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Background: Non-invasive ventilation (NIV) can be a lifesaving treatment for patients with acute hypercapnic respiratory failure. The 2017 'Inspiring Change' National Confidential Enquiry into Patient Outcome and Death (NCEPOD) 1 report highlighted variations in the delivery of NIV care and outcomes across the United Kingdom. At Nottingham University Hospitals NHS Trust, a newly dedicated NIV ward opened in 2022. A retrospective audit revealed that the mean time to starting NIV after the initial blood gas was 9 hours 34 minutes . Subsequently a quality improvement initiative was designed to improve initiation times on the new ward. Aim: To evaluate the outcomes of a quality improvement project for patients requiring acute NIV. Methods: A service improvement initiative was implemented consisting of specialist staff training and introduction of an NIV referral proforma. The ward was then re-audited to see if any changes had occurred. Results: A total of 46 patients were included in the re-audit of the ward. The mean time to initiating NIV reduced from 9hrs 34mins to 3hrs 50mins. Discussion The main contributing factor to prolonged NIV initiation was delay in recognition of acute hypercapnic respiratory failure as well as delay in patient transfer. Implementation of staff training and the referral proforma has improved the NIV initiation time significantly. The quality improvement initiative has demonstrated an improvement in initiation of NIV as well as inpatient mortality. Conclusion: The implementation of a quality improvement initiative has demonstrated a reduction in NIV initiation times. References 1. Acute Non-Invasive Ventilation: Inspiring Change. Available Online: https://www.ncepod.org.uk/2017niv.html
Jacobs et al. (Thu,) studied this question.