Journal of Acute Care Physical Therapy最新文献_第8页

Evaluating the Benefits of Early Intensive Rehabilitation for Patients With Sepsis in the Medical Intensive Care Unit: A Retrospective Study 评价重症监护室脓毒症患者早期强化康复的益处:一项回顾性研究

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Journal of Acute Care Physical Therapy Pub Date : 2021-01-13 DOI: 10.1097/JAT.0000000000000160

Bahitha Uthup, Adele Myszenski, N. Saigh, Preethy S. Samuel

{"title":"Evaluating the Benefits of Early Intensive Rehabilitation for Patients With Sepsis in the Medical Intensive Care Unit: A Retrospective Study","authors":"Bahitha Uthup, Adele Myszenski, N. Saigh, Preethy S. Samuel","doi":"10.1097/JAT.0000000000000160","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000160","url":null,"abstract":"Purpose: To evaluate the benefits of early rehabilitation intervention for patients with sepsis in a medical intensive care unit (MICU) and to identify the factors associated with positive outcomes at discharge. Methods: A retrospective review of 97 electronic medical records of patients with sepsis admitted to 2 similar-sized MICU pods of an urban tertiary care hospital was conducted. Bivariate analyses were conducted to compare the sociodemographics, length of stay, mobility level, and discharge disposition of 47 patients who received early rehabilitation intervention in MICU pod 1, with 46 patients who received standard rehabilitation intervention in MICU pod 2. In addition, multivariate analysis of the entire sample was conducted to identify the factors associated with positive discharge outcomes. Results: Patients in pod 1 had significantly higher level of mobility at discharge (mean difference = 0.80, P = .009) and a better discharge disposition (λ2 = 25.05, df = 7, P < .001) than those in pod 2. The positive outcomes of increased mobility and return to home at discharge were associated with rehabilitation intensity (F1,91 = 52.30; P < .001, b = 0.82) and rehabilitation initiation (adjusted odds ratio: 0.85, P = .039), respectively. Conclusion: These findings provide empirical support for the safety and benefits of providing early intensive rehabilitation for patients in the MICU with sepsis using a therapist-driven model of care.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"12 1","pages":"185 - 193"},"PeriodicalIF":0.5,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45602646","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}

引用次数: 2

The Utility of Mayo Clinic's Early Screen for Discharge Planning (ESDP) Tool: A Critical Narrative Review 梅奥诊所的早期筛查出院计划(ESDP)工具的效用:一个关键的叙事回顾

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Journal of Acute Care Physical Therapy Pub Date : 2021-01-13 DOI: 10.1097/JAT.0000000000000159

Caitlyn P. Socwell, Kumutha Kanagasaba, R. Pope

{"title":"The Utility of Mayo Clinic's Early Screen for Discharge Planning (ESDP) Tool: A Critical Narrative Review","authors":"Caitlyn P. Socwell, Kumutha Kanagasaba, R. Pope","doi":"10.1097/JAT.0000000000000159","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000159","url":null,"abstract":"Purpose: The aim of this critical narrative review was to identify and synthesize available research evidence on the utility of Mayo Clinic's Early Screen for Discharge Planning (ESDP) tool to (1) identify adult patients early during their hospital stay who require referral to specialized hospital discharge planning services (SHDCPS) and (2) review its utility in predicting patient outcomes including hospital length of stay (LOS), readmission risk, and discharge destination. This review also begins by highlighting the important role of physical therapists in discharge planning. Methods: A critical narrative review was conducted of relevant studies identified through a systematic search of PubMed, CINAHL, Embase, and ProQuest databases and subsequent systematic screening and selection process. Studies were included and critically appraised if they met eligibility criteria: studies investigating the development, predictive validity and utility of the ESDP in hospital patient populations, and studies comparing the ESDP with other discharge planning tools. Key data were then extracted and tabulated before a critical narrative synthesis of key findings was completed. Results: Seven studies met the eligibility criteria, with 5 studies receiving a rating of “good” quality. The included studies investigated the ESDP tool in adults within acute inpatient hospital settings, including heart failure, colorectal surgery, general medical and surgical, and oncology wards. Conclusion: Five of the 7 included studies were of good quality and, together, studies provided evidence that the ESDP tool correctly identifies adults requiring referral to SHDCPS. However, further research of the ESDP tool is recommended to account for variations observed in special populations and expand knowledge of its utility to predict outcomes such as hospital LOS, readmission risk, and discharge destination.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"13 1","pages":"24 - 44"},"PeriodicalIF":0.5,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43489973","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}

