A Survey of Physiotherapists' Current Practice with Closed Suction Systems in Adult Patients

Cross, Jane

doi:10.1080/14038190120851

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…7,8 Such limitations result in lowquality evidence that is of limited clinical value. Surveys have indicated that NSI has been used extensively with patients requiring suction; [11][12][13] 39% of physiotherapists and 43% of respiratory therapists in Canada have reported using it routinely, and 46% and 51% respectively have reported using it sometimes.…”

Section: Introductionmentioning

confidence: 99%

Consensus among Physiotherapists in the United Kingdom on the Use of Normal Saline Instillation Prior to Endotracheal Suction: A Delphi Study

Roberts

2009

Physiotherapy Canada

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Purpose: To investigate whether physiotherapists consider normal saline instillation (NSI) useful before endotracheal suctioning and, if so, when. Methods: Sixty-eight respiratory physiotherapists recruited from the United Kingdom's Association of Chartered Physiotherapists in Respiratory Care agreed to participate in a Delphi study. Clinicians' opinion of when NSI should be used was established and developed into statements. Level of agreement with each statement was collated through three rounds of a questionnaire. Clinicians' experiences were also reported. Results: From the 52 responses to the third questionnaire, there was consensus that respiratory physiotherapists in the United Kingdom would use NSI when sputum retention is a problem, particularly when treatment options are limited (96%) and when sputum is obstructing the airway (92%). They agreed that non-bronchoscopic bronchoalveolar lavage can be used to resolve persistent atelectasis (70%). They would not use NSI for a test treatment during initial assessment without evidence of retained secretions (94%), when secretions are copious but can be cleared by alternative physiotherapy techniques (96%), to enhance a cough unless very strong evidence indicates retained secretions (81%), or to compensate for inadequate suction technique (90%). Conclusion: This study provides clinicians' views about when NSI could be used.Key Words: Delphi study, intensive care, physiotherapy, saline, suction

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Section: Introductionmentioning

confidence: 99%

Consensus among Physiotherapists in the United Kingdom on the Use of Normal Saline Instillation Prior to Endotracheal Suction: A Delphi Study

Roberts

2009

Physiotherapy Canada

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“…This section will discuss the key findings in relation to the research questions and available literature. suction has been described in adult intensive care (Cross, 2001, Ntoumenopoulos et al, 2018 and closed suction in PICU demonstrated equivalent rates of adverse events and no differences in the incidence of ventilator acquired pneumonia (Evans et al, 2014, Morrow et al, 2012. In a paediatric intensive care model using an animal research laboratory, CS was less effective than OS at removing thin and thick secretions in injured lung (Copnell et al, 2007).…”

Section: Discussionmentioning

confidence: 97%

Identifying and Understanding Risk Factors for Instability and Adverse Events Associated With Chest Physiotherapy in Ventilated Children

2019

CMR

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BackgroundChest physiotherapy is a treatment option for ventilated children. Evidence supporting treatment effectiveness is limited and the safety profile is unknown.This study aimed to identify and understand risk factors for physiological instability and adverse events associated with chest physiotherapy in ventilated children. MethodsThis was a convergent mixed methods study.Work package 1: Explanatory sequential study to describe current physiotherapy practice and explore decision making, utilising an anonymous questionnaire, semi-structured interviews, focus groups, and document analysis. Work package 2:Retrospective single-centre study, using high-resolution data and electronic patient records. Mechanically ventilated children, aged 0-4 years, receiving chest physiotherapy were included. The primary outcome was oxygen saturation index (OSI). Incidence of adverse events (change ≥0.3) in the 60 minutes post-physiotherapy was investigated. ResultsThe questionnaire was sent to 26/27 (96%) UK paediatric intensive care units, with a response rate of 61% (72/118). Sixteen physiotherapist interviews and two focus groups (n=7) were completed. Twenty-nine organisational documents were analysed. The most frequently used techniques were position changes, saline instillation, manual hyperinflations and chest wall vibrations. Variation in practice included the personnel involved in treatments. Clinical decision making was described as complex, iterative, and collaborative, with experience and expertise important factors. OSI data were available for 247 patients. OSI adverse event rates were between 7.4%-9.3%. The highest rate was recorded in the 5 minutes immediately post-ARDS Acute respiratory distress syndrome ASL Airway surface liquid BD Twice daily CAQDAS Computer assisted qualitative data analysis software CF Cystic Fibrosis CICU Cardiac intensive care unit CO2 Carbon dioxide COPD Chronic obstructive pulmonary disease COVID19 Severe acute respiratory syndrome coronavirus 2 2019 pandemic CPB Cardiopulmonary bypass CPT Chest physiotherapy CS Closed suction CVVH Continuous veno-venous haemofiltration CWV Chest wall vibrations CXR Chest x-ray

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Outcomes research in the ICU: An aid in defining the role of physiotherapy

Hanekom¹,

Faure²,

Coetzee³

2007

Physiotherapy Theory and Practice

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The economic reality of consumers, funders, and regulatory agencies demanding evidence regarding the quality of care patients are receiving in the intensive care unit (ICU) will have an effect on many of the routinely used practices in ICU, including physiotherapy. Outcomes research is a method that has been used to obtain evidence for the medical and respiratory management of patients in ICU. An overview of the literature was conducted to answer the following questions: 1. What is outcomes research? 2. Which outcomes should be measured in the adult critical care environment? 3. Which outcomes are physiotherapists currently including in research reports? Outcomes research is recognized by critical care specialists as a cost-effective method of determining what works in the real world. The value of physiologic measures is questioned, whereas the importance of patient centered, economic, and traditionally accepted outcome measures is increasingly being recognized. Most physiotherapy research reports still include physiologic measurements as the primary outcome of an intervention. Outcomes research provides researchers with the tools to define the role of the physiotherapist in the critical care environment. The outcomes measured must be relevant to patients, families, and funders.

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A Survey of Physiotherapists' Current Practice with Closed Suction Systems in Adult Patients

Cited by 4 publications

References 18 publications

Consensus among Physiotherapists in the United Kingdom on the Use of Normal Saline Instillation Prior to Endotracheal Suction: A Delphi Study

Consensus among Physiotherapists in the United Kingdom on the Use of Normal Saline Instillation Prior to Endotracheal Suction: A Delphi Study

Identifying and Understanding Risk Factors for Instability and Adverse Events Associated With Chest Physiotherapy in Ventilated Children

Outcomes research in the ICU: An aid in defining the role of physiotherapy

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