The University of Notre Dame Australia, School of Physiotherapy, 19 Mouat Street (PO Box 1225), Fremantle, WA 6959, Australia; Fiona Stanley Hospital Perth, Intensive Care Unit, Locked Bag 100, Palmyra DC, WA 6961, Australia.
Curtin University, School of Physiotherapy and Exercise Science, Kent Street, Bentley Perth, WA 6102, Australia.
Intensive Crit Care Nurs. 2020 Oct;60:102854. doi: 10.1016/j.iccn.2020.102854. Epub 2020 May 22.
To conduct multidisciplinary peer-review of expert consensus statements for respiratory physiotherapy for invasively ventilated adults with community-acquired pneumonia, to determine clinical acceptability for development into a clinical practice guideline.
A qualitative study was undertaken using focus groups (n = 3) conducted with clinician representatives from five Australian states. Participants were senior intensive care physiotherapists, nurses and consultants. Thematic analysis was used, with a deductive approach to confirm clinical validity, and inductive analysis to identify new themes relevant to the application of the 38 statements into practice.
Adult intensive care.
Senior intensive care clinicians from physiotherapy (n = 16), medicine (n = 6) and nursing (n = 4) participated. All concurred that the consensus statements added valuable guidance to practice; twenty-nine (76%) were deemed relevant and applicable for the intensive care setting without amendment, with modifications suggested for remaining nine statements to enhance utility. Overarching themes of patient safety, teamwork and communication and culture were identified as factors influencing clinical application. Cultural differences in practice, particularly related to patient positioning, was evident between jurisdictions. Participants raised practicality and safety concerns for two statements related to the use of head-down patient positioning.
Multidisciplinary peer-review established clinical validity of expert consensus statements for implementation with invasively ventilated adults with community-acquired pneumonia.
对社区获得性肺炎有创通气成人呼吸物理治疗的专家共识声明进行多学科同行评议，以确定其是否适合制定为临床实践指南。
采用定性研究方法，对来自澳大利亚五个州的临床医生代表进行焦点小组讨论（n=3）。参与者包括高级重症监护物理治疗师、护士和顾问。采用主题分析法，采用演绎法确认临床有效性，并采用归纳法确定与 38 条声明在实践中应用相关的新主题。
成人重症监护病房。
来自物理治疗（n=16）、医学（n=6）和护理（n=4）的高级重症监护临床医生参加了会议。所有人都认为共识声明为实践提供了有价值的指导；29 项（76%）被认为与重症监护环境相关且适用，无需修改，其余 9 项则建议修改以提高实用性。影响临床应用的因素包括患者安全、团队合作和沟通以及文化。在实践中存在文化差异，特别是在患者体位方面，不同司法管辖区之间存在差异。与会者对与头低位患者体位相关的两项声明的实用性和安全性提出了担忧。
多学科同行评议确立了专家共识声明在有创通气的社区获得性肺炎成人患者中的实施的临床有效性。
