In 1998, the RPH Physiotherapy Department commenced an acute NIV service, in conjunction with the Respiratory Medicine Department, for patients external to the intensive care unit (ICU). From treating nine patients in its foundation year, the service has grown consistently to 180 episodes provided in 2002, and currently averages 13 patients per month, with many more patients assessed but NIV deemed inappropriate. The NIV service is provided within RPH Physiotherapy Department’s existing rostered 24-hour, seven-day cover. The initial service delivery and subsequent growth in NIV has resulted in many challenges within physiotherapy. The NIV service has not received dedicated funding or staffing from the onset 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 the domain of select senior staff. In a department that historically has a significant turn-over of staff and sixmonthly rotational posts, a significant degree of ongoing education, training and support has been required to achieve this NIV service delivery model. A significant cultural shift and change to work practices, particularly among 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. (2004). Physiotherapy and non-invasive ventilation (NIV) at Royal Perth Hospital — a unique service delivery model?Australian Journal of Physiotherapy, 50(3), 83.
Available at: http://works.bepress.com/shane-patman/25/