Current Physiotherapy Practice in Intensive Care Units Needs Cultural and Organizational Changes: An Observational Cross-Sectional Study in Two Albanian University Hospitals

Shpata, Vjollca; Kreka, Manika; Tani, Klejda

doi:10.2147/jmdh.s319236

Cited by 5 publications

(12 citation statements)

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“…However, in more than 90% of the rehabilitation teams, the presence of the physiotherapist is encouraging, compared to realities in other countries, similar in development (20).…”

Section: Discussionmentioning

confidence: 94%

“…Based on this, there are different European experiences (16,17), and, as such, EM has been recommended by scientific societies around the world (17,18). There is also experience in low-income countries, as reported by Shpata, which may be more similar to what happens in Latin America, where health professionals deal with challenges such as poverty, low salaries, and low quality of employment (19,20). Additionally, health systems vary across Latin American countries, and a mix of public and private ICUs exist, sometimes with uneven resource distribution (21).…”

Section: Introductionmentioning

confidence: 83%

“…Our results are similar to high-income developed countries, such as the German and Swiss experiences that describe the same professionals primarily involved ( 24 , 25 ). However, in more than 90% of the rehabilitation teams, the presence of the physiotherapist is encouraging, compared to realities in other countries, similar in development ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

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Early mobilization in intensive care unit in Latin America: A survey based on clinical practice

et al. 2022

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BackgroundThe application of early mobilization (EM) in intensive care units (ICUs) has shown to improve the physical and ventilatory status of critically ill patients, even after ICU stay. This study aimed to describe the practices regarding EM in ICUs in Latin America.MethodsWe conducted an observational, cross-sectional study of professionals from all countries in Latin America. Over 3 months, professionals working in ICU units in Latin America were invited to answer the survey, which was designed by an expert committee and incorporated preliminary questions based on studies about EM recommendations.ResultsAs many as 174 health professionals from 17 countries completed the survey. The interventions carried out within each ICU were active mobilization (90.5%), passive mobilization (85.0%), manual and instrumental techniques for drainage of mucus secretion (81.8%), and positioning techniques (81%). The professionals who most participated in the rehabilitation process in ICUs were physiotherapists (98.7%), intensive care physicians (61.6%), nurses (56.1%), and respiratory therapists (43.8%). In only 36.1% of the ICUs, protocols were established to determine when a patient should begin EM. In 38.1% of the cases, the onset of EM was established by individual evaluation, and in 25.0% of the cases, it was the medical indication to start rehabilitation and EM.ConclusionThis report shows us that EM of critically ill patients is an established practice in our ICUs like in other developed countries.

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“…However, in more than 90% of the rehabilitation teams, the presence of the physiotherapist is encouraging, compared to realities in other countries, similar in development (20).…”

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Early mobilization in intensive care unit in Latin America: A survey based on clinical practice

et al. 2022

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“…An electronic self-reporting survey (online supplement) was designed on SurveyMonkey (Momentive, Inc., San Mateo, California, United States) by the first author, F.K. The survey included questions used in previous international surveys and was designed to address the specific objectives of our study (Berney et al 2013 ; Norrenberg & Vincent 2000 ; Shpata et al 2021 ; Skinner et al 2008 ). Questions on the organisation and structure included questions on the number of hospital beds in the hospital in which the department was based; who is responsible for running the physiotherapy department; the total number of physiotherapists working in the respective departments; the number of physiotherapists in each job rank category (e.g.…”

Section: Methodsmentioning

confidence: 99%

“…Physiotherapists are trained to provide quality care which could improve patient outcomes with minimal cost to the healthcare budget, thereby improving efficiency in the healthcare system (Morris et al 2021 ). However, globally, many variations in the role and practices of physiotherapists in the management of patients in intensive care have been reported (Berney, Haines & Denehy 2012 ; Lottering & Van Aswegen 2016 ; Norrenberg & Vincent 2000 ; Shpata, Kreka & Tani 2021 ). While work has been done internationally and locally to define and standardise the physiotherapy provided in ICU (Hanekom et al 2015 ; Skinner et al 2016 ; Twose, Jones & Cornell 2019 ; Van Aswegen et al 2017 ), it is important to understand the context within which hospital-based physiotherapy departments, who are responsible for providing a service to ICUs in SA, function.…”

