Quality control of equipment in home mechanical ventilation: a European survey

Abstract

Quality control of the equipment used in home mechanical ventilation is necessary in order to ensure that patients safely and accurately receive the prescribed ventilatory support. The aim of this study was to carry out a survey on the quality-control procedures in different centres and countries.The survey was carried out in the context of a European Commission Concerted Action covering 16 European countries. The study was extensive and detailed, involving 326 centres, which provided home ventilation to .20,000 patients.The survey showed that: 1) ventilator servicing was mainly carried out by external companies (62% of centres), with a servicing frequency ranging 3-12 months; 2) interaction between servicing companies and prescribers was limited (only 61% of centres were always informed of major incidents); 3) participation of centres in equipment quality control was poor (only 56% of centres assessed that patients/caregivers correctly cleaned/maintained the ventilator); and 4) centres were insufficiently aware of vigilance systems (only 23% of centres). Moreover, the data showed considerable inter-and intra-country differences. The size of the centre was an important determinant of many of these quality-control aspects.This survey provides information that will enable the European Commission Concerted Action to formulate recommendations on procedures for home-ventilator quality control.

Home Mechanical Ventilation in Canada: A National Survey

“…Similar variability (both inter-country and intra-country) was identified in the Eurovent survey. 24 Issues relating to ventilator equipment failure are not infrequent. In the United Kingdom, Chatwin and colleagues 25 reported on 1,211 ventilator-assisted individuals receiving NIV over a 6-month time frame and found an 8% failure rate per NIV device manufacturer, with higher failure rates in highly ventilator-dependent individuals and older devices.…”

Tele-monitoring of ventilator-dependent patients: a European Respiratory Society Statement

“…There is poor exchange of information and feedback among the centres prescribing HMV and the external companies performing the ventilator servicing, with the frequency of communication ranging from 3-12 months [3,15]. Tele-monitoring may play a major role in improving HMV quality control, by remotely monitoring ventilation variables and facilitating exchange of information on quality control among partners involved in HMV.…”

“…Furthermore, factors such as patients' chronic diseases and their exacerbations, need of technology and lack of professional supervision make the management of ventilator dependent individuals (VDI) by family and non-professional caregivers a difficult task. Supervision by external companies has many limitations, such as lack of standardisation, lack of regular feedback to the prescribing centres [3], costs and logistical problems. The need to reduce healthcare costs and to improve safety has prompted the development of tele-monitoring for VDIs.…”

Guidelines for Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure

“…The first control examination with nocturnal diagnostics should take place within the first 4 -8 weeks [32,33]. Any side-effects of the ventilation treatment must be duly recorded and a thorough check of the complete ventilation system is obligatory.…”