Determining Current Physical Therapist Management of Hip Fracture in an Acute Care Hospital and Physical Therapists' Rationale for This Management

Thomas, Susie; Mackintosh, Shylie; Halbert, Julie

doi:10.2522/ptj.20100310

Cited by 16 publications

(8 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The literature on rehabilitation of patients not in the ICU after operative repair of traumatic hip fractures reveals that although early mobilization is seen as a priority, 39 these patients often suffer from orthostatic intolerance, putting them at increased risk of fainting, falls, and damage to prostheses. 40 How this translates to an ICU patient with polytrauma is unknown.…”

Section: Safety and Feasibility In Surgical Patientsmentioning

confidence: 99%

Acquired Neuromuscular Weakness and Early Mobilization in the Intensive Care Unit

2013

View full text Add to dashboard Cite

Survival from critical illness has improved in recent years, leading to increased attention to the sequelae of such illness. Neuromuscular weakness in the intensive care unit (ICU) is common, persistent, and has significant public health implications. The differential diagnosis of weakness in the ICU is extensive and includes critical illness neuromyopathy. Prolonged immobility and bedrest lead to catabolism and muscle atrophy, and are associated with critical illness neuromyopathy and ICU-acquired weakness. Early mobilization therapy has been advocated as a mechanism to prevent ICU-acquired weakness. Early mobilization is safe and feasible in most ICU patients, and improves outcomes. Implementation of early mobilization therapy requires changes in ICU culture, including decreased sedation and bedrest. Various technologies exist to increase compliance with early mobilization programs. Drugs targeting muscle pathways to decrease atrophy and muscle-wasting are in development. Additional research on early mobilization in the ICU is needed.

show abstract

Section: Safety and Feasibility In Surgical Patientsmentioning

confidence: 99%

Acquired Neuromuscular Weakness and Early Mobilization in the Intensive Care Unit

2013

View full text Add to dashboard Cite

show abstract

“…Coverage for skilled care in each of these locations must follow specifi c guidelines. The decision of where to send a patient for post-acute care is often made by assessing mobility status 13 and estimating how much therapy the patient can tolerate. The requirement for IRFs is to provide 3 hours of therapy daily.…”

Section: Post-acute Care: Inpatient Rehabilitation and Skilled Nursinmentioning

confidence: 99%

“…23 A recent report attempted to describe and analyze the rationale behind physical therapy acute care practice in Australian patients following hip fracture. 13 Focus group sessions involving senior, junior, and student PTs in acute care were recorded and analyzed for themes and then compared with chart audits. It is not surprising, knowing there is little evidence supporting specifi c interventions, that one theme discovered was that the majority of treatment decisions were based upon senior PT's clinical judgment and experience.…”

Section: Interventions In Acute Carementioning

confidence: 99%

Rehabilitation of Hip Fractures Across the Continuum of Care

Criss

Takacs

2013

Topics in Geriatric Rehabilitation

View full text Add to dashboard Cite

“…While most physical therapists embrace this concept in principle, the reality of integrating research evidence into everyday clinical practice has proven challenging [2-6]. One potential method for addressing this problem is the use of theoretically founded, evidence-based educational programs to improve therapists’ capacity and proclivity to use research in practice.…”

Section: Introductionmentioning

confidence: 99%

Promoting physical therapists’ use of research evidence to inform clinical practice: part 2 - a mixed methods evaluation of the PEAK program

et al. 2014

View full text Add to dashboard Cite

BackgroundClinicians need innovative educational programs to enhance their capacity for using research evidence to inform clinical decision-making. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists’ integration of research evidence into clinical decision-making. This, second of two, papers reports a mixed methods feasibility study of the PEAK program among physical therapists at three university-based clinical facilities.MethodsA convenience sample of 18 physical therapists participated in the six-month educational program. Mixed methods were used to triangulate results from pre-post quantitative data analyzed concurrently with qualitative data from semi-structured interviews and focus groups. Feasibility of the program was assessed by evaluating change in participants’ attitudes, self-efficacy, knowledge, skills, and self-reported behaviors in addition to their perceptions and reaction to the program.ResultsAll 18 therapists completed the program. The group experienced statistically significant improvements in evidence based practice self-efficacy and self-reported behavior (p < 0.001). Four themes were supported by integrated quantitative and qualitative results: 1. The collaborative nature of the PEAK program was engaging and motivating; 2. PEAK participants experienced improved self-efficacy, creating a positive cycle where success reinforces engagement with research evidence; 3. Participants’ need to understand how to interpret statistics was not fully met; 4. Participants believed that the utilization of research evidence in their clinical practice would lead to better patient outcomes.ConclusionsThe PEAK program is a feasible educational program for promoting physical therapists’ use of research evidence in practice. A key ingredient seems to be guided small group work leading to a final product that guides local practice. Further investigation is recommended to assess long-term behavior change and to compare outcomes to alternative educational models.

show abstract

Determining Current Physical Therapist Management of Hip Fracture in an Acute Care Hospital and Physical Therapists' Rationale for This Management

Abstract: Current physical therapist management in the acute setting for patients following hip fracture varies and is driven by system pressures as opposed to evidence-based practice.

Cited by 16 publications

References 39 publications

Acquired Neuromuscular Weakness and Early Mobilization in the Intensive Care Unit

Acquired Neuromuscular Weakness and Early Mobilization in the Intensive Care Unit

Rehabilitation of Hip Fractures Across the Continuum of Care

Promoting physical therapists’ use of research evidence to inform clinical practice: part 2 - a mixed methods evaluation of the PEAK program

Contact Info

Product

Resources

About