HospitalInspections.org

Based on record review and interview, the hospital failed to maintain documented evidence of training for paramedic personnel assigned to perform specific respiratory care services. This deficient practice was evidenced by failure of the hospital to provide documented evidence of respiratory care service training and competency for 2 (SFF14PAR, SFF16PAR) of 6 (SFF13PAR-SFF18PAR) paramedic personnel records reviewed.
Findings:

Review of hospital policy number RS 1000, titled "Respiratory Services Ascension," last revised 11/2025, revealed in part: "PURPOSE: To provide Respiratory Care services to patients at the Ascension campus. POLICY: 2. Delivery of Respiratory Care services occurs via collaboration amongst competently trained physicians, advanced practiced professionals, nursing staff, paramedics, and Respiratory Therapist as needed. 3. Respiratory Care services are primarily handled by nursing staff and paramedics under the direct supervision of physicians with Respiratory Therapist available via telephone consults and/or services provided by an on-call Respiratory Therapist on site as needed. PROCEDURE: 1. Performed by: 3. Paramedics."

Review of hospital policy number HR-100, titled "Competency Validation, Employee," last revised 04/2023, revealed in part: "PURPOSE: To ensure that all employees in the organization demonstrate competence - application of knowledge, skills and behaviors to carry out job role. POLICY: 1. Verification and documentation of competence is assessed and maintained on each employee. PROCEDURE: 2. Competency Assessment - Orientation: The initial orientation of all employees and volunteers will include job training and information necessary for the individual to safely and competently perform his/her assigned role. Additionally, a probationary period will be utilized to evaluate the new employees' competency based on the job description and performance expectations. C. Unit Department Orientation is the responsibility of the Department Manager and specific to the departmental/work setting job role responsibilities."

Review of the Job Description and Performance Criteria titled, "Paramedic - Emergency Department," date written/revised: 09/2025, revealed in part: "JOB PURPOSE AND MISSION: Administers immediate, advanced patient care to sick or injured persons in emergency department environments in accordance with applicable laws, regulations and hospital policies. Performs job duties appropriately for the age population served as defined in the department's scope of service. Essential Job Functions include, but are not limited to: 1. Administers patient care to patients in the Emergency Department: Treating patients in the emergency department environments in accordance with federal, state, local laws, regulations, and standards and in accordance with Baton Rouge General policies and guidelines. Perform advanced airway management including managing airway/ventilation equipment."

In an interview on 11/24/2025 at 11:29 AM, SFF7DOE confirmed that the paramedics working in the emergency department received respiratory care service education/training titled:
2025 Ascension Emergency Department On-Boarding
Drill - Ascension Emergency Department Paramedic Intubation
SFF7DOE further confirmed that the above-mentioned paramedic education included, in part, the following learning objectives:
-Nebulizer treatments, equipment, policies/protocols; including use with ventilation.
-Hamiliton ventilator usage, modes, pre-op checks, programming, CMV (continuous mechanical ventilation), BiPAP/CPAP modes.
-Application of in-line suction for endotracheal tubes, sterile suction catheters.
-Application of BiPAP/CPAP masks per physician order.
-Demonstrate Vapotherm set-up, application, troubleshooting.
-Review equipment in red respiratory/yellow difficult intubation boxes, intubation simulation.

Review of employee education files for SFF14PAR and SFF16PAR failed to reveal the paramedic respiratory care service education/training titled:
2025 Ascension Emergency Department On-Boarding
Drill - Ascension Emergency Department Paramedic Intubation

Review of the staffing schedules from 10/28/2025-11/24/2025 revealed in part the following:
-SFF14PAR worked 7PM-7AM: 11/19/2025.
-SFF16PAR worked 7PM-7AM: 10/30/2025, 11/01/2025, 11/13/2025, and 11/22/2025.
Further review of the staffing schedules revealed that SFF14PAR and SFF16PAR were scheduled to work independently.

In an interview on 11/25/2025 at 11:49 AM, SFF1EDM and SFF3DR confirmed the above-mentioned findings. SFF1EDM also confirmed that SFF14PAR and SFF16PAR have not completed orientation at the time of the survey and were working independently without a chaperone in the ED.