Discharge planning and management for patients with chronic respiratory failure using home mechanical ventilation

Educational aims

1. To identify some of the clinical issues associated with the safe and effective care of the patient using home ventilatory support.

2. To recognise those patients and clinical situations where problems related to home ventilation are more likely to occur.

3. To assist in developing discharge plans to improve quality of care for patients using long-term home ventilation.

Summary The use of home mechanical ventilation (HMV) to manage chronic respiratory failure (CRF) is becoming increasingly prevalent, and is usually delivered by means of a mask interface and pressure preset device. Although the transition from initial acclimatisation and prescription of ventilation to long-term home use is fairly straightforward for many patients with respiratory failure, issues such as nutrition, progressive ventilatory dependence and psychosocial problems can arise. Anticipating these problems and identifying resources and procedures that can reduce the negative impact of complex care carried out in the home is important for the long-term success and safety of HMV.