{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:59:23Z","timestamp":1790816363079,"version":"4.1.0"},"reference-count":15,"publisher":"AACN Publishing","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Noninvasive ventilation is increasingly delivered outside intensive care units; however, ventilator alarm management, documentation, and competency validation remain inconsistent when paper-based processes are used. Delayed or inconsistent responses to actionable alarms may contribute to clinical deterioration and escalation of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Local Problem<\/jats:title>\n                    <jats:p>Nurses and respiratory therapists reported fragmented documentation, limited access to standardized troubleshooting guides, and time-consuming competency tracking for noninvasive ventilation devices in acute medical units that provide intermediate-level care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This quality improvement project, which used a pre-post design, involved implementation of a digital ventilator safety workflow using QR code\u2013linked alarm guidance and a secure online checklist. Data were collected during a 6-month baseline period and a 6-month postimplementation period. Clinical content, workflow mapping, and alarm-guidance pathways were developed in-house by the respiratory therapy department and deployed through AskVijay, a digital clinical guidance platform. Competency validation was conducted during onboarding and annual assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Digital implementation was associated with an increase in checklist completion compliance from 80% to 100% and a reduction in checklist completion time from a median of 8.5 minutes to 3.9 minutes. Use of required digital fields supported more complete documentation. Centralized electronic records enabled consolidated competency documentation and facilitated tracking of checklist and competency completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A digital ventilator safety workflow supported standardized documentation, point-of-care access to alarm guidance, and competency tracking for unit-based noninvasive ventilation care. In-house clinical development enabled iterative refinement to align with local practice needs and workflows.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4037\/ccn2026554","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:02:59Z","timestamp":1790812979000},"page":"53-60","source":"Crossref","is-referenced-by-count":0,"title":["Digitalizing Ventilator Safety: Enhancing Workflow Efficiency and Competency in Critical Care"],"prefix":"10.4037","volume":"46","author":[{"given":"Wei Jun Dan","family":"Ong","sequence":"first","affiliation":[{"name":"Wei Jun Dan Ong is a senior respiratory therapist, Department of Respiratory Therapy, Ng Teng Fong General Hospital, National University Health System, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor Dela","family":"Pe\u00f1a","sequence":"additional","affiliation":[{"name":"Eleanor Dela Pe\u00f1a is a senior principal respiratory therapist, Department of Respiratory Therapy, Ng Teng Fong General Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faheem A.","family":"Khan","sequence":"additional","affiliation":[{"name":"Faheem A. Khan is a senior consultant and clinical leader in emergency and critical care medicine, Intensive Care Medicine, Ng Teng Fong General Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woon Hean Keenan","family":"Chong","sequence":"additional","affiliation":[{"name":"Woon Hean Keenan Chong is a consultant intensivist, Intensive Care Medicine, Ng Teng Fong General Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence Ace","family":"Azul","sequence":"additional","affiliation":[{"name":"Lawrence Ace Azul is a principal respiratory therapist, Department of Respiratory Therapy, Ng Teng Fong General Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"1","key":"2026093020025242000_b1-0460053","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1186\/s12912-023-01305-w","article-title":"Clinical nurse competence and its effect on patient safety culture: a systematic review","volume":"22","author":"Zaitoun","year":"2023","journal-title":"BMC Nurs"},{"issue":"4","key":"2026093020025242000_b2-0460053","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1097\/NCI.0b013e3182a903f9","article-title":"Alarm fatigue: a patient safety concern","volume":"24","author":"Sendelbach","year":"2013","journal-title":"AACN Adv Crit Care"},{"issue":"1","key":"2026093020025242000_b3-0460053","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.mpsur.2020.11.002","article-title":"Care of the critically ill patient","volume":"39","author":"Jackson","year":"2021","journal-title":"Surgery (Oxf)"},{"issue":"1","key":"2026093020025242000_b4-0460053","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1186\/s13104-020-05199-8","article-title":"Enhancing healthcare efficiency to achieve the Quadruple Aim: an exploratory study","volume":"13","author":"Arnetz","year":"2020","journal-title":"BMC Res Notes"},{"issue":"1","key":"2026093020025242000_b5-0460053","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1186\/s12912-025-03500-3","article-title":"The effect of a clinical approach to ventilator alarm management on alarm fatigue in intensive care nurses: a randomized controlled trial","volume":"24","author":"Nasirmoghadas","year":"2025","journal-title":"BMC Nurs"},{"issue":"4","key":"2026093020025242000_b6-0460053","doi-asserted-by":"publisher","first-page":"mzad086","DOI":"10.1093\/intqhc\/mzad086","article-title":"Facilitators and barriers to the implementation of surgical safety checklist: an integrative review","volume":"35","author":"Lim","year":"2023","journal-title":"Int J Qual Health Care"},{"issue":"4","key":"2026093020025242000_b7-0460053","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.jointm.2023.04.004","article-title":"Prevention of ventilator-associated pneumonia through care bundles: a systematic review and meta-analysis","volume":"3","author":"Mart\u00ednez-Reviejo","year":"2023","journal-title":"J Intensive Med"},{"issue":"3","key":"2026093020025242000_b8-0460053","doi-asserted-by":"publisher","first-page":"189","DOI":"10.4037\/aacnacc2023662","article-title":"Ten years later, alarm fatigue is still a safety concern","volume":"34","author":"Albanowski","year":"2023","journal-title":"AACN Adv Crit Care"},{"issue":"22","key":"2026093020025242000_b9-0460053","doi-asserted-by":"publisher","first-page":"8409","DOI":"10.3390\/ijerph17228409","article-title":"Impact of alarm fatigue on the work of nurses in an intensive care environment\u2014a systematic review","volume":"17","author":"Lewandowska","year":"2020","journal-title":"Int J Environ Res Public Health"},{"issue":"12","key":"2026093020025242000_b10-0460053","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1136\/bmjqs-2015-004411","article-title":"SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process","volume":"25","author":"Ogrinc","year":"2016","journal-title":"BMJ Qual Saf"},{"key":"2026093020025242000_b11-0460053","unstructured":"Government Technology Agency of Singapore\n          . 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