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Developing an Evidence-Based Interprofessional Algorithm to Apply Noninvasive Ventilation in Acute Exacerbation of
Mary Jo S Farmer1, Christine D Callahan1, Ashley M Hughes1
1Department of Medicine, Pulmonary & Critical Care Division (M. J. S. F.), UMASS Chan Medical School - Baystate, Springfield, MA; the Heart and Vascular Research (C. D. C.), Baystate Medical Center, Springfield, MA; the Department of Biomedical and Health Information Sciences (A. M. H.), College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL; the Center for Innovation in Chronic, Complex Healthcare (A. M. H.), Edward Hines Jr VA Hospital, Hines, IL; the Baystate Medical Center (K. L. R.), Springfield, MA; and the Division of Pulmonary, Critical Care & Sleep Medicine (N. S. H.), Tufts University School of Medicine, Boston, MA.
Noninvasive ventilation (NIV) improves outcomes for acute hypercapnic respiratory failure in COPD exacerbations. This study developed an interprofessional algorithm to optimize NIV use and patient care.
Area of Science:
- Respiratory Medicine
- Critical Care
- Interprofessional Healthcare
Background:
- Noninvasive ventilation (NIV) reduces mortality and intubation in acute hypercapnic respiratory failure from COPD exacerbations.
- Despite guidelines, NIV uptake in AECOPD can be improved.
- Effective NIV delivery requires interprofessional team coordination.
Purpose of the Study:
- To develop an evidence-based, interprofessional algorithm for NIV application in AECOPD.
- To enhance appropriate utilization of NIV in patients with AECOPD.
Main Methods:
- Prospective qualitative descriptive study involving expert physicians, nurses, and respiratory therapists.
- Semistructured interviews guided by CCRQ checklist.
- Deductive thematic analysis to identify interprofessional collaboration themes.
- Algorithm construction based on guidelines and integrated interprofessional tasks.
Main Results:
- An interprofessional, team-based algorithm for NIV delivery in AECOPD was developed.
- The algorithm covers patient selection, initiation, titration, monitoring, and weaning.
- The aim is to increase appropriate NIV uptake in the AECOPD population.
Conclusions:
- Interprofessional team roles and responsibilities for NIV in AECOPD were identified.
- These findings can inform interprofessional education programs.
- Emphasis is placed on collaborative best practice, communication, and professional autonomy.
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