{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T14:40:16Z","timestamp":1769697616938,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Bilevel positive airway pressure (BiPAP) management is a cornerstone in treating acute hypercapnic respiratory failure, with varying outcomes depending on the care model. This retrospective cohort study aims to compare the effectiveness of nurse\u2010led versus physician\u2010led BiPAP management in this context.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed medical records of 189 patients with acute hypercapnic respiratory failure treated with BiPAP between January 2020 and December 2022. Patients were divided into nurse\u2010led (<jats:italic>n<\/jats:italic>\u2009=\u2009101) and physician\u2010led (<jats:italic>n<\/jats:italic>\u2009=\u200988) groups based on their BiPAP management leadership. Outcomes measured included arterial blood gas (ABG) parameter improvements, intubation rates, length of hospital stay and 30\u2010day readmission rates. Statistical analysis involved chi\u2010squared tests, <jats:italic>t<\/jats:italic>\u2010tests, Mann\u2013Whitney <jats:italic>U<\/jats:italic> tests and multivariable regression to adjust for confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both groups demonstrated significant improvements in ABG parameters, with no significant differences between groups. The nurse\u2010led group exhibited a lower intubation rate (9.9% vs. 21.6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.026) and higher patient satisfaction scores (median 8 vs. 6, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Mortality rates, complication rates and 30\u2010day readmission rates were similar between the groups. Multivariable logistic regression confirmed the nurse\u2010led group had a lower likelihood of intubation (AOR: 0.401, <jats:italic>p<\/jats:italic>\u2009=\u20090.032) and higher patient satisfaction (AOR: 7.770, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>Our findings indicate that nurse\u2010led and physician\u2010led BiPAP management strategies for acute hypercapnic respiratory failure are equally effective in terms of ABG improvement, intubation rates, hospital stay length, and readmission rates. This suggests that with adequate training and supervision, nurse\u2010led BiPAP management can be as effective as physician\u2010led management, offering a viable alternative in healthcare settings where physician resources are limited.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nop2.70232","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T03:44:17Z","timestamp":1745379857000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparing Nurse\u2010Led and Physician\u2010Led Bilevel Positive Airway Pressure Management in Hypercapnic Respiratory Failure: A Retrospective Cohort Study"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9347-7310","authenticated-orcid":false,"given":"Zhimin","family":"Zhao","sequence":"first","affiliation":[{"name":"School of Medicine Henan Kaifeng College of Science Technology and Communication  Kaifeng China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4562-7332","authenticated-orcid":false,"given":"Zhen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Medicine The First Affiliated Hospital of Henan University  Kaifeng China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinlei","family":"Li","sequence":"additional","affiliation":[{"name":"School of Medicine Henan Kaifeng College of Science Technology and Communication  Kaifeng China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Medicine The First Affiliated Hospital of Henan University  Kaifeng China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinqian","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Medicine The First Affiliated Hospital of Henan University  Kaifeng China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.336.13972"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/17534666251318616"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/JXX.0000000000000402"},{"key":"e_1_2_11_5_1","unstructured":"Balfour L.2020.Implementation and Evaluation of a Clinical Pathway for Non\u2010Invasive Ventilation in Critical Care: A Person\u2010Centred Practice Development Approach: University of Pretoria (South Africa)."},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000819"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2024.08.006"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2024.08.006"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2018.02.002"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.13469"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02456"},{"issue":"24","key":"e_1_2_11_12_1","first-page":"53","article-title":"The Respiratory Nurse Specialist Role at a Medical Assessment Unit","volume":"100","author":"Conway A.","year":"2004","journal-title":"Nursing Times"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/CNQ.0b013e31823b1fec"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0237-2022"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/682621"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2019.01.005"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.160535"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/23779608221141237"},{"key":"e_1_2_11_19_1","unstructured":"Guilhermino M. 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