|Title:||An Audit on the implementation and follow-up of patients prescribed Non-invasive Ventilation (NIV) for long term hypercapnia in Chronic Obstructive Pulmonary Disease|
|Author(s):||C. Gray S. Shelley J. Brady R. Kennedy N. Nyambe P. Nadarajan|
|Institution:||St. James's Hospital|
|Poster:||Click to view poster|
|Abstract:||NIV has been shown to improve survival rates in acute respiratory failure however NIV in stable hypercapnia COPD patients is less studied but potentially may improve clinical symptoms, admissions and survival¹. |
The implementation of NIV and follow-up in this patient group is disjointed and uncoordinated in St James hospital. We decided to audit the current patients prescribed domiciliary NIV.
Sixty-two (62) patients were identified as having home NIV. Forty-four (44) of these patients had a diagnosis of COPD. Information was gathered using the electronic patient record (EPR).
The audit results showed 6 (9.7%) of patients had a diagnosis of asthma, 10 (16.1%) had no recorded Arterial Blood Gas (ABG) on the EPR prior to commencing domiciliary NIV. Of those with a diagnosis of COPD that had an ABG done 4 (9.1%) did not show hypercapnia and 41 (93.2%) had an ABG and respiratory follow-up however the timing of this was haphazard and ranged from months to years.
A more structured and standardised approach is needed in the care of COPD patients commencing home NIV. This review has prompted a larger scale quality improvement project to standardise domiciliary NIV care in line with international guidelines.
1. Macrea, M., Oczkowski S., et al. An Offical American Thoracic Society Clinical Practice Guideline: Long-term Noninvasive Ventiliation in Chronic Stable Hypercapnic Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine 2020 Vol 202(4):e74-e87.