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Position Summary:
The Director of Respiratory Therapy Services is responsible for directing the programs and staff of the Respiratory Therapy Department and overseeing the provision of diagnostic, treatment, and educational services for patients with respiratory disorders. This position develops and implements respiratory care services in accordance with State and Federal regulations, as well as company policy, monitors patient progress and treatment plans, and reports progress and makes suggestions to the Clinical Team.

Director Role Duties and Responsibilities:

• Perform quality improvement activities, including direct observation and auditing. Attend monthly QAPI meetings and share reports.
  Be knowledgeable of State and Federal regulations, as well as current Standard Precautions, policies and procedures.
  Assist all facilities in troubleshooting and problem-solving as related to respiratory care.
  Develop, create, and implement policies and procedures as indicated or requested, with submission the Executive Team for approval.
  Annually review Policies and Procedures for continuing accuracy and current content. Report accommodations to the QAPI committee.
  Monitor current contracts for supplies and equipment to assure the best pricing possibilities.
  Attend care conferences and other meetings as required. Suggest therapies, report progress made, and future scheduling.
  Operate the department within the established budget.
  Conduct trainings organization-wide as indicated by resident needs.

Duties and Responsibilities as a Respiratory Therapist:

• Check orders – making sure all match and are present, perform ventilator checks every four hours, oxygen therapy with all modalities, equipment changes as scheduled, suctioning (RCPs responsibility when on duty – licensed nursing to assist), trach care (to be done BID), breathing treatments as ordered (Nebs, MDI's, DPI's), and charting in a timely manner.

• Weaning schedules written out and posted in treatment books, MARs and vent chart.

• New respiratory modality setups and physical assessments.

• Communication is a must with nurses and other team members for the best continuity of care for the patient. Communication with physician to explain what is needed by the patient and why.

• Proper use of respiratory equipment and adapt equipment to meet the needs of the patient.

• If on-call, must respond to facility call within thirty minutes.

• Oxygen - Setup concentrators, H-tanks, and portable devices upon doctor's order from Charge Nurse. Label and tag all equipment according to the policy. Obtain pulse oximetry prior to setup and fifteen minutes after setup. Report findings to Charge Nurse and chart the information in the respiratory care section of the electronic chart.

• Maintain oxygen equipment, tubing changes per policy, and chart in respiratory care section of the electronic chart. Report maintenance completed to the Charge Nurse.

• Nebulizers – setup, deliver, label and tag all equipment and chart in the respirator section of the electronic chart. Report delivery and setup completion to Charge Nurse.

• Maintain Nebulizer equipment, medicine cup changes per policy and chart it. Report maintenance completed to the Charge Nurse.
  RRT will give respiratory medications per nebulizer and meter dose inhalers in conjunction with charge nurse per policy.

• Suctioning – setup, deliver, label and tag all equipment. Chart it and report delivery and setup complete to the Charge Nurse.

• Maintain suction equipment, tubing and Yonkers changes per policy, and chart it. Report maintenance completed to the Charge Nurse.

• RRT performs suctioning of ventilator patients with Ballard suctioning equipment, deep suctioning equipment, and Yonkers in conjunction with Charge Nurse per policy. Deep suctioning will be performed by the RRT or licensed nursing personnel per the policy and job description.

• BIPAP/CPAP - setup, deliver, label and tag all equipment. Chart it and report deliver and set up to the Charge Nurse.

• Maintain CPAP/BIPAP equipment, tubing and masks per policy, chart it, and report maintenance completed to the Charge Nurse.

• RRT will perform BIPAP/CPAP checks every four hours in conjunction with Charge Nurse per the policy. RRT or Licensed Nurse will perform setting changes per the policy and job description.

• Ventilators - initial ventilator setup and admission respiratory evaluation will be performed by RRT/CRT only. RRT will perform ventilator checks every four hours in conjunction with Charge Nurse per policy. Setting changes will be performed according to the ventilator plan set forth by the RRT and the Doctor. Maintain ventilator equipment, tubing and associated equipment per policy, chart it, and report maintenance completed to Charge Nurse.

• Maintains all ventilator records for both patient and maintenance/tracking/billing.

• Trach Care – RRT or designee will perform trach care and disposable inner cannula changes. Trained RRT and licensed personnel may also do trach intubating/extubating on established trach patients. Information will be charted, and trach care completion reported to the Charge Nurses.

• Inflating/deflating trach cuffs – RRT will perform inflating and deflating techniques using the minimal occluding technique.

• RRT/CRT will also provide monitoring of ventilator/trach patients with meals, monitoring swallowing, cuff inflation/deflation, and performing suctioning if needed. Information will be charted and reported to the Charge Nurse.

• Educate residents, families and staff as to what pertains to the respiratory treatment and safety of the residents.

• Review transfer orders on admission patients and have appropriate respiratory equipment available.

• Inventory and maintain all respiratory care supplies.

• Maintain proper operation of respiratory equipment per manufacturers standards.

• Write and review respiratory therapy orders in patient charges and in treatment books.

• Review all equipment with nursing personnel and chart their understanding for proper patient care and QI purposes.

• Stock and maintain the proper emergency equipment in patient's room. Apply respiratory equipment to patient and evaluate its effectiveness.

• On-site patient evaluations (as assigned by Admission Director, Director of Respiratory Services, or Administrator) for probably admission.

Required/Desired Qualifications:

Education, Training, and Experience:

Associates degree or equivalent.
Registered from the National Board of Respiratory Care.
Current BLS Card, and at least two years of experience working with ventilator/respiratory care patients in acute care or long-term care.

Specific skills, knowledge, and abilities:

Thorough knowledge of general respiratory principles and procedures and understanding of the concepts of aging and the needs and concerns of the elderly population and those with terminal illness.
Knowledge of State and Federal health regulations and clinical standards of respiratory practice and delivery systems, supervision management, staff development and cost containment.
Ability to perform comprehensive assessments and develop individualized plans of care based on patient needs.
Ability to communicate effectively, verbally and in writing, with all levels of healthcare professionals and support staff.
Must be able to work under varying degrees of supervision.
Must display a positive, professional image and enhance positive public relations for the facility.

Other Special Requirements:

• Tolerate potential exposure to blood, body tissues, and fluids with occasional exposure to hazardous materials and infectious diseases as well as, frequent exposure to chemicals, latex, and plastic materials used for personal protective equipment.

• Manual dexterity required to operate equipment.

• Ability to travel as needed or assigned.

• In the event of an emergency, must be physically able to assist in patient evacuations and life support procedures.

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