Development of a physiotherapy-led bronchoscopy service: a regional hospital perspective

Lockstone, Jane; Boden, Ianthe; Zalucki, Nadia; Darvas, James; Parkes, Scott

doi:10.1071/ah19144

Cited by 5 publications

(9 citation statements)

References 15 publications

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“…It was widely acknowledged that novice practitioners needed to sequentially acquire further knowledge and skills to support any progression of their scope, in addition to their entry‐level qualification. This expectation was consistent across all professional groups and practice settings, 19,23,24,26,28–30,32,34,42–44,54,61,63,69,74,85–114 recognising that each individual's SOP will differ to a greater or lesser extent from that of their peers and professional colleagues, informed by their cumulative professional experience and additional education and training.…”

Section: Resultsmentioning

confidence: 80%

“…In this context, the vertical dimension of ‘depth’ reflected performance levels of SOP, from new graduate to experienced practitioner, whilst ‘breadth’ signified the horizontal dimension of scope applied across focused or generalist diagnostic groups, populations and clinical settings. Although increased depth of practice was often seen as equating to professional ‘specialisation’, 19,80,102,109,173,174 the Pharmaceutical Society of Australia contended that specialisation ‘ can occur without any associated enhancement in performance (p.9)’ 34 and should not be inferred as directional advancement or confused with the protected title of ‘specialist’, which is restricted for use by medical, dental and podiatry professions (as per the Health Practitioner Regulation National Law Act 2009) .…”

Section: Resultsmentioning

confidence: 99%

“…31,42,68,154 A small number of alternate conceptual models and understandings further distinguished between the vertical and horizontal dimensions of SOP change. 34,38,43,55,72,96,102,105,172 In this context, the vertical dimension of 'depth' reflected performance levels of SOP, from new graduate to experienced practitioner, whilst 'breadth' signified the horizontal dimension of scope applied across focused or generalist diagnostic groups, populations and clinical settings.…”

Section: Theme 4 Sop Is Informed By the Individual's Ongoing Training...mentioning

confidence: 99%

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How can scope of practice be described and conceptualised in medical and health professions? A systematic review for scoping and content analysis

Downie

Walsh

Kirk-Brown

et al. 2023

Health Planning & Management

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BackgroundThe term scope of practice (SOP) refers to the limits of a health professional's knowledge, skills and experience and reflects all tasks and activities they undertake within the context of their professional role. Inconsistency in definitions of SOP contributes to uncertainty and confusion regarding professional practice boundaries and potentially impacts societal access to safe, effective and efficient healthcare options. The aim of this paper is to understand the conceptual diversity that may exist in terminology used to describe medical, nursing/midwifery and allied health SOP within an Australian practice context exemplar.MethodsA systematic review for scoping and content analysis of SOP definitions and concepts, involving inductive thematic analysis and synthesis of published and grey literature.ResultsThe initial search strategy yielded 11,863 hits, of which 379 were suitable for inclusion. Data coding identified various SOP terms and definitions and the emergence of six, conceptual elements underpinning the theoretical construct. These were subsequently proposed as a preliminary conceptual model (‘Solar’) to explain how the six conceptual elements may be applied across various professions, clinical settings and jurisdictions to better understand and address current and evolving SOP issues.ConclusionThe findings of this study highlight limited consistency in SOP definitions and terminology within a single jurisdiction, and the conceptual complexity of the underlying theoretical construct. Further research is required to build on the proposed ‘Solar’ conceptual model and create a universal SOP definition across jurisdictions, to enhance understanding of the importance of SOP to workforce policy, clinical governance, service models and patient outcomes.

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Section: Resultsmentioning

confidence: 80%

Section: Resultsmentioning

confidence: 99%

Section: Theme 4 Sop Is Informed By the Individual's Ongoing Training...mentioning

confidence: 99%

See 1 more Smart Citation

How can scope of practice be described and conceptualised in medical and health professions? A systematic review for scoping and content analysis

Downie

Walsh

Kirk-Brown

et al. 2023

Health Planning & Management

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confidence: 99%

“…We previously published an article in Australian Health Review describing the implementation of a physiotherapy-led bronchoscopy service at Launceston General Hospital in Tasmania. 1 There has been increasing interest in this article from physiotherapy colleagues, and this letter hopes to address some of the questions asked.…”

mentioning

confidence: 99%

Physiotherapy-led bronchoscopy in the ICU

Lockstone

Brain

2022

Aust. Health Rev.

Self Cite

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We previously published an article in Australian Health Review describing the implementation of a physiotherapy-led bronchoscopy service at Launceston General Hospital in Tasmania. 1 There has been increasing interest in this article from physiotherapy colleagues, and this letter hopes to address some of the questions asked.From our intensive care unit (ICU) perspective, the physiotherapy-led bronchoscopy service has been well received and respected by all ICU medical and nursing staff. Due to our ICU acuity, demand can fluctuate, and the number of physiotherapy-led bronchoscopies indicated and undertaken can range from two to four procedures per week, to one per month. Since credentialing, the senior ICU physiotherapist has undertaken 48 bronchoscopies and has assisted in 10 percutaneous tracheostomy procedures by being responsible for the bronchoscopy component. There have been no major adverse events or complications during any physiotherapy-led bronchoscopies.Although evidence suggests chest physiotherapy is as effective as bronchoscopy, 2,3 we find physiotherapy-led bronchoscopy to be a valuable, time-efficient treatment for significant mucous plugging and assisting airway clearance in patients who are already sedated and occasionally paralysed and/or when other physiotherapy interventions may not be appropriate or successful. Physiotherapy-led bronchoscopies can help guide future chest physiotherapy, allows an assessment of airway integrity and can be a beneficial adjunct when used in combination with other chest physiotherapy interventions.As identified when initiating the service, patients require an increase in sedatives, topical local anaesthetic and/or addition of neuromuscular blocking agents for bronchoscopies to occur safely, which physiotherapists are unable to prescribe or administer.To overcome this, we followed recommendations, and modified existing protocols from Alfred Health, Victoria, Australia, that ensures medical staff pre-prescribe the medications required and ICU nursing staff administer them. This protocol works well in our ICU and there have been no barriers to physiotherapy-led bronchoscopies due to medication prescription/administration limitations. Another concern was implementation of a physiotherapy-led bronchoscopy service may reduce physiotherapy time and resources available to focus on other physiotherapy duties within ICU, such as early mobilisation and rehabilitation. Anecdotally, we have not observed or had any reports of practice change to patients receiving timely and appropriate physiotherapy. Rather, physiotherapy-led bronchoscopy is part of a package of lung clearance therapies that spans from diagnosis (chest X-ray and physiotherapist lung ultrasound), ventilator and pharmacologic therapies for secretion burden, chest physiotherapy and where appropriate, bronchoscopy.The senior ICU physiotherapist remains the only physiotherapist who has been credentialed in physiotherapy-led bronchoscopy. This is predominantly due to our ICU physiotherapy staffing model. We have one ...

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