Safe and Proper Use of Equipment
Proper use of all equipment is essential to providing safe and quality care for clients.
During the skills evaluation, and the orientation process all equipment functioning is reviewed and covered.
Purpose: The Vest therapy is a safe, effective, non-invasive airway clearance method that clears excess mucus from lungs and airways. The System uses a vest attached to a machine that creates compressions (HFCWO- high frequency chest wall oscillation) to the chest, helping to loosen, thin and move mucus through the lungs. The vest has 3 modes- 1) normal mode-most commonly used-present frequency/pressure setting/ treatment time. 2) ramp mode- utilized to allow patients to adjust to the vest by increasing frequency/pressure/time allowing them to adjust to the settings. 3) program mode with cough pause option- vest pauses when client coughs during treatment and resumes after cough.
Critical Nursing Measures: Verification and documentation of the Physician Prescribed orders for- Frequency of use, Machine settings (which include: frequency, pressure setting, treatment time). These are displayed for 10 seconds when the machine is turned on. Make sure the Vest is operating properly by: turning the machine on, and checking the machine settings prior to placement on the client. Perform a respiratory assessment before placement of the vest and after to note effectiveness- document. Bronchodilator medications via nebulizer treatment are best administered just prior to vest placement to facilitate the opening of airways and the movement of secretions. Steroid medications administered via inhalation are best administered after vest use to gain maximum effectiveness and promote full absorption into lung tissues.
Document the respiratory assessment/settings on the vest and tolerance and effectiveness of the vest via a follow up respiratory assessment for all clients receiving this treatment.