Daily Workflow

Start of Shift

  • Take report from the outgoing therapist, ensuring you are fully updated on patient status, ongoing treatments, and pending tasks.

  • Perform a quick wellness check on all assigned patients:

  • Confirm they are resting comfortably from both a visual and audible standpoint.

  • Reassure them you will be starting rounds shortly.

Safety, Readiness & Airway/Ventilator Management

  • Verify patient orders in the chart/EMR.

  • Confirm emergency equipment is at bedside (Ambu bag, spare trachs, inner cannulas, surgical lubricant).

  • Perform ventilator checks on all assigned machines.

  • Check and record pulse oximetry readings.

  • Suction ventilator and trach collar patients as needed.

  • Conduct trach care, including inner cannula change.

  • Replace HME devices (per schedule).

  • Replace sterile water for trach collar patients.

Treatments & Therapy

  • Administer scheduled nebulizer treatments.

  • Document and support ventilator weaning trials, including capping and PMV trials, in progress notes.

Documentation

  • Complete ventilator check assessment form.

  • Complete progress notes for ventilator weaning, capping, PMV trials, and assessments.

  • Record treatments and interventions in the MAR, ensuring completion before the end of the shift.

    • If a MAR task is not completed, mark “NO” and document the reason.

  • Update orders as required.

  • Note reasons for any incomplete tasks.

Documentation Guidelines

  • Documentation should be completed during rounds or immediately after performing care.

  • Documentation should not be delayed until the end of the shift.

  • If you are unable to document for any reason, you must notify your manager during the shift.

Supplies & Medications

  • Order medications when stock is low.

  • Notify respiratory director/manager if critical supplies are low.

  • Organize and restock the respiratory supply room and carts.

End of Shift

  • Complete Shift Hand-Off Report and update respiratory assignment sheet.

  • Conduct thorough handoff to incoming therapist, reviewing changes in patient status, orders, and pending tasks.

Weekly & Monthly Tasks

Weekly Tasks

  • Trach ties change – Every Monday and Thursday (Day Shift)

  • Ballards and Yankauers replaced – Every Tuesday (Day Shift)

  • Nebulizer set-ups on ventilator and trach collar patients – Every Wednesday (Night Shift)

  • Trach collar set-up with nebulizer large-volume humidification on trach collar patients – Every Thursday (Night Shift)

  • Suction canister with tubing changed – Every Friday (Night Shift)

  • Organize respiratory supply room and carts – As needed

Monthly Tasks

  • Trach change – Every 30 days

    • Document in progress notes.

  • Ventilator circuit with bacterial filter change – 1st Tuesday of every month (Night Shift)

    • Document in ventilator assessment.