Journal of Acute Care Physical Therapy最新文献

{"title":"Partial Substitution of Simulation-Based Learning Allows Equal Student Self-confidence in the Acute Care Setting","authors":"Daniel C. Dale, E. Perlow, Ann M. Lucado","doi":"10.1097/JAT.0000000000000199","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000199","url":null,"abstract":"Purpose: This study examines whether 20% substitution of a simulation-based learning experience (SBLE) during a physical therapist (PT) education integrated clinical experience (ICE) produces differences in student confidence in the acute care setting. Methods: Twenty-one students were randomized into 2 groups. The control group received the traditional 5 days of ICE. The experimental group received 4 days of ICE and 1 day of SBLE focused on the acute care setting. Students were administered the Acute Care Confidence Survey (ACCS) at the beginning, midterm, and conclusion of the semester. Statistical methods were used to examine within- and between-group differences in the ACCS. Results: Eleven of 15 items on the ACCS did not demonstrate any significant difference in change of scores between groups at midterm. Four items related to psychomotor-based skills showed a significant difference, with the group receiving simulation showing greater improvements in confidence scores at midterm. Acute care confidence improved significantly in both groups over time; however, no significant difference between groups was observed in self-reported confidence levels by the end of the semester. Conclusion: Health care simulation has the potential to increase the self-confidence of students in the acute care setting and should be further examined to see whether SBLE could potentially supplement or substitute ICE days in PT education.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"14 1","pages":"10 - 17"},"PeriodicalIF":0.5,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45660807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapt and Fear Less","authors":"Kristin Curry Greenwood","doi":"10.1097/jat.0000000000000189","DOIUrl":"https://doi.org/10.1097/jat.0000000000000189","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42440139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception and Utilization of Standardized Outcome Measures in Acute Care Physical Therapy","authors":"Darby Smith, M. Furtado, Gregory Brusola","doi":"10.1097/JAT.0000000000000191","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000191","url":null,"abstract":"Purpose: To assess the relationship between characteristics of acute care physical therapists (PTs) and use of standardized outcome measures (OMs); also describe the perceived barriers, facilitators, and resources to the use of OMs by PTs in the acute care setting. Methods: An electronic survey was distributed to PTs who currently work, or have worked, in the adult acute care setting in the past 5 years. Separate quantitative and qualitative analyses were performed followed by triangulation of findings. Results: A convenience sample included 227 respondents. Most respondents (n = 159, 70%) reported using OMs. PTs with a clinical specialty used OMs significantly more (P = .041) than those without. No significant difference was found in the frequency of OM use between years of experience, entry-level degree, and primary patient population. The top barrier was lack of time (60%). The top facilitator was support from administration (81%). Themes generated for barriers, facilitators, and resources included lack of resources, setting specificity, patient population and acuity, objective data, facility support, and continuing education. Conclusions: Most acute care PTs reported using OMs, although a higher frequency was observed in those with a clinical specialty. This study presents opportunities to provide knowledge translation and resources to combat barriers to OM use in the acute care setting.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"13 1","pages":"174 - 181"},"PeriodicalIF":0.5,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45862002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Extracorporeal Membrane Oxygenation Education Vary in Entry-Level Doctor of Physical Therapy Programs","authors":"Jenna Driscoll, J. Elkins","doi":"10.1097/JAT.0000000000000188","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000188","url":null,"abstract":"Background/Purpose: Extracorporeal membrane oxygenation (ECMO) with high risks of mismanagement is being used more frequently in critical care for cardiorespiratory failure. The safety and feasibility of physical therapy (PT) for patients on ECMO have been established. Little is known about ECMO education and training for entry-level physical therapist students. The purpose of this study is to determine the characteristics of ECMO education in entry-level doctor of physical therapy (DPT) educational programs and examine any correlations among these characteristics. Methods: A survey was developed on the basis of a literature search and author experience. The anonymous survey was disseminated electronically to directors of all Commission on Accreditation in Physical Therapy Education (CAPTE)–accredited DPT programs in the United States. Results: Faculty from 31 (12.8%) programs responded. Some level of ECMO-related education was included in 25 (80.65%) programs. Content of didactic education varied across programs. Other modes of ECMO education included case study discussions, simulation training, and hands-on experience. Statistically significant relationships were identified among university affiliation with an academic medical center and the presence of case studies (n = 6, P < .05) and hands-on experience (n = 8, P = .001), as well as between instructor cardiovascular and pulmonary specialist credentials and the presence of hands-on experience (n = 12, P < .001). Discussion/Conclusion: The extent and characteristics of ECMO-related education vary among entry-level DPT programs. Programs affiliated with academic medical centers and specialty-certified instructors may provide exposure to broader critical care content, such as ECMO. Formalized curricular guidelines may be necessary to help adequately prepare students for clinical practice. Entry-level clinicians should advocate for advanced training when appropriate.