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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...

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Autores principales: Slaich, Bhavandeep, Garrett, Frederick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: IOS Press 2022
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.
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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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