Training activity information
Details
Develop a patient pathway for domiciliary non-invasive ventilation from initial assessment through to withdrawal
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- What are the key stages in the patient pathway for domiciliary NIV, from initial assessment to potential withdrawal?
- What are the critical decision points and considerations at each stage?
- How does multidisciplinary team working contribute to this pathway?
- What knowledge about the overall journey of a patient requiring long-term NIV at home are you hoping to gain?
- What challenges do you expect in outlining the different stages and the transitions between them?
- What insights into the roles of various healthcare professionals involved in this pathway are you seeking?
- Will you research existing patient pathways for domiciliary NIV (if available)?
- Will you consider the different clinical and practical aspects involved in each stage (assessment, initiation, monitoring, follow-up, withdrawal)?
- Have you discussed the key elements of this pathway with your training officer and other relevant team members?
- What are your initial thoughts on the complexities of managing patients on long-term ventilatory support within the community?
In action
- What stages of the patient pathway are you currently outlining? What key decision points and actions are you including at each stage? Why are you structuring the pathway in this way?
- What considerations are you taking into account regarding patient assessment, initiation, monitoring, follow-up, and the criteria for NIV withdrawal? Are you drawing on relevant guidelines and best practices?
- Which parts of developing this patient pathway feel more straightforward based on your current knowledge, and where are you needing to think more strategically about the sequence of events and responsibilities?
- How effectively are your current actions contributing to the creation of a clear and comprehensive patient pathway? What challenges are you encountering in anticipating all the necessary steps and considerations?
- What insights are you gaining about the holistic management of patients on domiciliary NIV as you develop this pathway?
- Are there any potential gaps or areas for improvement in the pathway you are developing? Would it be beneficial to review existing pathways or consult with experienced colleagues at this stage? Are you ensuring the pathway is patient-centred and reflects best practice?
On action
- Outline the key stages and components of the patient pathway you developed for domiciliary non-invasive ventilation (NIV). What were the critical decision points within the pathway? What considerations were included for initial assessment, initiation, ongoing management, and withdrawal of NIV? How were patient perspectives and multidisciplinary team involvement integrated into the pathway?
- What specific skills or knowledge related to developing patient pathways and understanding the holistic management of patients on domiciliary NIV did you develop or improve? How did you consider national guidelines and best practices in creating the pathway? What challenges did you encounter in mapping out the different stages and potential complexities of the patient journey?
- What areas for continued development in developing and implementing patient pathways have been identified? How can you apply the learning from this activity to other areas of respiratory and sleep science practice? What specific actions or ‘next steps’ will you take to further develop your understanding of patient pathway design and service improvement? What support or resources might you need for further development, such as reviewing existing pathways or discussing with service leads?
Beyond action
- Have you had opportunities to observe or be involved in different stages of the domiciliary NIV pathway you developed or similar pathways?
- Have you seen instances where patients were initiated on and potentially withdrawn from domiciliary NIV? What were the key decision points and processes?
- Consider if your understanding of the entire patient journey for domiciliary NIV, including assessment, initiation, monitoring, and withdrawal, has broadened.
- Have you discussed different approaches to NIV pathways with colleagues or reviewed relevant literature?
- Do you now have a more holistic understanding of the complexities involved in domiciliary NIV provision?
- Has this experience influenced how you think about service development and patient care pathways in general?
- How has this training activity contributed to your understanding of appraising patient pathways?
- What transferable skills, such as system thinking, pathway development, and understanding multidisciplinary care, did you develop?
- How will you approach future tasks involving pathway development or review?
- What clear actions for continued development in understanding and optimising domiciliary NIV pathways have you identified?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 7 |
Outcome
Appraise patient pathways from diagnosis to end of life care. |
| # 8 |
Outcome
Practice effectively as part of a multidisciplinary team to interpret complex scientific and technical data which will form part of the diagnosis and management plan. |