Canberra Hospital Intensive Care Unit, Garran, Canberra, Australia; Australian National University Medical School, Canberra, Australia.
Australian National University Medical School, Canberra, Australia.
Aust Crit Care. 2020 May;33(3):264-271. doi: 10.1016/j.aucc.2019.05.006. Epub 2019 Aug 8.
There is scant literature on the barriers to rehabilitation for patients discharged from the intensive care unit (ICU) to acute care wards.
The objective of this study was to assess ward-based rehabilitation practices and barriers and assess knowledge and perceptions of ward clinicians regarding health concerns of ICU survivors.
METHODS, DESIGN, SETTING, AND PARTICIPANTS: This was a single-centre survey of multidisciplinary healthcare professionals caring for ICU survivors in an Australian tertiary teaching hospital.
The main outcome measures were knowledge of post-intensive care syndrome (PICS) amongst ward clinicians, perceptions of ongoing health concerns with current rehabilitation practices, and barriers to inpatient rehabilitation for ICU survivors.
The overall survey response rate was 35% (198/573 potential staff). Most respondents (66%, 126/190) were unfamiliar with the term PICS. A majority of the respondents perceived new-onset physical weakness, sleep disturbances, and delirium as common health concerns amongst ICU survivors on acute care wards. There were multifaceted barriers to patient mobilisation, with inadequate multidisciplinary staffing, lack of medical order for mobilisation, and inadequate physical space near the bed as common institutional barriers and patient frailty and cardiovascular instability as the commonly perceived patient-related barriers. A majority of the surveyed ward clinicians (66%, 115/173) would value education on health concerns of ICU survivors to provide better patient care.
There are multiple potentially modifiable barriers to the ongoing rehabilitation of ICU survivors in an acute care hospital. Addressing these barriers may have benefits for the ongoing care of ICU survivors.
关于从重症监护病房（ICU）出院到急性护理病房的患者的康复障碍，相关文献甚少。
本研究旨在评估基于病房的康复实践和障碍，并评估病房临床医生对 ICU 幸存者健康问题的知识和看法。
方法、设计、地点和参与者：这是对澳大利亚一所三级教学医院中照顾 ICU 幸存者的多学科医疗保健专业人员进行的单中心调查。
主要观察指标是病房临床医生对 ICU 后综合征（PICS）的了解程度、对当前康复实践中持续存在的健康问题的看法，以及 ICU 幸存者住院康复的障碍。
总体调查回复率为 35%（573 名潜在工作人员中有 198 名）。大多数受访者（66%，126/190）不熟悉 PICS 一词。大多数受访者认为 ICU 幸存者在急性护理病房中常见的健康问题是新出现的身体虚弱、睡眠障碍和谵妄。患者的身体移动存在多方面的障碍，主要的机构障碍包括多学科人员配备不足、缺乏移动的医疗指令，以及床边物理空间不足，而患者体弱和心血管不稳定则是常见的患者相关障碍。大多数接受调查的病房临床医生（66%，115/173）认为对 ICU 幸存者健康问题的教育将有助于更好地提供患者护理。
在急性护理医院中，ICU 幸存者持续康复存在多种潜在的可改变障碍。解决这些障碍可能对 ICU 幸存者的持续护理有益。
