Respiratory Care Practitioner II Registered

Under physician supervision, in accordance with policies and procedures approved by the Medical Director, is expected to assume primary clinical responsibility for all respiratory care modalities and to exercise considerable independent clinical judgment in the respiratory care of patients. Must be capable of serving as a technical resource person to the physician regarding current practices in respiratory care and to the hospital staff regarding effective and safe methods for administering respiratory care. Works under the general supervision of an administrative supervisor or the direction of a technical lead to deliver respiratory care services to patients in all areas of the hospital. Must be able to adapt to the particular area of duty assignment and to perform special duties required by the assignment. Standards of performance for the area to which the individual is assigned must be maintained.
Special duties may include provision of basic and advanced respiratory care to neonatal and pediatric patients in the intensive care unit and during transport, which frequently requires making rapid decisions and assisting physicians to respond to status changes in neonatal and pediatric patients.
Special duties may include performance of a variety of diagnostic tests of the cardiopulmonary system and to determine the effect of disease and treatment on that system.

• Selects Reviews, Obtains and Interprets Data:
  Reads and evaluates physicians orders, clarifying as needed. Accurately transcribes physician orders to electronic charting system or departmental patient master. Reviews patient information including history, lab data, radiologic studies, progress notes, respiratory and cardiovascular monitoring data and performs assessment/data collection in systematic manner.
• Systematically assesses patients overall cardiopulmonary status by inspection, palpation, percussion, auscultation, and patient interview.
• Interprets data to formulate goal-directed plan of care and determines requirements for treatment such as type and duration of therapy, precautions to be observed, equipment required, and medication and dosages.
• Determines modifications to physician orders, which optimize patient, care and makes recommendations to physician. Recommends procedures to obtain additional data including radiographs, bronchoscopy, Gram stain and C&S, spirometry, blood gas analysis, lung mechanics, work of breathing, EKG, noninvasive monitoring.
• Performs Diagnostic Modalities:
  Performs procedures and interprets results:
  ABG sampling and analysis, co-oximetry, spirometry, pressure-volume and flow-volume loops, cuff pressure, sputum induction. May perform EKGs. May place Holter monitor. May perform pulmonary function, and sleep diagnostic tests.
• May perform Exercise Stress Tests. May perform indirect calorimetry.
• Selects Assembles and Checks Equipment for Proper Function, Operation and Cleanliness:
  Selects, assembles and checks equipment for cleanliness, proper function and safe operation. Ensures proper function and ready availability of respiratory related life support equipment. Troubleshoots and performs minor repairs of equipment. May perform Quality control procedures for blood analysis devices.
• May perform Quality control, calibrate, maintain and troubleshoot pulmonary function diagnostic equipment.
• Participates in routine departmental programs of cleaning, disinfecting and sterilizing of respiratory care and other related equipment.
• Participates in routine departmental preventive maintenance program and performs basic repairs.
• Orders/stocks departmental supplies.
• Initiates, Conducts and Modifies Prescribed Therapeutic or Diagnostic Procedures:
  Operates all medical equipment within manufacturer and department guidelines to safely treat patients. Checks and adjusts alarms. Observes established safety and security procedures and protects patients from nosocomial infection. Explains planned therapy or procedure and goals to patient in understandable terms to achieve optimal therapeutic outcome. Conducts therapeutic procedures to maintain a patent airway, remove bronchopulmonary secretions, and/or achieve adequate ventilation and oxygenation
• Monitors patients physiological responses to therapy, recognizes patient adverse reaction and stops or modifies or recommends modification to procedure based on patient response.
• Documents all required information in the medical record according to departmental policy and procedure. Initiates pressure-cycled/volume-cycled/high frequency ventilation. Weans/modifies mechanical ventilation according to assessment and physician orders.
• Assists with or performs extubation.
• Conducts patient education and disease management. Performs cardiopulmonary resuscitation according to resuscitation guidelines. May assist with or perform intubation. May assist the physician when performing bronchoscopy, thoracentesis, tracheostomy, cardioversion, and intubation.
• May participate in land/air critical care transport. May assist with high risk deliveries. May assist with surfactant replacement in neonates. May participate in pulmonary rehabilitation, home care. May assist with discharge planning. May assist with community outreach. May initiate and implement therapist driven protocols.
• Supervision and Administration:
  May assign, organize and coordinate the work of assigned Respiratory Care Practitioners. May demonstrate respiratory care procedures to trainees and other health care personnel. May train assigned practitioners and complete assigned practitioner competency reviews.
• Contributes to departmental quality improvement activities. May schedule staff and perform staffing functions.
• Assesses priorities for delivery of patient care and redistributes resources as necessary throughout shift. Protects data from intentional or unintentional destruction, modification, or disclosure.
• Maintains a current knowledge base of departmental information management systems, including collection, maintenance, and dissemination of information, as well as appropriate audit trails.
• May develop policies and procedures, both clinical and administrative. May serve as Timekeeper for TIME system.
• Other Assessment Criteria:
  Complies with attendance and punctuality expectations and with meal and break schedules. Accurately documents time in/out in TIME keeping system or time card.
• Maintains a professional a
  Associated topics:
  aso, crt, resp, respiratory, respiratory care, respiratory therapist, rrt, therapist