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The use of non-invasive ventilation by emergency doctors in Johannesburg Academic Hospitals, South Africa – assessing knowledge, attitudes and practices
INTRODUCTION: Non-invasive ventilation (NIV) is an alternative ventilatory method to endotracheal intubation and invasive ventilation in patients presenting in acute respiratory failure. Appropriate and timely application of NIV has shown benefits over invasive ventilation. In recent years, there ha...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
African Federation for Emergency Medicine
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10665829/ https://www.ncbi.nlm.nih.gov/pubmed/38021353 http://dx.doi.org/10.1016/j.afjem.2023.11.002 |
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author | Bird, Dr Holly Beringer, Dr Craig Parris, Dr Pano |
author_facet | Bird, Dr Holly Beringer, Dr Craig Parris, Dr Pano |
author_sort | Bird, Dr Holly |
collection | PubMed |
description | INTRODUCTION: Non-invasive ventilation (NIV) is an alternative ventilatory method to endotracheal intubation and invasive ventilation in patients presenting in acute respiratory failure. Appropriate and timely application of NIV has shown benefits over invasive ventilation. In recent years, there has been an increase in the use of NIV for varying pathologies in response to limited resources. Emergency department doctors’ knowledge of NIV, as well as their attitude towards its use can have significant effects on the success of NIV. The aim of this study was to assess emergency doctors’ use of NIV in the South African setting. METHODS: This was a multi-centre prospective cross-sectional study that was conducted across three academic emergency departments in Johannesburg, South Africa. Doctors of various grades were included in the study and their responses were analysed according to their level of experience and their job description. RESULTS: The mean knowledge score of the participants was shown to increase with an increase in job designation (p < 0.001). The doctors’ attitude towards NIV was more positive in those with higher knowledge scores (p < 0.001). Participants with previous critical care experience versus those without was associated with a higher average knowledge score (77% vs. 69 %, p = 0.009) as was formal NIV training versus those without (77% vs. 69 %, p = 0.01). The COVID-19 pandemic increased confidence in the use of NIV in 61 % of participants. The majority (69 %) of participants did not use a checklist when administering NIV. Only 53 % used a guideline when initiating a patient on NIV and just 26 % used a locally produced protocol. CONCLUSION: Increased clinical experience, critical care exposure and formal NIV training corresponded with higher knowledge scores. Formal NIV training programs, the implementation of a checklist and the development of locally produced protocols are recommended to improve knowledge, attitudes and NIV practice that is in-keeping with international standards. |
format | Online Article Text |
id | pubmed-10665829 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | African Federation for Emergency Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-106658292023-11-11 The use of non-invasive ventilation by emergency doctors in Johannesburg Academic Hospitals, South Africa – assessing knowledge, attitudes and practices Bird, Dr Holly Beringer, Dr Craig Parris, Dr Pano Afr J Emerg Med Original Article INTRODUCTION: Non-invasive ventilation (NIV) is an alternative ventilatory method to endotracheal intubation and invasive ventilation in patients presenting in acute respiratory failure. Appropriate and timely application of NIV has shown benefits over invasive ventilation. In recent years, there has been an increase in the use of NIV for varying pathologies in response to limited resources. Emergency department doctors’ knowledge of NIV, as well as their attitude towards its use can have significant effects on the success of NIV. The aim of this study was to assess emergency doctors’ use of NIV in the South African setting. METHODS: This was a multi-centre prospective cross-sectional study that was conducted across three academic emergency departments in Johannesburg, South Africa. Doctors of various grades were included in the study and their responses were analysed according to their level of experience and their job description. RESULTS: The mean knowledge score of the participants was shown to increase with an increase in job designation (p < 0.001). The doctors’ attitude towards NIV was more positive in those with higher knowledge scores (p < 0.001). Participants with previous critical care experience versus those without was associated with a higher average knowledge score (77% vs. 69 %, p = 0.009) as was formal NIV training versus those without (77% vs. 69 %, p = 0.01). The COVID-19 pandemic increased confidence in the use of NIV in 61 % of participants. The majority (69 %) of participants did not use a checklist when administering NIV. Only 53 % used a guideline when initiating a patient on NIV and just 26 % used a locally produced protocol. CONCLUSION: Increased clinical experience, critical care exposure and formal NIV training corresponded with higher knowledge scores. Formal NIV training programs, the implementation of a checklist and the development of locally produced protocols are recommended to improve knowledge, attitudes and NIV practice that is in-keeping with international standards. African Federation for Emergency Medicine 2023-12 2023-11-11 /pmc/articles/PMC10665829/ /pubmed/38021353 http://dx.doi.org/10.1016/j.afjem.2023.11.002 Text en © 2023 The Authors. Published by Elsevier B.V. on behalf of African Federation for Emergency Medicine. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Original Article Bird, Dr Holly Beringer, Dr Craig Parris, Dr Pano The use of non-invasive ventilation by emergency doctors in Johannesburg Academic Hospitals, South Africa – assessing knowledge, attitudes and practices |
title | The use of non-invasive ventilation by emergency doctors in Johannesburg Academic Hospitals, South Africa – assessing knowledge, attitudes and practices |
title_full | The use of non-invasive ventilation by emergency doctors in Johannesburg Academic Hospitals, South Africa – assessing knowledge, attitudes and practices |
title_fullStr | The use of non-invasive ventilation by emergency doctors in Johannesburg Academic Hospitals, South Africa – assessing knowledge, attitudes and practices |
title_full_unstemmed | The use of non-invasive ventilation by emergency doctors in Johannesburg Academic Hospitals, South Africa – assessing knowledge, attitudes and practices |
title_short | The use of non-invasive ventilation by emergency doctors in Johannesburg Academic Hospitals, South Africa – assessing knowledge, attitudes and practices |
title_sort | use of non-invasive ventilation by emergency doctors in johannesburg academic hospitals, south africa – assessing knowledge, attitudes and practices |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10665829/ https://www.ncbi.nlm.nih.gov/pubmed/38021353 http://dx.doi.org/10.1016/j.afjem.2023.11.002 |
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