TY - JOUR T1 - Risk analysis of non-invasive ventilation outside the intensive care unit in the Netherlands JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P2970 AU - Anna van Gemert AU - Folkert Brijker AU - Ron Vaartjes AU - Michiel Wagenaar Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P2970.abstract N2 - Objective It is crucial to ensure patient safety in patients treated with non-invasive ventilation (NIV) on general wards. Previous studies have focused on patient characteristics associated with NIV failure, but not on technical and management aspects. Therefore, we performed a risk analysis to assess these technical and management aspects and to describe preventive measures.Methods A risk assessment of NIV was performed on the two general wards in a Dutch general hospital in 2008. Riskfactors for (1) NIV failure and (2) the unavailability of NIV were determined. Risk quantification and prioritization was performed by calculating a riskcoefficient (RC; scale: 1-25) based on the Healthcare Failure Model en Effect analysis. Riskfactors with a RC of eight and higher had a moderate to high priority for which preventive measures were identified.Results The most important riskfactors for NIV failure and the unavailability of NIV were: absence of mask/tubes (RC 8), mask leaking (RC 12), insufficient cleaning (RC 8), equipment malfunction (RC 8), inappropriate indication (RC 10), unfitting (RC 9), incorrect initial settings (RC 9), incorrect NIV adjustment (RC 12), decubitus (RC 12), aerophagia (RC 9), weaning too early (RC 8), delayed intubation (RC 10). The following measures might prevent these factors: preparing a program of requirements, staff training, protocol drafting, periodic patient monitoring, the use of alarms, adequate stock keeping and periodic equipment monitoring.Conclusion In patients treated with NIV, it is essential to perform a risk assessment, which focuses not only on patient characteristics but also on technical and management aspects, to ensure patient safety. ER -