Department of Physical Therapy and Human Movement Science, Sacred Heart University, Fairfield, CT, USA.
Physical Therapy, Gaylord Specialty Healthcare, Wallingford, CT, USA.
Physiother Theory Pract. 2022 Dec;38(12):2019-2028. doi: 10.1080/09593985.2021.1898065. Epub 2021 Mar 12.
Outcome measures (OMs) have been emphasized by healthcare professions to optimize patient examination; however, a lack of regular use of OMs exists. The purpose of this study was to describe the outcome of a knowledge translation (KT) intervention to increase the use of OMs by physical therapists in an inpatient rehabilitation setting.
A quasi-experimental pre-post study design was used. A multi-component KT intervention including education, organizational support, documentation, and environmental changes to increase the use of five OMs was implemented. Audit and feedback (A&F) was added to the KT intervention at month 6. Documented use of OMs was determined through manual chart audit (n = 864) and electronically (n = 2599). Regression analyses were used to identify factors associated with OMs use across time and diagnoses.
Following the addition of A&F to the KT intervention at month 6, there was a significant increase in the odds of OMs use across all time intervals (months 6-12, 12-18, 18-24)(Odds Ratio (OR) 5.9, 95% Confidence Interval (CI) 4.1-8.5; OR 8.5, 95% CI 6.0-12.1; OR 10.8, 95% CI 7.6-15). There was also a significant increase in the odds of documenting OMs on individuals with neurological diagnoses (OR 0.3, 95% CI 0.5-0.8).
This KT intervention increased and sustained OMs use over 24-months. This intervention can be replicated to improve the evidence-based practices of physical therapists.
医疗保健专业人员强调使用结局测量(OMs)来优化患者检查;然而,OMs 的使用并不常见。本研究的目的是描述一项知识转化(KT)干预措施的结果,以增加物理治疗师在住院康复环境中使用 OMs 的情况。
采用准实验前后研究设计。实施了一项多组分 KT 干预措施,包括教育、组织支持、文档记录以及环境改变,以增加五种 OMs 的使用。在第 6 个月时增加了审核和反馈(A&F)。通过手动图表审核(n=864)和电子方式(n=2599)确定 OMs 的使用情况。回归分析用于确定与 OMs 使用相关的因素随时间和诊断的变化。
在第 6 个月时将 A&F 添加到 KT 干预措施中后,在所有时间间隔(6-12 个月、12-18 个月、18-24 个月)使用 OMs 的几率显著增加(优势比(OR)5.9,95%置信区间(CI)4.1-8.5;OR 8.5,95%CI 6.0-12.1;OR 10.8,95%CI 7.6-15)。在记录神经诊断个体的 OMs 方面,也显著增加了几率(OR 0.3,95%CI 0.5-0.8)。
这项 KT 干预措施在 24 个月内增加并维持了 OMs 的使用。可以复制这种干预措施,以改善物理治疗师的循证实践。