Section: Introductionmentioning

confidence: 99%

Public sector physiotherapists’ organisation and profile: Implications for intensive care service

Karachi

Gosselink

Hanekom

2023

S. Afr. j. physiother.

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Background: Physiotherapists are essential in the management of hospitalised patients. The way in which a physiotherapy service is offered in intensive care units (ICUs) can affect ICU patient outcomes.Objectives: To provide a clear picture of the organisation and structure of physiotherapy departments, the number and types of ICUs requiring physiotherapy services and the profile of physiotherapists working in South African public-sector central, regional and tertiary hospitals that house Level I–IV ICUs.Method: Cross-sectional survey design using SurveyMonkey, analysed descriptively.Results: One hundred and seventy units (the majority Level I, functioning as mixed [37%, n = 58] and neonatal [22%, n = 37] units) are serviced by 66 physiotherapy departments. The majority of physiotherapists (61.5%, n = 265) were younger than 30 years, had a bachelor’s degree (95.1%, n = 408) and were employed in production Level I and community service posts (51%, n = 217) with a physiotherapy-to-hospital-bed ratio of 1:69.Conclusion: Insight into the organisational structure of physiotherapy departments and physiotherapists working in public-sector hospitals with ICU facilities in South Africa was provided. It is evident that physiotherapists employed within this sector are young and early in their career development. The large number of ICUs functioning within these hospitals and high bed-to-physiotherapist ratio is concerning, highlighting the high burden of care within this sector and the possible effect on physiotherapy services in the ICUs.Clinical implications: A high burden of care is placed on public-sector hospital-based physiotherapists. The number of senior-level posts within this sector raises concern. It is not clear how the current staffing levels, physiotherapist profile and structure of hospital-based physiotherapy departments affect patient outcomes.

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Status quo and influencing factors of multiprofessional and multidisciplinary teamwork for early mobilization in mechanically ventilated patients in ICUs: A multi‐centre survey study

Wang,

Lv,

Zhang

et al. 2024

Journal of Advanced Nursing

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AimTo understand the status quo of multiprofessional and multidisciplinary collaboration for early mobilization of mechanically ventilated patients in Chinese ICUs and identify any factors that may influence this practice.DesignA multi‐centre cross‐sectional survey.MethodsFrom October to November 2022, the convenience sampling method was used to select ICU multiprofessional and multidisciplinary early mobility members (including physicians, nurses and physiotherapists) from 27 tertiary general hospitals in 14 provinces, cities and autonomous regions of China. They were asked to complete an author‐developed questionnaire on the status of collaboration and the Assessment of Inter‐professional Team Collaboration Scale. A multiple linear regression model was used to analyse the factors associated with the level of collaboration.ResultsPhysicians, nurses and physiotherapists mostly suffered from the lack of normative protocols, unclear division of responsibilities and unclear multiprofessional and multidisciplinary teams when using a collaborative approach to early activities. Multiple linear regression analysis showed that the number of ICU patients managed, the existence of norms and processes, the attitude of colleagues around them, the establishment of a team, communication methods and activity leaders were significant influences on the level of collaboration among members of the multiprofessional and multidisciplinary early activities.ConclusionThe collaboration of multiprofessional and multidisciplinary early activity members for mechanically ventilated patients in the ICU remains unclear, and the collaboration strategy needs to be constructed and improved, taking into account China's human resources and each region's economic development level.ImpactThis study investigates the collaboration status of multiprofessional and multidisciplinary activity members from the perspective of teamwork, analyses the reasons affecting the level of collaboration and helps to develop better teamwork strategies to facilitate the implementation of early activities.Patient or Public ContributionThe participants in this study were multiprofessional and multidisciplinary medical staff who performed early activities for ICU patients.

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Current Physiotherapy Practice in Intensive Care Units Needs Cultural and Organizational Changes: An Observational Cross-Sectional Study in Two Albanian University Hospitals

Cited by 5 publications

References 46 publications

Early mobilization in intensive care unit in Latin America: A survey based on clinical practice

Early mobilization in intensive care unit in Latin America: A survey based on clinical practice

Public sector physiotherapists’ organisation and profile: Implications for intensive care service

Status quo and influencing factors of multiprofessional and multidisciplinary teamwork for early mobilization in mechanically ventilated patients in ICUs: A multi‐centre survey study

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