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King J.1,2,3, McKim D.3,4,5,6, LeBlanc C.4,6, Lam S.6, Taylor-Sussex R.6, Woolnough A.7,8, Nonoyama M.9, Lemaire E.5,6,7
1University of Ottawa, Physiotherapy, Ottawa, Canada, 2The Ottawa Hospital, Physiotherapy, Ottawa, Canada, 3CANuVENT Research Group, Toronto, Canada, 4The Ottawa Hospital, CANVent Respiratory Rehabilitation Services, Ottawa, Canada, 5University of Ottawa, Faculty of Medicine, Ottawa, Canada, 6Ottawa Hospital Research Institute, Ottawa, Canada, 7The Ottawa Hospital, The Institute for Rehabilitation Research and Development, Ottawa, Canada, 8Zimmer Biomet Canada, Mississauga, Canada, 9University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, Canada
Background: Individuals with life-threatening acute respiratory failure are often unnecessarily provided invasive respiratory support and tracheostomy ventilation. The resulting increase in complexity and cost of care, prevents patients from returning home, and leads to a lesser quality of life. Implementing non-invasive ventilation and airway management (NIVAM) has been shown to reduce health care utilization and maintain patient independence in the home. Yet many individuals with life-threatening respiratory failure in parts of the world are not being informed about NIVAM by their health care professionals (HCPs), including physiotherapists. HCPs acknowledge that often they do not have sufficient knowledge to implement NIVAM. An eLearning resource could address this knowledge gap and provide HCPs access from anyway in the world to evidence-based NIVAM information.
Purpose: The purpose of this study was to design and evaluate an evidenced-based e-learning resource to assist HCPs with the knowledge and skills to use NIVAM.
Methods: A mixed methods multi-phased iterative approach was used. Data was collected from HCPs using an online knowledge, skills and attitudes (KSA) survey about NIVAM. As well HCPs attended hands-on focus groups in which they interacted with the eLearning resource. Data was collected through a think aloud approach and questionnaires. The eLearning resource was designed using evidenced-based content information about NIVAM interventions as well as best practices for eLearning and adult learning. The framework uses for the eLearning resource was a chronological approach to assessment and treatment of a person living with a progressive neuromuscular disease and what noninvasive measures would be the most appropriate for diagnosis, monitoring and prevention of respiratory complications.
Results: Eighty-eight HCPs from across Canada completed the survey. Seventy-five percent of respondents indicated that they were aware of glossopharygeal breathing yet only 36% felt they have the knowledge and skills in using the technique. The majority of respondents (84%) indicated that they would use a multimedia eLearning resource to gain NIVAM skills. Eighteen of these HCPs participants attended two different focus groups. Data from the focus groups indicated that over 80% of the participants had increased their knowledge of NIVAM interventions and felt more confident to apply the techniques with patients after interacting with the eLearning resource. As well findings indicated that all participants found that the videos were very helpful in demonstrating the techniques and participants recommended more videos as well as step by step guides on using techniques in printable documents. These recommendations have been incorporated into the eLearning resource.
Conclusion(s): This study demonstrated that an evidence-based eLearning resource can increase HCPs knowledge about NIVAM. Further studies will investigate if the eLearning resource can also change practice and to expand the eLearning resource to incorporate a patient and caregiver section.
Implications: This evidenced-based eLearning resource can be used by physiotherapists anywhere in the world to improve their knowledge, skill and confidence in providing NIVAM which in turn could lead to improved quality of life for people living with a variety of conditions that impact on their respiratory function.
Funding acknowledgements: The Ottawa Hospital Academic Medical Organization
Topic: Cardiorespiratory
Ethics approval: The Ottawa Health Science Network Research Ethics Board and the University of Ottawa Research Ethics Board
All authors, affiliations and abstracts have been published as submitted.
