Abstract
Background:
It has been shown that utilizing order protocols can improve order accuracy in healthcare. An established ventilator protocol in place at BWH had greatly improved order accuracy following chart reviews. An erroneous noninvasive ventilation order was uncovered noninvasive ventilation per protocol and was being documented in patient charts. This discovery led to the implementation of a hospital wide algorithm and protocol for all noninvasive orders.
Methods:
Multidisciplinary teams within the hospital collaborated to create a universal NIV algorithm and protocol for acute/non-acute BPAP, acute/non-acute CPAP, and for the use of a patient’s home NIV device. A smart phrase template was created to access the protocol. General safe parameter ranges were established so most patients’ settings were within the guidelines. Once approved by leadership, education was provided on how to correctly use the algorithm and protocol. Daily chart audits for all noninvasive ventilation patients were reviewed for order accuracy.
Results:
Overall order accuracy increased from 67% in March 2022 to 85% in March 2023
Conclusions:
Mass General Brigham enterprise is currently in the process of adopting the protocol for use system-wide. The updated system-wide protocol will have a direct link to the protocol within the order. Even though the NIV order protocol and smart phrase are currently available to all staff, we found it to be underutilized.
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