Improving adherence to BTS Acute NIV Standards: A single-centre audit and re-audit

The British Thoracic Society (BTS) has published national quality standards for acute non-invasive ventilation (NIV), though adherence is often variable.¹ We undertook a quality improvement project in a London teaching hospital (Sep 2024–Sep 2025) within the acute medical unit. Data were collected retrospectively over 2 months for patients started on NIV. Variables included indication, treatment escalation plan (TEP) completion, timing, senior involvement, arterial blood gas (ABG) monitoring, and documentation. After baseline data collection, a consultant-led teaching session was delivered to doctors, and the audit repeated. Twelve patients were included in the baseline audit and eight in the re-audit. TEP documentation and guideline-based initiation were sustained at 100%. NIV prescription use improved from 16% to 38%, and arterial line use from 17% to 38%. Senior respiratory team involvement, provision of optimal therapy within 1 hour, and documentation of adjustments or follow-up ABGs remained poor. The audit coincided with staff transition, which may have influenced results. Consultant-led teaching improved adherence to several BTS standards, particularly prescribing and monitoring. Regular refresher sessions and stronger documentation are needed to embed sustained improvements in NIV delivery. erjor;12/suppl_17/112/F1 F1 F1 ¹Davies M et al. BTS Quality Standards for acute NIV in adults. BMJ Open Resp Res. 2018;5:e000283. doi:10.1136/bmjresp-2018-000283