5.1.6 Ventilator Management

Ventilator Management

5.1.6

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5.1.6 Ventilator Management Contents Preamble ............................................................................................................................. 3 Details .................................................................................................................................. 3 Plan Development ............................................................................................................ 4 Policies and Procedures................................................................................................... 5 Support Worker Training .................................................................................................. 5 Procedure ............................................................................................................................ 6 Summary ............................................................................................................................. 6 Supporting Documents ........................................................................................................ 7 Policies ............................................................................................................................. 7 Forms ............................................................................................................................... 7 Information Sheets ........................................................................................................... 7 NGO Training ................................................................................................................... 7 Legislation ........................................................................................................................ 7 NDIS Practice Standards and Quality Indicators ................................................................. 8 5.1 High Intensity Daily Personal Activities .......................................................................... 8 5.1.6 Ventilator Management ........................................................................................... 8 Human Services Quality Standards ..................................................................................... 9 3 Responding to Individual Need ..................................................................................... 9 6 Human Resources......................................................................................................... 9 Delegation of Authority......................................................................................................... 9 Version Details ................................................................................................................... 10

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Preamble BigDog Support Services Pty Ltd (BigDog) ensures that each client requiring ventilator management receives appropriate support relevant and proportionate to their individual needs and the specific ventilator used.

Non-invasive ventilation (NIV) is defined as ventilator management without the use of an invasive artificial airway e.g. endotracheal tracheal tube (ETT) or tracheostomy tube.

IMV is for clients who are unable to protect their airway and have poor respiratory rate and/or are at risk of respiratory failure.

BigDog considers it imperative to involve our clients in all aspects of their service delivery and the direction of their services to their ability. The dignity of risk is an essential part of this choice and control.

Details In recent years advancements in technology have led to the development of portable and lightweight ventilator systems, which have greatly improved the mobility and quality of life for individuals who require ventilator support.

By utilising portable ventilators, clients have been gained increased independence and the freedom to engage in social activities, travel, and pursue employment and educational opportunities. Moreover, the availability of portable ventilators has reduced the need for long-term hospital stays.

The Respiratory System

Ventilator Support Ventilator support is a life-saving intervention taken when a client is unable to facilitate their own breathing due to low oxygen levels, severe shortness of breath or other causes of respiratory distress.

Ventilation takes over the work of breathing by delivering oxygen into the lungs, reducing the level of effort required by the client.

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BiPAP (Bi-Level Positive Pressure Ventilation BiPAP delivers two different pressures, one during inhalation and one during exhalation.

CPAP (Continuous Positive Airway Pressure) Uses mild air pressure to keep breathing airways open while the client sleeps. It uses the same amount of pressure whether the client is breathing in or out.

Plan Development Each client is involved in the assessment and development of the plan for their ventilator management. With their consent, the client’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure client wellbeing.

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Policies and Procedures BigDog has appropriate policies and procedures in place, including a training plan for workers, that relate to the support provided to each client who is ventilator dependent.

Both the training plan and the management support plan will include the identification of risks including actions and escalations.

Support Worker Training BigDog will ensure that each worker has completed training, relating specifically to each client’s ventilation needs, managing a related incident and the high intensity support skills descriptor for ventilator management, delivered by an appropriately qualified health practitioner or person who meets the high intensity support skills descriptor for ventilator management.

NGO Ventilator Support Part 1 Within this course, workers will get an in-depth understanding of what a ventilator is, how it works and how to use one. They will learn the two types of ventilation and they will be shown step-by-step procedures on how to assemble and use a ventilator to provide ventilator support safely and effectively to their client.

After this lesson workers will be able to: 1. Explain what ventilator support is and how a ventilator works.

2. Set up a ventilator.

3. Know what non-invasive ventilation is and how it can be delivered.

4. Know what invasive ventilation is and how it works.

Course duration: 35 minutes NGO Ventilator Support Part 2 Within this course, workers will get an in-depth understanding on how to support a client needing ventilator support. They will learn how to assess the need for ventilator support, how to monitor and promote good ventilator support, how to respond to the common problems they might encounter while delivering support and lastly, how to recognise incidents and emergencies and how to respond to them.

After this lesson support workers will be able to: 1. Assess a client needing ventilator support.

2. Monitor and promote good ventilator support.

3. Know how to respond to complications and common problems.

4. Know how to respond to incidents and emergencies.

Course duration: 41 minutes Any other client specific training will be delivered by an appropriately qualified RTO.

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Procedure Setting up a ventilator

Connecting a Breathing Circuit to a Ventilator

Mask Application and Fitting 1. Place cushioned nose or face mask piece to the client’s face.

