{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T13:25:37Z","timestamp":1763558737579,"version":"3.45.0"},"reference-count":49,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Australian Government Research Training Program Scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Non-invasive ventilation (NIV) is a highly effective and safe treatment for hypercapnic acute respiratory failure (ARF). This study aimed to identify and examine the content and recommendations within local health guidance documents (LHGDs) that facilitate ward-based implementation of NIV for the treatment of ARF in adults in Australian health services. Methods: A scoping review was conducted on 26 May 2023, updated on 11 January 2024 and 16 September 2025 to identify public health services NIV LHGDs. Data were extracted and analysed regarding NIV initiation, monitoring, maintenance and weaning, and management of clinical deterioration. Results: Twenty-two LHGDs were included, of which only six (27.3%) referenced international NIV guidelines. Most LHGDs (n = 17, 77.3%) required an arterial blood gas (ABG) measurement before NIV initiation, with eight (36.4%) specifying PaCO2 &gt; 45 mmHg and pH &lt; 7.35 as a basis to consider NIV initiation. Most (n = 13, 59.1%) specified a target SpO2 range to monitor NIV, but recommendations varied. NIV implementation recommendations general wards (n = 12, 54.5%) were most common, followed by respiratory wards (n = 5, 22.7%) and respiratory care units (n = 4, 18.2%). Most LHGDs did not specify criteria for medical review (n = 13, 59.1%), clinical escalation (n = 13, 59.1%) or palliation care (n = 13, 59.1%), and weaning guidance was rarely specified (n = 7, 31.8%). Conclusions: There was substantial variation in the structure and content of LHGDs for ward-based NIV across Australian hospitals, including inconsistencies in initiation, monitoring, weaning, and detection of patient deterioration. Variation and limited alignment with major clinical guidelines may impact care quality and safety.<\/jats:p>","DOI":"10.3390\/jcm14228152","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T12:55:31Z","timestamp":1763556931000},"page":"8152","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Non-Invasive Ventilation Therapy Implementation in Medical Wards\u2014A Scoping Review to Understand Hospitals\u2019 Protocols and Procedures"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4071-2187","authenticated-orcid":false,"given":"Catherine","family":"Buchan","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, The Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia"},{"name":"Respiratory Research@Alfred, School of Translational Medicine, The Alfred Centre, Monash University, Melbourne, VIC 3004, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Idinakachukwu","family":"Chukwu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4559-1833","authenticated-orcid":false,"given":"Anne","family":"Walker","sequence":"additional","affiliation":[{"name":"Respiratory Research@Alfred, School of Translational Medicine, The Alfred Centre, Monash University, Melbourne, VIC 3004, Australia"},{"name":"Department of Respiratory and Sleep, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia"},{"name":"Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eli","family":"Dabscheck","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia"},{"name":"Respiratory Research@Alfred, School of Translational Medicine, The Alfred Centre, Monash University, Melbourne, VIC 3004, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3403-3586","authenticated-orcid":false,"given":"Natasha","family":"Smallwood","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia"},{"name":"Respiratory Research@Alfred, School of Translational Medicine, The Alfred Centre, Monash University, Melbourne, VIC 3004, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.ccc.2023.12.001","article-title":"Diagnosis and Epidemiology of Acute Respiratory Failure","volume":"40","author":"Chen","year":"2024","journal-title":"Crit. 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