School of Nursing
Doctor of Nursing Practice (DNP)
Noninvasive Ventilation, Protocol, Endotracheal Intubation, Mortality, BiPAP
Tinsman, Janise Pierce, "Noninvasive Ventilation Protocol Development" (2019). Doctoral Dissertations and Projects. 2239.
Endotracheal intubation results in many serious complications including regurgitation, vocal cord paralysis, and death. Noninvasive ventilation using bi-level positive airway pressure has been shown to provide the necessary support without intubation and is also associated with better outcomes if trialed prior to endotracheal intubation. A noninvasive ventilation protocol was applied in a rural acute care facility. Results: The average length of stay for acute respiratory failure decreased from 5.32 to 4.44 days, while intubations fell from 41.9% to zero, and mortality fell from 9.7% to zero during the pilot period. Five cases met criteria for noninvasive ventilation, and three received prompt intervention with lengths of stay of two to four days. One did not have CO2 levels assessed upon admission resulting in delayed noninvasive ventilation, and a twelve-day stay. The fifth refused the therapy and was discharged on hospice.