Role of a Nurse in Non-invasive Positive Pressure Ventilation: A Conceptual Model for Clinical Practice

Non-invasive ventilation (NIV) has proven to be effective in acute respiratory illness of various etiologies in Intensive Care Units (ICU) and general ward/Unit settings. It is viewed as complementary to invasive ventilation and primarily a means of preventing some patients from deteriorating to the point at which intubation is needed. Benefits include the avoidance of endotracheal-tube-associated infections, reduction of morbidity and mortality, improvement in patient outcomes and a gross reduction in health care costs. Nurse staffing levels will continue to vary in ICUs, high dependency units or general wards but the intensity of nursing input will be much lower in the general wards than on the ICU, particularly at night. In developing countries with scarce technology and less ICU beds, NIV will be an asset in general wards for nurses who have adequate experience in caring for acutely ill patients. The most important ingredient for an acute NIV nurse led service is a welltrained enthusiastic ward team. This article highlights the factors that should be considered in providing an acute NIV nurse led service in general or acute care settings. Utilizing the Roper, Logan and Tierney nursing model, which focuses on patients as individuals, recommendations are made for best nursing practices based on 12 activities of living, promoting independence with quality of life and essential functions of living.