The Advantage to Having Registered Nurses in Hyperbaric Facilities
The clinical world of hyperbaric medicine is truly team concept with each member (physicians, nurses, and technicians) bringing the best of each respective scope of practice. The Undersea and Hyperbaric Medical Society (UHMS) accreditation process utilizes physicians, registered nurses (CHRNs) and technicians (CHTs) to evaluate hyperbaric facilities as each professional brings his or her own perspective to the comprehensive care that patients receive.
The specialty of nursing is a multifunctional part in the medical model. Nursing is the profession representing patient rights. According to the American Nurses Association, “Nurses use theoretical and evidence- based knowledge of human experiences and responses to collaborate with health-care consumers to assess, diagnose, and identify outcomes, and plan, implement, and evaluate care.” 1
“Nurses provide management for quality improvement, documentation, infection control, patient education, and intervention as well as initial and ongoing nursing assessment of patient care,” notes HG Vincent in Hyperbaric Nursing.2,3
The perception is that the quality of documentation equates to the quality of care. Documentation is an essential aspect of the nursing process, which includes chart reviews for accurate, comprehensive charting to meet regulatory and reimbursement guidelines for patient care, patient safety, and billing/reimbursement.4
Patients receiving hyperbaric oxygen treatments benefit from having the hyperbaric-trained RNs as part of their initial and ongoing nursing evaluations. The trained hyperbaric nurse uses critical thinking skills in the areas of quality improvement by gathering, assessing and evaluating data for patients going into the altered environment of 100% oxygen under increased atmospheric pressure. This data includes the following:
physical and psychosocial assessments, patient attitude
education, how patients learn, barriers to learning
patient compliance, ability to deal with health-care issues
baseline functional status, social environment,cultural environment, emotional states, and safety issues to identify initial and ongoing nursing interventions and revisions 2,3
To further assess the potential for patient issues going into the hyperbaric chamber, including the goal/rationale and actions for each issue, the Baromedical Nurses Association (BNA) Guidelines for Standard of Care for the Patient Receiving Oxygen Therapy (HBO2) are available on the BNA website at hyperbaricnurses.org/about-us/standards-of-care/.
American Nurses Association. Nursing: Scope and Standards of Practice, 2nd ed. Silver Spring, MD: Nursesbooks.org;2010.
Vincent HG. Documentation. In: Larson-Lohr V, Norvell H, eds. Hyperbaric Nursing. Flagstaff, AZ: Best Publishing Company; 2002. p. 5-78.
Vincent HG. Documentation of the Nursing Process as it Relates to Hyperbaric Oxygen Therapy, In: Larson-Lohr V, Norvell H, eds. Hyperbaric Nursing. Flagstaff, AZ: Best Publishing Company; 2002. p. 79-119.
Larson-Lohr ed. Hyperbaric Nursing and Care. Flagstaff, AZ: Best Publishing Company;2010.