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"13 1","pages":"159 - 165"},"PeriodicalIF":0.5,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44016279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Balance Measures as Poststroke Predictors of Ambulation Status at Discharge From Inpatient Rehabilitation","authors":"Olivia M B Berry, Christina Voigtmann, C. Curran, Nicole T. Dawson, J. Domínguez, Morris C. Beato","doi":"10.1097/JAT.0000000000000186","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000186","url":null,"abstract":"Purpose: Early predictors of the degree of walking ability poststroke are vital considering the decreased length of stay in most inpatient rehabilitation facilities (IRFs). Prediction of functional walking capability upon discharge from IRFs requires more investigation. This study aimed to (1) determine whether the Postural Assessment Scale for Stroke (PASS) and the Berg Balance Scale (BBS) can predict an individual's IRF discharge poststroke gait category and (2) establish cut-off scores for these assessments to better forecast gait category upon discharge. Methods: A total of 180 individuals with an admitting stroke diagnosis were assessed with both balance measures and the 10-m walking test at admission and discharge from inpatient rehabilitation. Participants were stratified by gait speed into 4 groups (nonambulators: 0 m/s; household ambulators: <0.4 m/s; limited community ambulators: 0.4-0.8 m/s; and community ambulators: >0.8 m/s). Results: Both the admission PASS and the BBS scores may predict patients who will be ambulatory and performed similarly in differentiating between gait classifications upon discharge from inpatient rehabilitation (P < .01). Cut-off scores of 6 or less on the BBS (sensitivity 96%; specificity 83%) and 17 on the PASS (sensitivity 92%; specificity 90%) were established to predict nonambulators, and cut-off scores of 29 or more on the BBS (sensitivity 92%; specificity 86%) and 30 on the PASS (sensitivity 80%; specificity 87%) were established to predict community ambulators. Conclusions: These results can inform clinicians of poststroke patients' walking prognosis and advise discharge needs early in a patient's IRF stay.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"13 1","pages":"126 - 134"},"PeriodicalIF":0.5,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43806064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Snapshot in Time","authors":"Traci L. Norris","doi":"10.1097/jat.0000000000000187","DOIUrl":"https://doi.org/10.1097/jat.0000000000000187","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44605279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Improvement During Prolonged Hospitalization in a Patient With Acute Myeloid Leukemia Utilizing Physical and Occupational Therapy Comanagement","authors":"J. Strikwerda, Emily A. Bodensteiner Schmitt","doi":"10.1097/JAT.0000000000000184","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000184","url":null,"abstract":"Background and Purpose: Being physically active and mobile in the acute care setting has been shown to improve functional outcomes in individuals with cancer. Patient participation in occupational (OT) and physical therapy (PT) activities contributes to this; however, specific interventions and strategies are rarely described in the rehabilitation literature. Even more limited are descriptions of the purpose and implementation of OT and PT cotreatment therapy sessions. This case report describes OT and PT treatment interventions, including cotreatment therapy sessions, used in the management of a patient with prolonged hospitalization. Case Description: A 65-year-old man with a medical diagnosis of acute myeloid leukemia was admitted to the hospital for abdominal pain, dehydration, and poor appetite. His hospital course totaled 101 days and included 27 days in the intensive care unit (ICU). Medical complications included graft-versus-host disease and recurrent gastrointestinal bleeding. At therapy evaluation, voluntary motor activation was not visualized or felt during transfers. The patient had impaired balance and impaired cognition, and he needed total assistance to sit at the edge of the bed. Intervention: The patient received 13 weeks of OT and PT treatment in the ICU and continued until hospital discharge. OT and PT cotreatment therapy sessions were used throughout this period of patient care to maximize the patient's recovery of mobility and endurance. Results: At hospital discharge, the patient was independent in bed mobility and ambulation using a 4-wheeled walker. He was able to navigate 6 stair steps using handrails. For activities of daily living, he was independent in grooming, upper body dressing, toileting, lower body dressing, and showering from a seated position. Discussion: The use of both cotreatment and individual therapy sessions may be beneficial for individuals with cancer at different stages of functional recovery in the acute care setting. Cotreatment therapy sessions were used in this case when both OT and PT providers could address their different therapy goals during the same treatment session. The patient in this case report initially required total assistance for functional mobility and activity and achieved near-full independence at hospital discharge.