Improving the delivery of acute NIV at Kings Mill Hospital: A closed loop quality improvement project.

IF 0.9 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE Pub Date : 2022-01-01 DOI:10.3233/JRS-227028

Bhavandeep Slaich, Frederick Garrett

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引用次数: 0

Abstract

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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改善国王磨坊医院急性NIV的交付:一个闭环质量改进项目。

背景:英国胸科学会(BTS)急性无创通气(NIV)标准规定，所有需要急性无创通气的患者应在入院后两小时内开始使用NIV。急性NIV的分娩是一项时间关键的干预措施，因为急性NIV的及时应用大大降低了急性高碳酸血症性呼吸衰竭患者的死亡率。目的:本审计旨在评估延迟急性NIV启动的患者数量。我们还评估了急性NIV患者入院的结果。方法:收集2019年1月2日至2019年3月31日king Mill医院收治的急性NIV患者的数据。对急性NIV的认识和知识被强调为一个需要改进的领域。设计了关于“急性NIV”的电子学习包并发送给医务人员。对2020年2月1日至2020年3月31日因急性NIV入院的患者重复审计，并使用卡方检验进行分析。结果:首次审核25例，再审核30例。干预前31%的患者延迟开始急性NIV，干预后增加到77% (p < 0.05)。结论:需要进一步的工作来确保急性NIV的持续交付达到BTS标准，然而目标的可变成就似乎不会对患者预后产生显着的不利影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

2.20

自引率

17.60%

发文量

102

期刊介绍： The International Journal of Risk and Safety in Medicine is concerned with rendering the practice of medicine as safe as it can be; that involves promoting the highest possible quality of care, but also examining how those risks which are inevitable can be contained and managed. This is not exclusively a drugs journal. Recently it was decided to include in the subtitle of the journal three items to better indicate the scope of the journal, i.e. patient safety, pharmacovigilance and liability and the Editorial Board was adjusted accordingly. For each of these sections an Associate Editor was invited. We especially want to emphasize patient safety.