Thomas Peter, Chaseling Wendy, Marais Leanne, Matheson Claire, Paton Michelle, Swanepoel Nelmari
Royal Brisbane and Women's Hospital, Brisbane, Australia.
St George Hospital, Kogarah, Australia.
Aust Crit Care. 2025 Mar;38(2):101108. doi: 10.1016/j.aucc.2024.08.005. Epub 2024 Sep 21.
Intensive care staffing guidelines provide recommendations for the safe and effective delivery of health care while recognising professional requirements of the workforce. To guide recommendations for physiotherapy staffing guidelines, profession-specific consultation is needed.
The objective of this study was to develop consensus-based recommendations for minimum workforce standards for physiotherapy in intensive care.
A Delphi survey process was conducted involving physiotherapists from Australia and New Zealand.
The panel consisted of 65 physiotherapists in the first round and 60 in the second round (92% retention). Respondents were from both Australia (49, 76%) and New Zealand (16, 24%) who had been physiotherapists for an average of 18.8 ± 9.0 years and were primarily senior intensive care physiotherapists (44, 68%). Respondents had experience across level 3 (50, 77%), level 2 (18, 28%), and level 1 (5, 8%) adult intensive care units (ICUs), adult high-dependency units (27, 42%), and paediatric intensive care (6, 9%). A total of 42 statements were presented, with 37 reaching consensus after two rounds. After two rounds, consensus was achieved for a minimum staffing ratio in paediatric ICUs of one physiotherapist per six (1:6) beds. For adult ICUs, use of the median value of the participant's responses was supported to establish minimum staffing ratios of 1:8, 1:7, 1:6, and 1:8 for levels 1, 2, and 3 ICUs and high-dependency units, respectively. The requirement for an additional allocation for senior physiotherapist staffing for each ICU level was also established. Statements that also gained consensus included recommendations for access to on-call and weekend services for all ICU settings and the consideration of evening shifts specifically for level 3 and paediatric ICUs.
Recommendations for minimum staffing for physiotherapy in intensive care settings were achieved and supported requirements for clinical service delivery, supervision, and training.
重症监护人员配备指南为安全有效地提供医疗保健提供建议，同时认可工作人员的专业要求。为指导物理治疗人员配备指南的建议，需要进行特定专业的咨询。
本研究的目的是就重症监护中物理治疗的最低劳动力标准制定基于共识的建议。
对来自澳大利亚和新西兰的物理治疗师进行了德尔菲调查。
第一轮有65名物理治疗师参与小组，第二轮有60名（保留率92%）。受访者来自澳大利亚（49名，76%）和新西兰（16名，24%），平均从事物理治疗工作18.8±9.0年，主要是高级重症监护物理治疗师（44名，68%）。受访者有三级（50名，77%）、二级（18名，28%）和一级（5名，8%）成人重症监护病房（ICU）、成人高依赖病房（27名，42%）和儿科重症监护（6名，9%）的工作经验。共提出42条陈述，两轮后37条达成共识。两轮后，儿科ICU达成了每六张（1:6）床位配备一名物理治疗师的最低人员配备比例共识。对于成人ICU，支持采用参与者回复的中位数来确定一级、二级和三级ICU以及高依赖病房的最低人员配备比例分别为1:8、1:7、1:6和1:8。还确定了每个ICU级别额外配备高级物理治疗师的要求。达成共识的陈述还包括为所有ICU设置提供随叫随到和周末服务的建议，以及特别考虑为三级和儿科ICU安排晚班。
达成了重症监护环境中物理治疗最低人员配备的建议，并支持临床服务提供、监督和培训的要求。
