The Royal Perth Hospital (RPH) Physiotherapy experience with non-invasive ventilation (NIV) – a unique service delivery model?
In 1998, the Royal Perth Hospital (RPH) physiotherapy department, in conjunction with the respiratory medicine department, commenced an acute non-invasive ventilation (NIV) service for patients external to the intensive care unit (ICU). From its foundation year in which nine patients were treated, the service has grown consistently to 180 episodes provided in 2002, with many more patients assessed but NIV deemed inappropriate. The RPH physiotherapy department provides the NIV service within its rostered 24 hour, 7 day cover. The initial service delivery and subsequent growth in NIV has resulted in many challenges within physiotherapy. From the outset, the NIV service has not received dedicated funding or staffing and has subsequently been provided from within existing services. Consequently, the physiotherapy department has pursued a unique service delivery model in which the understanding and application of NIV has been considered and deemed a core element for those physiotherapists working in the medical, surgical or critical care environments, as opposed to being considered an advanced practitioner skill that is the domain of select senior staff. Achieving this NIV service delivery model has required a significant degree of ongoing education, training and support in a department that historically has a significant turnover of staff and six-monthly rotational posts. A significant cultural shift and change to work practices, particularly amongst non-fulltime physiotherapy staff, has been required to enable the implementation of NIV services within current physiotherapy services. The future visions and expectations of the physiotherapy NIV service is presently tempered by the expansion of NIV services provided from the ICU and the possible commencement of a dedicated sleep unit at RPH.
Patman, S., Winship, P., & Harrold, M. (2003). The Royal Perth Hospital (RPH) Physiotherapy experience with non-invasive ventilation (NIV) – a unique service delivery model? Australian Journal of Physiotherapy, 49(3), 16.
Patman, S., Winship, P., & Harrold, M. (2003). The Royal Perth Hospital (RPH) Physiotherapy experience with non-invasive ventilation (NIV) – a unique service delivery model? Paper presented at the Australian Physiotherapy Association 8th National Cardiothoracic Group Conference. Brisbane, QLD, 4-6 September, 2003.