Differences in AHA Certification for Respiratory Therapists at Graduation: Cost Implications

Background: Certifications from the American Heart Association (AHA) guide respiratory therapists (RTs) in responding to emergencies efficiently. Respiratory students often receive training in their program; however, not all CoARC RT programs graduate students with the same AHA certifications. In our region (Northeast U. S. ), multiple respiratory care programs exist (AS and BS) that graduate students with differing AHA credentials. All of our local RT schools graduate students with BLS certification, while some graduate students with BLS plus additional certifications (PALS, ACLS). Our institution (260-bed pediatric hospital, Level 1 Trauma, Level IV NICU) requires BLS and PALS for all RTs. For students without PALS, additional orientation time is added to allow this valuable skill set to be obtained. We aim to evaluate the orientation cost of obtaining PALS for new graduate RT students during hospital orientation. Methods: In an IRB-approved retrospective analysis, we reviewed data from the last 5 years (2019-2024) to determine cost considerations and orientation time differences between new graduate RT (NGRT) students who start with and without PALS certification. Data metrics to evaluate cost implications in this study included the number of hires per year, number of hires per school, AHA certifications received during the program, orientation length (days), average salary, cost of PALS certification, and employment status (still employed with the organization or not). Data were excluded for new hire RTs with experience and RTs who did not complete the onboarding process and report to work on day one. Results: In the study period, 17 NGRTs from 4 local respiratory care programs were hired and onboarded. Half of the schools included PALS certification in their curriculum. Six RTs graduated with PALS, and 11 associates required the organizationally sponsored PALS course. Total cost of PALS for these NGRTs was 7, 711. 00 (Figure 1). All 17 associates included in the review continue to be employed at our institution. Conclusions: While obtaining PALS for NGRTs was costly, the certification offers valuable lifesaving skills for the pediatric population. Additionally, all NGRTs are still employed by the organization, highlighting the value of the investment. Challenges arise when orienting multiple NGRTs with varying certifications and skills relative to comprehension and schedule coordination that could be resolved if all respiratory care programs had standardized AHA graduation requirements. Figure 1 details the NGRT hires and cost of PALS certification for those who need to obtain it.