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Improving the delivery of acute NIV at Kings Mill Hospital: A closed loop quality improvement project
BACKGROUND: The British Thoracic Society (BTS) Acute Non-Invasive Ventilation (NIV) standards state all patients who require acute NIV should be initiated on NIV within two hours of hospital admission. The delivery of acute NIV is a time critical intervention as prompt application of acute NIV subst...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
IOS Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844061/ https://www.ncbi.nlm.nih.gov/pubmed/35871372 http://dx.doi.org/10.3233/JRS-227028 |
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author | Slaich, Bhavandeep Garrett, Frederick |
author_facet | Slaich, Bhavandeep Garrett, Frederick |
author_sort | Slaich, Bhavandeep |
collection | PubMed |
description | BACKGROUND: The British Thoracic Society (BTS) Acute Non-Invasive Ventilation (NIV) standards state all patients who require acute NIV should be initiated on NIV within two hours of hospital admission. The delivery of acute NIV is a time critical intervention as prompt application of acute NIV substantially reduces mortality for patients with acute hypercapnic respiratory failure. OBJECTIVE: This audit aimed to assess the number of patients for whom there is a delay in the initiation of acute NIV. We also assessed the outcome of admission for patients started on acute NIV. METHODS: Data was collected on patients admitted to Kings Mill Hospital for acute NIV between 1/2/2019 and 31/3/2019. Awareness and knowledge of acute NIV was highlighted as an area for improvement. E-learning packages on ‘Acute NIV’ were designed and sent to medical-staff. The audit was repeated for patients admitted for acute NIV between 1/2/2020 and 31/3/2020 and analysed using chi-square tests. RESULTS: 25 patients were included in the initial audit and 30 patients in the re-audit. Prior to intervention 31% of patients had a delay in the initiation of acute NIV, which increased to 77% post-intervention (p < 0.0001). Prior to intervention there was a mortality rate of 17% and a mortality rate of 13% post-intervention (p > 0.05). CONCLUSION: Further work is required to ensure the sustained delivery of acute NIV to BTS standards, however variable achievements in the targets does not seem to have a significant adverse effect on patient outcomes. |
format | Online Article Text |
id | pubmed-9844061 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | IOS Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-98440612023-01-30 Improving the delivery of acute NIV at Kings Mill Hospital: A closed loop quality improvement project Slaich, Bhavandeep Garrett, Frederick Int J Risk Saf Med Research Article BACKGROUND: The British Thoracic Society (BTS) Acute Non-Invasive Ventilation (NIV) standards state all patients who require acute NIV should be initiated on NIV within two hours of hospital admission. The delivery of acute NIV is a time critical intervention as prompt application of acute NIV substantially reduces mortality for patients with acute hypercapnic respiratory failure. OBJECTIVE: This audit aimed to assess the number of patients for whom there is a delay in the initiation of acute NIV. We also assessed the outcome of admission for patients started on acute NIV. METHODS: Data was collected on patients admitted to Kings Mill Hospital for acute NIV between 1/2/2019 and 31/3/2019. Awareness and knowledge of acute NIV was highlighted as an area for improvement. E-learning packages on ‘Acute NIV’ were designed and sent to medical-staff. The audit was repeated for patients admitted for acute NIV between 1/2/2020 and 31/3/2020 and analysed using chi-square tests. RESULTS: 25 patients were included in the initial audit and 30 patients in the re-audit. Prior to intervention 31% of patients had a delay in the initiation of acute NIV, which increased to 77% post-intervention (p < 0.0001). Prior to intervention there was a mortality rate of 17% and a mortality rate of 13% post-intervention (p > 0.05). CONCLUSION: Further work is required to ensure the sustained delivery of acute NIV to BTS standards, however variable achievements in the targets does not seem to have a significant adverse effect on patient outcomes. IOS Press 2022-12-02 /pmc/articles/PMC9844061/ /pubmed/35871372 http://dx.doi.org/10.3233/JRS-227028 Text en © 2022 – The authors. Published by IOS Press https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) , which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Slaich, Bhavandeep Garrett, Frederick Improving the delivery of acute NIV at Kings Mill Hospital: A closed loop quality improvement project |
title | Improving the delivery of acute NIV at Kings Mill Hospital: A closed loop quality improvement project |
title_full | Improving the delivery of acute NIV at Kings Mill Hospital: A closed loop quality improvement project |
title_fullStr | Improving the delivery of acute NIV at Kings Mill Hospital: A closed loop quality improvement project |
title_full_unstemmed | Improving the delivery of acute NIV at Kings Mill Hospital: A closed loop quality improvement project |
title_short | Improving the delivery of acute NIV at Kings Mill Hospital: A closed loop quality improvement project |
title_sort | improving the delivery of acute niv at kings mill hospital: a closed loop quality improvement project |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844061/ https://www.ncbi.nlm.nih.gov/pubmed/35871372 http://dx.doi.org/10.3233/JRS-227028 |
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