Cardiorespiratory Physiotherapy around the Clock: Experience at a University Hospital

Abstract

Purpose: To document and describe the use of a hospital-wide, 24-hour cardiorespiratory physiotherapy service run by an intensive care unit (ICU) team of physiotherapists. Methods: We prospectively collected data on all non-ICU hospital patients who used the 24-hours-per-day cardiorespiratory physiotherapy service over a 1-year period between July 2013 and June 2014. The ICU physiotherapists documented the reason, origin of referral, time of call, and type and frequency of treatment of each patient. Results: Over the 1-year period, the ICU physiotherapists administered 2,192 out-of-hours cardiorespiratory physiotherapy treatments (n=685 patients) outside the ICU. Most referrals originated from the emergency department (25%), the cardiopulmonary transplant unit (20%), and the pulmonology department (16%). Referrals were from a physiotherapist in 49% of cases, from a nurse in 32%, and from a physician in 19%. Of these, 89% were made between 4:00 p.m. and 8:00 a.m., and sputum retention was the most frequent reason (86%). Conclusion: Although proving its cost effectiveness is difficult, organizing a 24-hours-per-day, 7-days-per-week cardiorespiratory physiotherapy service in a large hospital is feasible.

Development of a Medium Care Unit Using an Inexperienced Respiratory Staff: Lessons Learned during the COVID-19 Pandemic

“…The physiotherapist/patient ratio was 1.5:12, although one physiotherapist was present in the unit 24 h a day to monitor the patients. The presence of a physiotherapist at night is usual in our hospital [ 41 ]; however, during this period, a specific physiotherapist was engaged for the COVID-19 and MC units to support the management of CPAPs, respiratory distress and other respiratory emergencies.…”

Clinician's Commentary on Devroey et al.

“…Devroey and colleagues 1 did not mention mobility practices at their site; this would have been a useful and interesting addition to the article.…”

An investigation of the pragmatic implementation of weekend rehabilitation services in Australia

“…On-call or extended hours of physiotherapy enables more patients to be seen or patients to be seen multiple times during the day (Ntoumenopoulos & Greenwood, 1996), as well as managing cardiorespiratory and orthopaedic patients requiring physiotherapy beyond usual working hours (Gough & Doherty, 2007). This service model is usually implemented in the acute setting, which allows physiotherapists more continuous management of acute respiratory conditions and complications occurring outside normal business hours (Devroey, Buyse, Norrenberg, Ros, & Vincent, 2016). This is especially relevant as the hospital system is structured to provide care 24 hours a day, not just during business hours.…”