The Utilization of Vital Signs During Physical Therapy Evaluation and Intervention After Elective Total Joint Replacement: A Mixed-Methods Pilot Study

Abstract

Background: Previous literature in physical therapy has suggested that vital signs (VS) are not used as often as is recommended in clinical practice. However, this finding has not been established in the immediate postorthopedic surgery population, and physical therapy practitioners' views toward VS assessment in this population have not been previously examined. Therefore, the purpose of the current study was to (1) determine how often VS are measured via chart review, (2) describe attitudes, inclinations, and factors that may influence VS measurement by physical therapist practitioners, and (3) provide an explanation for the use or nonuse of VS in an immediate postorthopedic surgical population. Methods: This was a mixed-methods study with 2 phases. Phase 1 (quantitative) involved a retrospective chart review of 50 patients treated after total joint arthroplasty. Phase 2 (qualitative) involved interviewing 2 physical therapists and 1 physical therapist assistant who had treated patients in phase 1 to provide an explanation for phase 1 data. Quantitative analysis was performed on phase 1 data, and qualitative analyses were performed on phase 2 data. These data were subsequently corroborated. Results: Vital signs were documented on only 29 occasions over 134 therapy sessions. No correlation was found between comorbidities and VS assessment. Five major themes were induced from the qualitative data. Discussion: The results of this study suggest that physical therapy practitioners may practice in a manner that is inconsistent with their beliefs with respect to the assessment of VS for patients following total joint arthroplasty. Multiple explanatory mechanisms for VS utilization are suggested by physical therapy clinicians.