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Table 4 Non-Invasive Ventilation (NIV) quality indicators

From: Introducing the national COPD resources and outcomes project

INDICATOR 'Met in Full'
NIV is used as the treatment of choice for persistent hypercapnoeic ventilatory failure during exacerbations despite optimal medical therapy. 80% 78/97
NIV is delivered in settings suitable for COPD patients, that is a designated area where staffs have been specifically trained in NIV. E.g. ITU, HDU, Emergency Admissions Unit or a dedicated Respiratory Ward. 74% 71/96
There is a named consultant responsible for the NIV service 78% 76/98
There is an ongoing inter-professional training programme for ALL staff involved in the care of patients established on NIV. 56% 54/96
Nurses and doctors outside of specialist respiratory wards do know how to manage patients with COPD, and are aware of the indications for and benefits of NIV. 40% 39/98
There is a written protocol that defines the monitoring of patients receiving NIV, and includes a minimum of regular clinical assessment, pulse oximetry and arterial blood gas measurements. 88% 85/97
There is a clear set of individualised written instructions for management of each patient receiving NIV, including what to do in event of deterioration and agreed ceilings of therapy 39% 38/97
Locally adapted written protocols for the management of COPD patients requiring NIV, including weaning from NIV, are available in ALL relevant clinical areas for ALL relevant staff. 57% 56/98
A selection of nasal and full face masks, types and nasal pillows are available. 55% 54/98
All areas offering NIV provide written information for patients about the indications for and patient experience of NIV. 19% 18/96
There is a policy for providing patient information about NIV to severe COPD patients whilst in a stable state e.g. in an out-patient setting or upon discharge from hospital. 7% 7/97
There is an annual audit of the use of NIV including ALL clinical areas. This audit covers both those patients offered NIV to examine its appropriate use AND those that might have benefited for NIV but who were not provided with this therapy. 32% 31/97
  1. Percentage of NCROP sites providing NIV in 2007 that said they currently 'met in full' these indicators (denominator = number of hospitals returning data)