Physical therapy utilization in intensive care units: Results from a national survey
Physical therapy utilization in intensive care units: Results from a national survey
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DOI：
10.1097/ccm.0b013e3181957449
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发表时间：
2009-02-01
影响因子：
8.8
通讯作者：
Moss, Marc
中科院分区：
文献类型：
--
作者：
Hodgin, Katherine E.;Nordon-Craft, Amy;Moss, Marc
客观的。进入重症监护病房 (ICU) 后幸存的患者通常会抱怨疲劳、虚弱和功能状态不佳。本研究旨在确定危重病康复患者对住院物理治疗 (PT) 的利用情况。设计：将调查问卷邮寄给来自美国各地的 9114 名物理治疗师。每项调查都包括有关 ICU 患者物理治疗师的人员配备和可用性的问题，以及 PT 在需要 ICU 入院和机械通气的六种患者情况下的使用情况。 主要结果：总体而言，482 名物理治疗师完成了调查。大多数雇用物理治疗师的医院（89%）都要求医生咨询才能为 ICU 患者启动物理治疗。只有 10% 的医院制定了在 ICU 启动 PT 的既定医院标准。与学术医院相比，社区医院更有可能在周末常规提供 PT (p = 0.03)。常规 PT 参与的可能性因临床情况而异（最高 87% 为脑血管意外后状态，最低 64% 为慢性阻塞性肺疾病，p < 0.001）。对这些危重患者进行的最常见的 PT 类型是功能活动再训练和治疗性运动。物理治疗师认为具有最积极影响的 PT 类型也根据临床情况而显着变化 (p < 0.001)。结论。在美国，ICU 患者通常在重病恢复期间接受 PT。然而，PT 的频率和类型因医院类型和临床情况而异。 （《重症监护医学》2009 年；37：561-568）
Objective. Patients who survive admission to the intensive care unit (ICU) commonly complain of fatigue, weakness, and poor functional status. This study sought to determine the utilization of inpatient physical therapy (PT) for patients recovering from critical illness.Design: Surveys were mailed to 9114 physical therapists from across the United States. Each survey included questions concerning staffing and availability of physical therapists for ICU patients, and the utilization of PT for six patient scenarios requiring ICU admission and mechanical ventilation.Main Results: Overall, 482 physical therapists completed their survey. The majority of hospitals (89%) at which the physical therapists were employed require a physician consultation to initiate PT for ICU patients. Established hospital criteria for the initiation of PT in the ICU were present at only 10% of the hospitals. Community hospitals were more likely to routinely provide PT on weekends compared with academic hospitals (p = 0.03). The likelihood of routine PT involvement varied significantly with the clinical scenario (highest 87% status postcerebrovascular accident, lowest 64% chronic obstructive pulmonary disease, p < 0.001). The most common types of PT that would be performed on these critically ill patients were functional mobility retraining and therapeutic exercise. The type of PT identified by the physical therapists as having the most positive impact also significantly varied according to the clinical scenario (p < 0.001).Conclusions. PT is commonly administered to ICU patients during the recovery from critical illness in the United States. However, the frequency and the type of PT significantly varies based on the type of hospital and the clinical scenario. (Crit Care Med 2009; 37:561-568)