I provi g Nurse’s Effective ess i i itiati g Non-Invasive Ventilation (NIV) in High

Dependency Unit, KKH.

Introduction

Non-invasive ventilator (NIV) refers to the administration of ventilatory support to

patients without the use of invasive artificial airways. When set up and administered

quickly, NIV is highly beneficial for patients treatment.

Aim

To improve nurses’ effectiveness in setting up and initiating the NIV to patient timely.

Methodology

A pre-/post-test questionnaires was selected to assess the effectiveness of nurses in

setting up NIV in High Dependency Unit (HDU).

The questionnaires consist of 10 closed ended questions with nurses demographic

data, nurses proficiency and factors affecting efficiency in setting up. The study

involved fifty HDU nurses. Based on the findings from the Pre-survey the team

implemented the following:

Trolley was set up with the required requisites for NIV..

Pictorial Guides on NIV set up and educational materials were made available for

easy reference

On-going education and validation of staff competency on setting up of NIV.

After two months, a post-survey was conducted.

Swaminathan, K., Nazimah,B.S., Tan. G.M., Timpug, E.F., Capanzana, R.A., Huang,C .L Divisio of Nursi g. KK Wo e ’s a d Childre ’s Hospital,

Singapore

Percentage of Nurses Before (%) After (%) Improvement

(%)

Encountered Difficulties 92 32 65.2

Experienced equipment shortage 82 18 78

Required Assistance 18 2 88.9

Confident about process 98 100 2

Took more than 20 minutes 56 6 89.3

Conclusion

Nurses’ efficiency in setting up NIV can be improved by ensuring adequate NIV supplies in an organized manner and the availability of reference materials. The nurses were able to

initiate NIV, promptly with greater confidence and less stress. Nevertheless, the team requires further efforts to sustain the initial implementation to foster the continuation of standard

process and ensure quality safe care for the younger population.

Timeframe of nurses initiate NIV

% o

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es

init

iate

NIV

Results

A total of 50 nurses completed the pre and post survey. Although 98% of the nurses

expressed confidence in the setting up process, however the pre survey result showed

that 92% of the nurses encountered difficulties in setting up NIV. Lack of appropriate

NIV requisites was a major factor that attribute to their difficulties (82%) and 56% of the

respondents spend more than 20 minutes to set up NIV.

There was significant relationships between effectiveness of HD nurses and their

educational backgrounds. 76% of the nurses with no Advance Diploma experienced

difficulties in setting up NIV as compared with those who had Advance Diploma training

(24%). On the other hand, results showed that the need to search for the right

equipment is an obstacle to the efficient setting up of the NIV regardless of varying

years of experience. Data also revealed that 18% of the respondents required

assistance to set up the NIV.

After the intervention, the post-survey results showed 30% of the respondents still

encountering difficulties in setting up NIV. However, the proportion of respondents able

to set up NIV within fifteen minutes had increased to 94% as compared to 44%. There

was 6% of the nurses still taking longer than fifteen minutes in setting up of the NIV. This

requires further review of the intervention process to improve the efficiency of nurses in

setting up NIV timely.

Working experience (years)

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Working experience (years)

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Difficulties encountered in setting up NIV (%)

Performance Summary of nurses before and after the initiative

Difficulty in NIV set up encountered by Nurses with different educational backgrounds

(Pre and Post survey)

Pre-survey Post-survey

RESULTS