Zhang Yanting, Zhang Wei, Ma Jing, Ding Xinbo
Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei Clinical Research Center for Critical Care Medicine, Wuhan, People's Republic of China.
Risk Manag Healthc Policy. 2024 Oct 2;17:2359-2373. doi: 10.2147/RMHP.S481303. eCollection 2024.
Patients in Intensive Care Units (ICUs) face high risks of physical, functional, cognitive, and mental impairments. Early rehabilitation activities are crucial for reducing mortality and complication rates. This survey investigates the characteristics, current implementation, and detailed status of early rehabilitation activities in ICUs across Central China.
A cross-sectional survey was conducted involving 158 hospitals, with 131 responding. Data on institutional characteristics and early rehabilitation activities were collected through questionnaires. Descriptive statistical analysis described the current status, and a univariate regression model identified factors associated with the implementation of early rehabilitation measures.
A total of 131 ICUs completed the survey, with a response rate of 82.91% (131/158). Results indicated that 82.44% (108/131) of ICUs implemented early rehabilitation activities, but only 65 (49.62%) had explicit early rehabilitation exercise protocols or standards/procedures. Before implementing early rehabilitation activities, approximately 89.97% (110/131) of ICUs conducted assessments, and 46.56% (61/131) regularly held structured interdisciplinary rounds to discuss early activity measures and goals. More than half of the participating adult ICUs reported screening patients for swallowing function (64.89%; 85/131), and 55.73% (73/131) of adult ICUs reported having a nutrition therapy specialist conduct regular consultations/visits. Only 26.72% (35/131) of adult ICUs reported having a speech therapist conduct consultations/visits. A total of 81.68% (107/131) of ICUs believed that the current implementation of early rehabilitation activities was insufficient. In the analysis of influencing factors, the presence of rehabilitation therapists in the ICU was a significant factor for the implementation of early rehabilitation activities (P<0.05).
The majority of ICUs in hospitals in central China have implemented early rehabilitation activities; however, less than half have explicit early rehabilitation exercise protocols or standards/procedures. The presence of professional rehabilitation therapists in the ICU is a key factor in the implementation of early rehabilitation activities in ICUs in hospitals in Central China.
重症监护病房(ICU)的患者面临身体、功能、认知和心理障碍的高风险。早期康复活动对于降低死亡率和并发症发生率至关重要。本调查旨在研究中国中部地区ICU早期康复活动的特点、当前实施情况及详细状况。
对158家医院进行横断面调查,131家医院做出回应。通过问卷调查收集机构特征和早期康复活动的数据。描述性统计分析描述当前状况,单变量回归模型确定与早期康复措施实施相关的因素。
共有131个ICU完成调查,回应率为82.91%(131/158)。结果表明,82.44%(108/131)的ICU实施了早期康复活动,但只有65个(49.62%)有明确的早期康复运动方案或标准/程序。在实施早期康复活动之前,约89.97%(110/131)的ICU进行了评估,46.56%(61/131)定期举行结构化的多学科会诊以讨论早期活动措施和目标。超过一半的参与调查的成人ICU报告对患者进行吞咽功能筛查(64.89%;85/131),55.73%(73/131)的成人ICU报告有营养治疗专家定期进行会诊/查房。只有26.72%(35/131)的成人ICU报告有言语治疗师进行会诊/查房。共有81.68%(107/131)的ICU认为当前早期康复活动的实施不足。在影响因素分析中,ICU中有康复治疗师是早期康复活动实施的一个重要因素(P<0.05)。
中国中部地区医院中的大多数ICU已实施早期康复活动;然而,不到一半的ICU有明确的早期康复运动方案或标准/程序。ICU中有专业康复治疗师是中国中部地区医院ICU实施早期康复活动的关键因素。