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"13 1","pages":"145 - 151"},"PeriodicalIF":0.5,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43779129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Active Rehabilitation in a Patient During and After Venovenous Extracorporeal Membrane Oxygenation With a Diagnosis of COVID-19: A Case Report.","authors":"Eric M Andersen,&nbsp;Tara L Kelly,&nbsp;Amanda Sharp,&nbsp;Manda L Keller-Ross,&nbsp;Melissa E Brunsvold","doi":"10.1097/JAT.0000000000000164","DOIUrl":"10.1097/JAT.0000000000000164","url":null,"abstract":"<p><strong>Purpose: </strong>The coronavirus disease-2019 (COVID-19) pandemic has resulted in an influx of critically ill patients requiring mechanical ventilation, some receiving venovenous (VV) extracorporeal membrane oxygenation (ECMO). The benefits of early mobility while undergoing ECMO have been previously documented. However, the COVID-19 pandemic has presented physical therapists with novel challenges, balancing the risk of a widespread shortage of personal protective equipment (PPE) with the benefits of early mobility for patients on ECMO. The purpose of this case study is to report the successful rehabilitation of a critically ill patient with COVID-19 undergoing VV ECMO.</p><p><strong>Methods: </strong>This is a case description of a 38-year-old man who presented to the hospital with COVID-19 and subsequent intubation and cannulation for VV ECMO. Physical therapy was initiated while the patient remained critically ill on VV ECMO. Focused coordination and education were employed to limit PPE usage by limiting the number of essential staff/therapists that entered the room as well as changing the frequency of therapy sessions dependent on how the patient was progressing functionally.</p><p><strong>Results: </strong>On VV ECMO day 11, he was able to sit up and perform a sit-to-stand. ECMO decannulation occurred on hospital day 14 with extubation on hospital day 18. The patient progressed functionally while quarantined in the room until he was discharged home with supplemental oxygen after spending 29 days in the hospital.</p><p><strong>Conclusion: </strong>This case study demonstrates the clinical decision-making used to provide physical therapy services for a critically ill patient with COVID-19. High-level team coordination resulted in limiting the use of PPE as well as reducing staff exposure frequency during rehabilitation. Despite his severe critical illness, the patient was successfully discharged home within 30 days.</p>","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"13 1","pages":"8-15"},"PeriodicalIF":0.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670079/pdf/jat-13-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39616382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Characteristics and Acute PT and OT Utilization During the Initial Surge of COVID-19: A Retrospective Observational Study.","authors":"Adele Myszenski, Romina Bello, Cynthia Melican, Nanette Pfitzenmaier","doi":"10.1097/JAT.0000000000000163","DOIUrl":"10.1097/JAT.0000000000000163","url":null,"abstract":"<p><strong>Objective: </strong>To describe the characteristics of patients and investigate the utilization of physical (PT) and occupational therapy (OT) intervention for those with a positive coronavirus disease-2019 (COVID-19) diagnosis compared with other patient populations during the first 6 weeks of the novel coronavirus pandemic.</p><p><strong>Methods: </strong>A retrospective, observational study of adult inpatients with a length of stay of 1 or more days at an urban hospital in Detroit, Michigan. Individuals with a COVID-19 diagnosis were compared with a cohort within similar diagnostic categories (respiratory, fever, and sepsis) but without COVID-19. Outcome measures included PT or OT intervention on 1 or more days, the timing of initial PT or OT visit, the average number of visits and units per patient, length of stay, discharge to home, and readmission within 30 days.</p><p><strong>Results: </strong>Individuals with COVID-19 had lower rates of discharge to home (<i>P</i> = .001), higher rates of readmission within 30 days of hospital discharge (<i>P</i> = .01), increased hospital length of stay (<i>P</i> = .001), and waited an average of 3.1 days longer for therapy evaluations than subjects in the comparison group (<i>P</i> = .001). The percentage of subjects who had one or more PT or OT visits during their hospital stays was comparable between groups. Once therapy was initiated, the average number of visits per patient and dosing of units in 15-minute increments were similar between the 2 groups.</p><p><strong>Conclusions: </strong>Patients acutely ill with COVID-19 hospitalized with the virus during the first 6 weeks of the pandemic remained in the intensive care unit and hospital longer than their counterparts without COVID-19 and had a delay in initiation of PT and OT intervention. PT and OT are important members of the care team for patients with the novel coronavirus. Understanding the descriptive characteristics of patients and therapy services during the initial surge could help improve utilization and patient outcomes.</p>","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"13 1","pages":"2-7"},"PeriodicalIF":0.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670083/pdf/jat-13-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39616380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hitting the Reset Button in 2022","authors":"Traci L. Norris","doi":"10.1097/jat.0000000000000185","DOIUrl":"https://doi.org/10.1097/jat.0000000000000185","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43157103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}