Authors: (including presenting author): :
HO SHA(1), LAM L(1), LEE PL(1), WONG KK(1), YIP C W(1), LUK YW(1), LAM PY(1), CHEUNG NL(1)
Affiliation: :
(1) Community Nursing Services, Caritas Medical Centre
Keyword 1: :
Non-invasive positive pressure ventilation Care
Keyword 2: :
Simulation training
Keyword 3: :
Community Nursing Service
Introduction: :
Non-invasive positive pressure ventilation (NIPPV) is now a cornerstone of community management for COPD, obstructive sleep apnoea, and neuromuscular diseases. Although many nurses are familiar with NIPPV in the controlled hospital environment, delivering safe and effective care in patients’ homes presents unique challenges: variable home settings, untrained family caregivers, poor adherence, mask intolerance, side effects, and significant psychosocial burden. This training programme was developed to close the critical competency gap between hospital-based expertise and real-world community practice, equipping nurses with both advanced technical skills and the empathy required for person-centred home ventilation support.
Objectives: :
The program aimed to: (1) enhance nurses’ understanding of NIPPV principles, indications, contraindications, and troubleshooting; (2) improve clinical assessment and management skills for home NIPPV care; (3) strengthen patient and caregiver education strategies; and (4) promote psychosocial support and resource linkage for families. The training targeted both novice and experienced community nurses, with a focus on hands-on, scenario-based learning.
Methodology: :
A blended-learning design was implemented for 59 community nurses.
•Didactic component: hybrid lecture covering NIPPV theory, indications/contraindications, home environmental assessment, complication management, emergency response (e.g., power failure), mask fitting, pressure injury prevention, and education strategies.
•Immersive simulation workshop (n=13): high-fidelity home setting with 9 nurses acting as community nurses and 4 as patients/caregivers. Participants performed full home visits: respiratory assessment, equipment set-up/adjustment, troubleshooting, and education. A distinctive feature required nurses to wear the NIPPV mask themselves to experience pressure, claustrophobia, and anxiety firsthand, fostering deep empathy. Each scenario was followed by structured debriefing focusing on technical, communication, and psychosocial elements.
Result & Outcome: :
Classroom component (n=59 matched pre/post tests)
Mean knowledge score increased from 45.5% to 95.9%. Greatest gains occurred in critical safety areas:
•Emergency response (power failure): Increased from 13.6% to 96.6%
•NIPPV indications: Increased from 25.4% to 94.9%
•Procedural Mastery: Seven of ten knowledge domains achieved >= 94% correct responses post-training.
Simulation workshop (n=13)
All domains scored ≥5.8/6.0 on Likert scales. Highest-rated elements: realism (6.0), content relevance (6.0), hands-on practice (5.9), and patient-perspective experience (wearing the mask). Participants reported large confidence gains in respiratory assessment, troubleshooting, and education (means 5.7–5.8/6). Qualitative themes: the mask-wearing experience was repeatedly described as “transformative” for empathy and communication; realistic home scenarios effectively bridged theory to practice; improved mask-fitting and troubleshooting techniques would be immediately applied.
Conclusion
The “From Theory to Home Visit” programme achieved exceptional knowledge gains and transformed nurses’ practical and empathetic skills for home NIPPV management. The combination of evidence-based didactic teaching with high-fidelity simulation—including the unique patient-perspective mask experience—proved highly effective. Participants demonstrated mastery of critical safety domains and significantly increased confidence in managing complex, unpredictable home environments. The initiative supports routine integration of immersive simulation into community nursing professional development to sustain competency, enhance treatment adherence, improve patient safety, and elevate quality of life for individuals dependent on long-term home ventilation.
