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重症监护中对活动动员的认知与障碍比较:护理人员与物理治疗师的比较——单中心服务评估

Comparison of perceptions and barriers to mobilization in critical care: A comparison of nursing staff and physiotherapists-A single-site service evaluation.

作者信息

Lewis Megan, Cumming Luke, Twose Paul

机构信息

Physiotherapy Department, University of Wales, Cardiff, UK.

School of Healthcare Sciences, Cardiff University, Cardiff, UK.

出版信息

Nurs Crit Care. 2023 Nov;28(6):1196-1203. doi: 10.1111/nicc.12625. Epub 2021 Apr 5.

Abstract

BACKGROUND

Mobilization is a key component in the recovery of those admitted to critical care. However, previous research has demonstrated challenges in the implementation of mobilization within critical care, including staff knowledge, attitudes, and behaviours.

AIM

The aim of the current study was to explore the perceived barriers and limitations to mobilization from the perspective of nursing staff, and to compare these with physiotherapists.

STUDY DESIGN

Single-site service evaluation utilizing the patient mobilizations attitudes and beliefs survey for ICU and locally developed barriers to rehabilitation questionnaire.

RESULTS

About 135 participants (126 nurses and 9 physiotherapists) were invited to anonymously complete the questionnaires (either paper or electronic), with a response rate of 73.0% (n = 92) for nursing staff and 100% for physiotherapists. Nursing staff reported significantly higher perceived barriers to rehabilitation on both questionnaires when compared with physiotherapy staff, which was not associated with years of experience within critical care. Behavioural barriers were most frequent in both professions which included items such as time availability and presence of perceived contra-indications to mobilization.

CONCLUSION

Nursing staff reported greater perceived barriers to rehabilitation when compared with physiotherapists. Further quality improvement projects are now required to reduce these barriers and assist the implementation of mobilization as part of the rehabilitation process.

RELEVANCE TO CLINICAL PRACTICE

Rehabilitation is an essential element of practice within critical care. Understanding the system, local and personal barriers will allow for improvement projects to enhance the delivery of care and improve clinical outcomes.

摘要

背景

活动能力训练是重症监护病房患者康复的关键组成部分。然而,先前的研究表明,在重症监护病房实施活动能力训练存在诸多挑战,包括工作人员的知识、态度和行为等方面。

目的

本研究旨在从护士的角度探讨活动能力训练中存在的感知障碍和限制,并与物理治疗师进行比较。

研究设计

采用针对重症监护病房的患者活动能力训练态度和信念调查问卷以及本地开发的康复障碍调查问卷进行单中心服务评估。

结果

共邀请了约135名参与者(126名护士和9名物理治疗师)匿名填写问卷(纸质或电子形式),护士的回复率为73.0%(n = 92),物理治疗师的回复率为100%。与物理治疗师相比,护士在两份问卷中均报告了更高的康复感知障碍,且这与重症监护病房的工作年限无关。行为障碍在两个职业中最为常见,包括时间可用性和存在活动能力训练的感知禁忌症等项目。

结论

与物理治疗师相比,护士报告的康复感知障碍更大。现在需要进一步开展质量改进项目,以减少这些障碍,并协助将活动能力训练作为康复过程的一部分加以实施。

与临床实践的相关性

康复是重症监护病房实践的重要组成部分。了解系统、本地和个人层面的障碍将有助于开展改进项目,以提高护理质量并改善临床结果。

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