|Survey of Awareness of local NIV guidelines and Confidence in prescribing NIV at Mayo University Hospital among NCHDs
|P. Ridge; S. Griffiths; CP. Rooney; MC. Mokoka
|Mayo University Hospital
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|Non-invasive ventilation (NIV) use in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) in a ward based NIV unit is effective and reduces the need for tracheal intubation (Plant etal). To ensure a standardised treatment approach for patients admitted with hypercapnic respiratory failure, NIV guideline was developed in MUH. We sought to assess the awareness of these guidelines amongst non-respiratory NCHDs, those whom in practise, commence the majority of NIV support out of hours.
An online anonymised questionnaire was administered to 42 medical NCHDs. The response rate was 45%. Of the respondents, 32% of individuals didn’t feel confident recognising those who require BiPAP, 53% didn’t feel confident prescribing initial settings and 37% didn’t feel confident adjusting ventilator pressures. As expected these results varied according to the grade of the NCHD. 32% of the respondents were aware of the local NIV protocol, however, only 2 individuals knew how to access the protocol despite a laminated copy being attached to the machine. Participants were asked initial NIV pressures as per MUH guidelines only 26% supplied the correct answer.
This survey highlights poor awareness of MUH NIV guidelines amongst NCHDs. As expected confidence in prescribing BiPAP varied according to the experience of the NCHD. However, no grade reported high levels of self reported confidence in prescribing NIV.
This survey was carried out in the midst of the COVID Pandemic and we believe the results may be heavily biased by the redeployment of our respiratory nurses and inability to carry out face to face teaching at the time.
Measures such as orientation and hands on skill sessions are being implemented and we hope a future survey will show improvement.