Predictive Factors for Physiotherapy Session Length at an Adult Intensive Care Unit: A Longitudinal Panel Study
•Patients’ characteristics are associated with physiotherapists’ workload in the ICU.•A service structure should be considered for human resource allocation.•Evidence-based recommendations should guide the caseload of ICU physiotherapists. To identify predictive factors for the length of physiothera...
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Veröffentlicht in: | Archives of physical medicine and rehabilitation 2024-07, Vol.105 (7), p.1275-1281 |
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Zusammenfassung: | •Patients’ characteristics are associated with physiotherapists’ workload in the ICU.•A service structure should be considered for human resource allocation.•Evidence-based recommendations should guide the caseload of ICU physiotherapists.
To identify predictive factors for the length of physiotherapy sessions for adult intensive care unit (ICU) patients.
Longitudinal panel study.
ICU of a secondary-care public teaching hospital, the University Hospital at the University of Sao Paulo, Brazil.
Medical and surgical patients who received physiotherapy (N=181) assessed in 339 physiotherapy sessions.
Interventions:Not applicable.
The study investigator followed physiotherapists during their work shift and timed the physiotherapy session's length with a stopwatch. The association between session length and patient, physiotherapist, and service-related factors was evaluated by a mixed model.
Assessed in this study were 339 physiotherapy sessions during 79 periods of observation that involved 181 patients and 19 physiotherapists. Median session length was 29 (interquartile range: 22.6-38.9) minutes; median number of patients assisted per physiotherapist per 6-hour shift was 5 (4-5). Physiotherapist's median age was 35 (26-39) years old, and median ICU experience was 13.0 (0.4-16.0) years. Patients were mostly older adults who were post surgery and had been at the ICU for 5 (2-9) days. Factors associated with physiotherapy session length (min) were the following: performing both motor- and respiratory-related physiotherapy procedures during the session (β=6.5; 95% confidence interval [CI], 3.8-9.2), altered chest x-ray (β=2.8; 95% CI, 0.3-5.3), ICU mobility scale (IMS) (β=1.2; 95% CI, 0.4-2.0), contraindication to any level of out-of-bed mobilization (β=–6.9; 95% CI, –10.5 to –3.3), afternoon shift (β=–4.0; 95% CI, –6.7 to –1.4), and Barthel index (β=–0.2; 95% CI, –0.3 to –0.1).
The factors associated with longer session lengths were performing both motor- and respiratory-related physiotherapy procedures during the session, altered chest x-ray, and the IMS. Contraindication to any level of out-of-bed mobilization and sessions performed during the afternoon shift (vs the morning shift) were associated with shorter session lengths. |
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ISSN: | 0003-9993 1532-821X 1532-821X |
DOI: | 10.1016/j.apmr.2024.01.025 |