Delivery of Physiotherapy Services in a Critical Care Setting in Nigerian Hospitals: The Challenges

Abstract

Nigerian hospitals continue to experience evolving roles of physiotherapists in the critical care arena, and there are hurdles to scale to develop high quality of critical care services. The Physiotherapist as a member of the critical care multidisciplinary team manages patients in the critical care unit of hospitals by using multisystem assessment to formulate individualized treatment plan. Such treatments often contributes to decreased Intensive Care Unit (ICU) and hospital stay, and improved physical function of patients. There is therefore, need for Nigerian physiotherapists to consolidate on gains already achieved, by identifying any gaps in their ICU service, closing these gaps, and further improving quality of service. This study examined the challenges faced by physiotherapists in delivering critical care service in Nigerian hospitals. Methods: Structured questionnaires were piloted, modified and administered to the physiotherapists during the annual conference of the Nigerian Society of Physiotherapists, 2016. The questionnaire contained questions regarding staffing, availability of equipment, referral and the like, in Likert scale form. Each challenge item was scored. Scores above the mean score were considered as a challenge to physiotherapy services in the ICU Results: Of the 150 physiotherapists who received the questionnaires, 90 completed the questionnaire (response rate of 60%). Respondents identified poor knowledge of critical care (3 .16±0.98), poor staffing (3.6±1.21), rotation of physiotherapists (3.19±1.08), lack of equipment (3.57±1.19), lack of team work (3.11±1.25), and poor referral (3.41±1.20) as challenges to physiotherapy service in the ICU Conclusion: This study identified many challenges to efficient physiotherapy ICU service in Nigeria. We suggest that hospitals should explore measures and strategies to overcome these challenges, so as to further improve patients' outcome in ICU care.

Expert consensus on the minimum clinical standards of practice for Nigerian physiotherapists working in intensive care units: A modified Delphi study

“…Hence, participants were given up to 2 weeks to complete the questionnaire for each round. The critical care capacity, resources and manpower are relatively low and limited in Nigeria compared with developed countries, [32] so the number of physiotherapists who were available for recruitment was relatively small. Future studies should focus on testing the knowledge of physiotherapists working in the ICU contained in the ‘essential items’ reaching consensus with a view to ascertaining specific areas of need in this environment.…”