Thorax | 2019
P42\u2005Development of an acute non-invasive ventilation teaching programme for trainees in a district general hospital following the NCEPOD report – inspiring change
Abstract
Introduction and Objectives The Inspiring Change(NCEPOD 2017) report in to acute Non Invasive Ventilation outlined recommendations to improve acute NIV care through service development and education. Review of our existing DGH service, identified no formal NIV teaching for doctors commencing and managing NIV. We aimed to develop an interactive case-based education programme to improve patient selection, clinical confidence and competence and patient outcomes in our trust. Method Baseline survey: 90% trainees had attended NIV teaching. 50% had not attended teaching in past 12 months. 70% felt confident in completing treatment escalation plans prior to commencing NIV. Average confidence in initiating NIV was 3/10. Therefore an interactive, case-based simulation teaching session was developed aimed at ST3+ and CMTs. Following trainee feedback a revised NIV teaching evening was developed and delivered in October 2018 and July 2019 encompassing all training grades. Results Three teaching sessions were arranged. Feedback found that confidence and knowledge improved across all sessions (figure 1). July 2018 SIM teaching (ST3+): Attendees liked the small group teaching, use of NIV machines and realistic cases; however, they felt the simulation aspect of the session did not add to experience and recommended the session was delivered out of hours. 66% felt NIV teaching should be mandatory. October 2018 NIV teaching evening(20 CMTs and ST3+): Attendees praised the small group aspect and liked the interactive use of machines. All attendees felt it should be part of their training curriculum. Feedback was used to develop the session further and was repeated in July 2019 July 2019 (14 F1s and CMTs): This most recent data suggests further improvements with the biggest development in the F1 confidence (2.7 to 6.9/10). Conclusion Development of a formal interactive case-based teaching programme has improved trainee confidence and knowledge of managing patients on acute NIV. This, along with other measures to optimise our acute NIV service, has reduced inpatient NIV mortality from 30% to 6%. The trust will now offer a bi-annual interactive teaching programme.Abstract P42 Figure 1 Confidence and knowledge ratings pre and post NIV teaching