Chest
Original Research: Critical Care MedicineUtilization of Noninvasive Ventilation in Acute Care Hospitals: A Regional Survey
Section snippets
Materials and Methods
A survey methodology was employed, including item generation and reduction, pretesting, clinical sensibility, and test-retest reliability, to develop a questionnaire consisting of 19 questions (see “Appendix.”). This was mailed to the directors of respiratory care (ie, nonphysician respiratory therapists) of all 81 acute care hospitals in the states of Massachusetts and Rhode Island. Reminders were issued via telephone and e-mail to nonresponders. The survey took place between September 2002
Results
The initial response rate to the mailed survey was 33%, but respiratory care directors at a total of 71 of the 81 acute care hospitals (88%) eventually responded after follow-up contact via phone and e-mail. The follow-up survey of four additional questions elicited a response from 42 of the 71 hospitals (59%) that had responded to the initial survey. Not all questions were completely answered by all responders, so the number of replies varies by question.
The 71 hospitals represented a total of
Discussion
Our survey confirms our hypotheses that hospitals vary widely in their utilization of NPPV and that a substantial portion of hospitals have low utilization rates. We also found that, despite the prevalence of low utilizers, most respondents considered their experience with NPPV as good to excellent. Furthermore, larger institutions differed from smaller ones in that they used NPPV in a higher percentage of patients in whom mechanical ventilation was started and more often to facilitate weaning.
Appendix
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