Chest physiotherapy techniques in neurological intensive care units of India: A survey

Context:As physiotherapy (PT) is a young profession in Nepal, there is a dearth of insight into the common practices of physiotherapists in critical care.Aims:To identify the availability of PT services in Intensive Care Units (ICUs) and articulate the common practices by physiotherapists in ICUs of Nepal.Settings and Design:All tertiary care hospitals across Nepal with ICU facility via an exploratory cross-sectional survey.Subjects and Methods:An existing questionnaire was distributed to all the physiotherapists currently working in ICUs of Nepal with 2 years of experience. The survey was sent via E-mail or given in person to 86 physiotherapists.Statistical Analysis Used:Descriptive and inferential statistics according to nature of data.Results:The response rate was 60% (n = 52). In the majority of hospitals (68%), PT service was provided only after a physician consultation, and few hospitals (13%) had established hospital criteria for PT in ICUs. Private hospitals (57.1%) were providing PT service in weekends compared to government hospitals (32.1%) (P = 0.17). The likelihood of routine PT involvement varied significantly with the clinical scenarios (highest 71.2% status cerebrovascular accident, lowest 3.8% myocardial infarction, P < 0.001). The most preferred PT treatment was chest PT (53.8%) and positioning (21.2%) while least preferred was therapeutic exercise (3.8%) irrespective of clinical scenarios.Conclusions:There is a lack of regular PT service during weekends in ICUs of Nepal. Most of the cases are treated by physiotherapists only after physician's referral. The preferred intervention seems to be limited only to chest PT and physiotherapists are not practicing therapeutic exercise and functional mobility training to a great extent.

Section: Discussionmentioning

confidence: 99%

Physiotherapy practice patterns in Intensive Care Units of Nepal: A multicenter survey

Baidya

Acharya

Coppieters

2016

“…List of hospitals was generated as described elsewhere. [ 17 ] A list of hospitals was prepared by selecting the hospital only once if they were present in both the websites. A total of 152 hospitals were listed from both Medical Council of India (MCI) website ( http://www.mciindia.org ) and National Accreditation Board for Hospitals and Healthcare Providers (NABH) website ( http://www.nabh.co/ ).…”

Section: Methodsmentioning

confidence: 99%

“…This study is a part of a larger survey assessing the physiotherapy practice in neurological ICUs in India. [ 17 ]…”

Section: Introductionmentioning

confidence: 99%

Mobilization of patients in neurological Intensive Care Units of India: A survey

Bhat

Pentapati

Rao

2016

Self Cite

Context:The rehabilitation needs of the patients in neurological Intensive Care Units (ICUs) vary from that of a medical ICU patient. Early mobilization is known to improve the various neurological outcomes in patients admitted to neurological ICUs, although little is known about the practice pattern among physiotherapists. The mobilization practice pattern may vary significantly than that of developed countries due to the reasons of differences in training of professionals, availability of equipment, and financial assistance by health insurance.Aim of the Study:To study the current mobilization practices by the physiotherapists in neurological ICUs of India.Subjects and Methods:A cross-sectional survey was conducted with a content validated questionnaire about the mobilization practices. Online questionnaire was distributed to physiotherapists working in neurological ICUs of India. Descriptive statistics were used.Results:Out of 185 e-mails sent, 82 physiotherapists completed the survey (survey response rate = 44%). Eighty participants (97.6%) mentioned that the patients received some form of mobilization during the day. The majority of the physiotherapists (58.5%), “always” provided bed mobility exercises to their patients when it was found appropriate for the patients. Many physiotherapists (41.5%) used tilt table “sometimes” to introduce orthostatism for their patients.Conclusion:Mobilization in various forms is being practiced in the neurological ICUs of India. However, fewer mobilization sessions are conducted on weekends and night hours in Indian Neurological ICUs.

“…Factors influencing physiotherapy practices in Indian ICUs include awareness of techniques, availability of equipment, training or education of the physiotherapist, physiotherapist to patient ratio, presence of respiratory therapists, cultural differences, attitude of other professionals toward physiotherapy, evidence-based practice (EBP) considerations, medical management of the patient (such as sedation practices, setting ventilator parameters, and inclination for early tracheostomy), open versus closed ICUs, and case-mix of unit. [ 6 ]…”

Section: Introductionmentioning

confidence: 99%

Physiotherapy practices in Intensive Care Units across Maharashtra

Yeole

Chand

Nandi

et al. 2015

Purpose:To find out the current physiotherapy practices in Intensive Care Unit (ICU) across Maharashtra.Materials and Methods:Study design was exploratory cross-sectional survey. Questionnaires were sent to the physiotherapists working in hospitals across Maharashtra state, India. Four weeks for completion of questionnaire was given in an attempt to ensure good response rates.Result:Of 200, 73 questionnaires were received representing a 36% response rate. The study revealed that 76% of the respondents were bachelors qualified, 15% were masters in physiotherapy with only 4% specialized in cardio-respiratory physiotherapy; 82% had <5 years experience in ICU. Almost 19% had not at all attended any seminars/workshops related to ICU management while 61% attended up to three within last 2 years. The availability of a physiotherapist during the night was affirmed by 63%, 58% responded initiation of physiotherapy to be “always physician referred” and 39% mentioned “physiotherapist initiated.” Almost 80% performed chest wall techniques, 86% positioning, 27% postural drainage, 5% manual hyperinflation, 12% application of nebulizer, and 56% bedsores management. Only 5% reported involvement in ventilator setting, 11% had their opinion sought before weaning from ventilator, 29% practiced noninvasive ventilation, 11% were involved in decision-making for extubation and 44% reported involvement in patient family education.Conclusion:The study showed that physiotherapists among the responding ICUs surveyed lack in experience and updated knowledge. Physician reference is necessary to initiate physiotherapy and there exists no established criteria for physiotherapy treatment in ICU. All physiotherapists were routinely involved in chest physiotherapy, mobilization, and positioning.