Role of physical therapists in the weaning and extubation procedures of pediatric and neonatal intensive care units: a survey

Bacci, Suzi Laine Longo dos Santos; Pereira, Janser Moura; Chagas, Amanda Cristina da Silva; Carvalho, Lais Ribeiro; Azevedo, Vívian Mara Gonçalves de Oliveira

doi:10.1016/j.bjpt.2018.08.012

Cited by 7 publications

(6 citation statements)

References 28 publications

(26 reference statements)

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“…A particularly intractable issue impacting consistency of care was availability of medical staff to undertake relevant tasks. In line with evidence of the benefits to be accrued from greater involvement of other suitably trained clinical staff in intensive care [46][47][48], our evidence upholds the value of ANPs and physiotherapists in mitigating the absence of medical cover.…”

Section: Plos Onesupporting

confidence: 72%

Delivery of a novel intervention to facilitate liberation from mechanical ventilation in paediatric intensive care: A process evaluation

Jordan,

Tume,

Clarke

et al. 2023

PLoS ONE

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Background Prolonged mechanical ventilation increases the risk of mortality and morbidity. Optimising sedation and early testing for possible liberation from invasive mechanical ventilation (IMV) has been shown to reduce time on the ventilator. Alongside a multicentre trial of sedation and ventilation weaning, we conducted a mixed method process evaluation to understand how the intervention content and delivery was linked to trial outcomes. Methods 10,495 children admitted to 18 paediatric intensive care units (ICUs) in the United Kingdom participated in a stepped-wedge, cluster randomised controlled trial, with 1955 clinical staff trained to deliver the intervention. The intervention comprised assessment and optimisation of sedation levels, and bedside screening of respiratory parameters to indicate readiness for a spontaneous breathing trial prior to liberation from ventilation. 193 clinical staff were interviewed towards the end of the trial. Interview data were thematically analysed, and quantitative adherence data were analysed using descriptive statistics. Results The intervention led to a reduced duration of IMV (adjusted median difference– 7.1 hours, 95% CI -9.6 to -5.3, p = 0.01). Overall intervention adherence was 75% (range 59–85%). Ease and flexibility of the intervention promoted it use; designated responsibilities, explicit pathways of decision-making and a shared language for communication fostered proactivity and consistency towards extubation. Delivery of the intervention was hindered by established hospital and unit organisational and patient care routines, clinician preference and absence of clinical leadership. Conclusions The SANDWICH trial showed a significant, although small, reduction in duration of IMV. Findings suggest that greater direction in decision-making pathways, robust embedment of new practice in unit routine, and capitalising on the skills of Advanced Nurse Practitioners and physiotherapists would have contributed to greater intervention effect. Trial registration isrctn.org Identifier: ISRCTN16998143.

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Section: Plos Onesupporting

confidence: 72%

Delivery of a novel intervention to facilitate liberation from mechanical ventilation in paediatric intensive care: A process evaluation

Jordan,

Tume,

Clarke

et al. 2023

PLoS ONE

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“…In contrast, in only 12% of the PICUs was weaning conducted by the multidisciplinary team (including nurses). ( 20 )…”

Section: Weaning Management - a Multiprofessional Issuementioning

confidence: 99%

Pediatric ventilation weaning

Lourenção

Carvalho

2020

Revista Brasileira De Terapia Intensiva

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“…(DABER; JACKSON, 1987;GOGNIAT et al, 2019) The respiratory aid removal process and extubation follow the same trend as the other tasks presented, the majority of physiotherapists in South America (77%) perform this procedure in their work routine, in line with that shown by some authors. (BACCI et al, 2019;PIOTTO et al, 2011) However, in other continents a small minority does it.…”

Section: Página3159mentioning

confidence: 99%

The Role of Physiotherapist in Hospitals Around the World: Use of Linkedin as a Support to Research

Blancato

Motta

2020

Rev. Elet. Gestão e Serviços

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This study aimed to determine the differences and similarities in the functions performed by hospital physical therapists from different countries. For this, a questionnaire was developed, in which physiotherapists were asked which interventions they perform in their work, this questionnaire was distributed through the LinkedIn social network to physical therapy professionals who work in hospitals around the world. Altogether, 185 physical therapists answered the survey, and this way, it was found that there are important differences in the role performed by the physiotherapists according to their location, and the main functions of physiotherapists are the prescription of physical exercises and chest therapy.

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Role of physical therapists in the weaning and extubation procedures of pediatric and neonatal intensive care units: a survey

Abstract: In this survey, intensive care units using physical therapy assistance 24h/7 days per week were associated with the use of a mechanical ventilation weaning protocol, an extubation decision and success commonly on the first attempt of extubation.

Cited by 7 publications

References 28 publications

Delivery of a novel intervention to facilitate liberation from mechanical ventilation in paediatric intensive care: A process evaluation

Delivery of a novel intervention to facilitate liberation from mechanical ventilation in paediatric intensive care: A process evaluation

Pediatric ventilation weaning

The Role of Physiotherapist in Hospitals Around the World: Use of Linkedin as a Support to Research

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