skills and clean, disinfect, and/or sterilize equipment;

Performance and Knowledge Objectives for Clinical Practice II

Upon completion of this course, the student will be able to:

assemble a circuit and humidifier system for a mechanical ventilator;
demonstrate the appropriate ability to set up and ensure the proper function of a mechanical ventilator;
demonstrate the appropriate ability to place initial ventilator settings on the mechanical ventilator;
demonstrate the appropriate ability to troubleshoot the ventilator;
demonstrate and understand how to assess a patient for the need for bronchopulmonary hygiene;
demonstrate appropriate use of the various bronchopulmonary hygiene techniques currently used;
select and appropriate bronchopulmonary hygiene device based on patient need/desire;
demonstrate an ability to appropriately suction a patient using both open and closed system methods; and
demonstrate an ability to assist with an intubation procedure.

Performance and Knowledge Objectives for Clinical Practice III & Clinical Practice IV:

Upon completion of this course, the student will be able to:

demonstrate an ability to make appropriate changes in mechanical ventilation settings based on a changing patient condition;
demonstrate how to assess a patient for their ability to wean from the mechanical ventilator;
demonstrate an ability to assist in extubation of a patient;
demonstrate an ability to draw and analyze an arterial blood gas sample;
demonstrate an understanding of and interpret arterial, venous, and capillary blood gas results;
demonstrate an ability to use advanced cardiopulmonary assessment techniques such as capnography, apnea monitoring, and transcutaneous monitoring;
demonstrate an ability to perform pulmonary function testing;
demonstrate an ability to perform electrocardiograms (EKG);
demonstrate an ability to apply hospital base protocols for the delivery of care to a patient;
demonstrate an ability to place a patient on non-invasive positive pressure ventilation;
demonstrate an ability to adjust the settings and mask based on patient response to non-invasive positive pressure ventilation;
demonstrate an ability to safely transport a patient within a hospital; and
demonstrate an ability to initiate and conduct home Respiratory Care.

Prerequisites: Matriculation in the Respiratory Care Program and successful completion of all previous Respiratory Care coursework.
S (N)