Non-Invasive Vent Removal has become increasingly prevalent with the aging and chronically ill patient populations. Many of these patients are unable to successfully wean off high-flow oxygen or BiPAP and may reach a point where the focus shifts to quality of life. In such cases, patients often choose to remove life-prolonging devices to prioritize comfort at the end of life.
To support this critical aspect of care, an extensive multidisciplinary effort, involving palliative care specialists and frontline experts, led to the development of a comprehensive protocol. The Palliative Care Unit Practice Council and Comfort Care Committee led this project with the aim to develop a protocol that ensures that nurses and physicians can seamlessly order and administer medications to prevent dyspnea and other symptoms during vent removal.
The process was guided by a thorough literature review, adapting guidance and guidelines from trusted sources in palliative and end-of-life (EOL) care, despite the limited availability of evidence. The protocol has been translated into several practical resources:
- Guideline Format: A clear and concise reference to support clinical decisions.
- Nursing HealthStream Module: An educational tool designed to bridge knowledge gaps.
- Order Panel for Physicians: A streamlined tool to guide medication orders effectively.
- Orientation Component: Educational materials incorporated into nursing orientation to build foundational knowledge.
The Comfort Care Committee played a vital role in improving workflows, collaborating with nursing colleagues and leadership to ensure smooth transitions for every patient who chooses to remove non-invasive ventilation. This initiative highlights the commitment to patient-centered care, prioritizing comfort and dignity at the end of life.