ArticleRespiratory care2023
Optimizing Respiratory Therapy Resources by De-Implementing Low-Value Care.
Article in Respiratory care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 17 citations in OpenAlex.
- A quality improvement initiative to reduce excess inhaled therapy use in the neonatal intensive care unit.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Empowering Respiratory Therapists to Restrict Nebulized 3% Saline and N-Acetylcysteine During Mechanical Ventilation.Respiratory care · 2025Article
- Empowering Respiratory Therapists and Reconsidering Mucolytics in Patients on Mechanical Ventilation: A Step Toward High-Value Care.Respiratory care · 2025Article
- Pediatric Intensive Care Nurse Staffing Measures and Patient Outcomes During the COVID-19 Pandemic.JAMA network open · 2025Observational
- Academic Output of Fellows of the American Association for Respiratory Care.Respiratory care · 2024Article
- Clinical Practice Guidelines: Phase 5 - New Methods Same Goals.Respiratory care · 2024Article
- Exploring knowledge gaps and research needs in respiratory therapy: a qualitative description study.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2024Article
- Effectiveness of N-acetylcysteine in treating patients with coronavirus disease 2019 may be in doubt but in uncertainty.Journal of the Chinese Medical Association : JCMA · 2023Article
- With Great Clinical Practice Guidelines Comes Great (or at Least Better) Resource Allocation.Respiratory care · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOur institution was experiencing a respiratory therapy staffing crisis during the COVID-19 pandemic, in part due to excessive workload. We identified an opportunity to reduce burden by limiting use of 3% hypertonic saline and/or N-acetylcysteine nebulizer therapies (3%HTS/NAC).
methodsLeveraging the science of de-implementation, we established a policy empowering respiratory therapists to discontinue 3%HTS/NAC not meeting the American Association for Respiratory Care (AARC) Clinical Practice Guideline: Effectiveness of Pharmacologic Airway Clearance Therapies in Hospitalized Patients. After a 3-month period of educating physicians and advanced practice practitioners the policy went to into effect. Outcomes measured included monthly number of treatments, orders, and full-time employees associated with administering nebulized 3%HTS/NAC.
resultsPost policy activation, the monthly mean 3%HTS/NAC treatments were significantly reduced to 547.5 ± 284.3 from 3,565.2 ± 596.4 (
conclusionsImplementing a policy that empowers respiratory therapists to promote adherence to AARC Clinical Guidelines reduced low-value therapies, costs, and staffing needs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.