2. Position to ensure good fit with minimal air leak present.

3. Adjust and tighten straps.

4. Reposition straps tightness, placement or mask piece if a leak is present.

5. Adjust straps to ensure there is no pressure being applied to the ears.

Summary Any client who requires a ventilator must be prescribed by a qualified health professional.

Any high intensity daily personal activity and management forms part of the formal training program and must be signed off by a Registered Training Organisation (RTO).

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Supporting Documents Policies 1.1 Person-Centred Supports 1.3 Privacy and Dignity 2.3 Quality Management 3.4 Responsive Support 5.1 High Intensity Daily Personal Activities 5.1.4 Tracheostomy Management

Forms Audit Checklist Ventilator Support Client Profile Kit NGO Course Report NGO User Report Training Attendance Sheet

Information Sheets Ventilator Support Part 1 Work Booklet Ventilator Support Part 2 Work Booklet

NGO Training Ventilator Support Part 1 Ventilator Support Part 2

Legislation Disability Discrimination Act 1992 (Cwth) Disability Services and Inclusion Act 2023 (Cwth) Disability Services Act 2006 (QLD) Health Act 1937 (QLD) Health Regulation Act 1996 (QLD) National Disability Insurance Scheme Act 2013 NDIS (Provider Registration and Practice Standards) Amendment Rules 2021 Queensland Guardianship and Administration Act 2000 (QLD) Queensland Human Rights Act 2019 (QLD) Queensland Mental Health Act 2016 (QLD)

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NDIS Practice Standards and Quality Indicators BigDog Support Services Pty Ltd (BigDog) is a registered NDIS provider and is required to apply the scheme’s practice standard and quality indicators.

The standards have been developed to create an important benchmark to assess provider performance and ensure that high quality and safe supports and services are provided to NDIS participants.

The four core modules are: 1.0 Rights and Responsibilities; 2.0 Governance and Operational Management; 3.0 The Provision of Supports; and 4.0 The Support Provision Environment.

The supplementary modules cover: 5.0 Specialist Support 5.1 High intensity daily personal activities 5.2 Implementing behaviour support plans

5.1 High Intensity Daily Personal Activities These NDIS Practice Standards set out the responsibilities of BigDog when providing supports and services to clients that require the following.

5.1.1 Complex Bowel Care 5.1.2 PEG Feeding and Management 5.1.3 Severe Dysphagia Management 5.1.4 Tracheostomy Management 5.1.5 Urinary Catheter Management 5.1.6 Ventilator Management 5.1.7 Subcutaneous Injections 5.1.8 Complex Wound Management

5.1.6 Ventilator Management Each participant requiring ventilator management receives appropriate support relevant and proportionate to their individual needs and the specific ventilator used.

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Human Services Quality Standards The Standards set a benchmark for the quality of service provision. Each Standard is supported by a set of performance indicators which outline what BigDog is required to demonstrate to meet that standard.

3 Responding to Individual Need The assessed needs of the individual are being appropriately addressed and responded to within resource capacity.

3.3 BigDog ensures that services to the individual/s are delivered, monitored, reviewed and reassessed in a timely manner.

6 Human Resources Effective human resource management systems, including recruitment, induction and supervisory processes, result in quality service provision.

6.3 BigDog provides people working in BigDog with induction, training and development opportunities relevant to their roles.

Delegation of Authority Name

Position

Details

Steven Paull

Director

Authorise review and implementation

Courtney Carroll

Director

Authorise review and implementation

David Burrett

Operations Manager

Ensure information dissemination

Monique Paull

HR Manager Lawyer

Ensure compliance by employees

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Version Details This policy will be reviewed every twelve (12) months unless circumstances deem it necessary to review earlier. The review process will involve an analysis of the usefulness of the policy and to note any changes which are required to improve the policy.

If minor changes are made in wording or to clarify the intent, the version number will indicate this by adding a ‘point’ i.e. Version 1.0 indicates the original version and 1.1 with the first round of minor changes made. A significant change or intent of the policy will be indicated by a whole new number i.e. Version 2.0.

The following rules also apply in interpreting this policy: • Headings are for convenience only and do not affect interpretation.

• A singular word includes the plural and vice versa.

• A word that suggests one gender includes the other genders.

Date

V

November 2021

5.0 New Policy

January 2022

5.1 Updated Responsible Offices details and NDIS (Provider Registration and Practice Standards) Amendment Rules 2021

January 2023

6.0 Included Human Services Quality Framework (HSQF) and Child Protection Act and the term “Participant” is returned to “Client” to allow for policies to cover NDIS and HSQF.

March 2024

6.1 Disability Services Act 1986 replaced with Disability Services and Inclusion Act 2023 and policy review process included.

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