引用次数: 1

PRESIDENT'S MESSAGE 总统的消息

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Journal of Acute Care Physical Therapy Pub Date : 2021-01-01 DOI: 10.1097/jat.0000000000000158

S. Gorman

引用次数: 0

Missed Physical Therapy Treatments in the Acute Hospital: Toward a More Complete Understanding 急诊医院错过的物理治疗：走向更全面的认识

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Journal of Acute Care Physical Therapy Pub Date : 2020-12-15 DOI: 10.1097/JAT.0000000000000156

G. Shan, Stephen Johnson, J. Fertitta, Jesse Kim, P. Williams, Qing Wu, Kan Ge, J. Daruwalla, Stephen D. Benning, Daniel L. Young

{"title":"Missed Physical Therapy Treatments in the Acute Hospital: Toward a More Complete Understanding","authors":"G. Shan, Stephen Johnson, J. Fertitta, Jesse Kim, P. Williams, Qing Wu, Kan Ge, J. Daruwalla, Stephen D. Benning, Daniel L. Young","doi":"10.1097/JAT.0000000000000156","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000156","url":null,"abstract":"Introduction: Therapy sessions that do not result in treatment (nontreatment) occur in 15% to 26% of scheduled sessions. The relationship between therapist personality and nontreatment is unknown. Objective: To determine the relationship between physical therapist personality and nontreatment events in the acute hospital. Methods: The relationship between physical therapist personality (Big Five Inventory) and nontreatment was statistically modeled adjusting for other therapist and patient factors. Results: There were 522 patients and 34 physical therapists with 918 scheduled physical therapy sessions included. The average age of patients was 71 (SD = 16, range = 17-99) and 41 (SD = 7, range 27-54) for therapists. Therapists with higher openness had lower nontreatment, odds ratio 0.93; 95% confidence interval 0.87 to 0.99; P = .045. Conclusions: The positive effect of physical therapy is minimized when scheduled treatment does not occur. Lower nontreatment is associated with more trait openness. Attributes related to openness (eg, inquisitiveness and problem-solving) should be cultivated. More research is needed to understand nontreatment and guide therapists in hospital patient care.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"12 1","pages":"158 - 164"},"PeriodicalIF":0.5,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48760812","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}

引用次数: 1

An Explanatory Model for the Relationship Between Physical Therapists' Self-perceptions of Value and Care Prioritization Decisions in the Acute Hospital 急诊医院物理治疗师价值自我认知与护理优先决策关系的解释模型

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Journal of Acute Care Physical Therapy Pub Date : 2020-12-15 DOI: 10.1097/JAT.0000000000000157

Joshua K. Johnson, Daniel L. Young, R. Marcus

{"title":"An Explanatory Model for the Relationship Between Physical Therapists' Self-perceptions of Value and Care Prioritization Decisions in the Acute Hospital","authors":"Joshua K. Johnson, Daniel L. Young, R. Marcus","doi":"10.1097/JAT.0000000000000157","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000157","url":null,"abstract":"Purpose: The aim of the study was to understand how acute care physical therapists' perceptions of the value of physical therapy inform their decisions regarding which patients to treat. Methods: This was a qualitative study using a grounded theory approach. Data were collected using semistructured interviews with a purposive sample of acute hospital physical therapists in the United States. Interview transcriptions were analyzed to derive codes and identify an explanatory model. Results: Participants included 16 physical therapists from 4 hospital systems. Their descriptions indicate that care prioritization is influenced by a self-perception of value informed by both patient- and system-driven thinking. Patient-driven thinking prioritizes factors considered most important to individual patients (eg, improved functional independence). System-driven thinking prioritizes factors most important to the health system (eg, a certain patient population or productivity expectation). The relative contribution of system- and patient-driven thinking in prioritization decisions was variable from one participant to another. Conclusions: In addition to the perceived value of physical therapy for individual patients, acute hospital physical therapists integrate organization-level factors into prioritization decisions. Future research should seek to understand how this may influence practice variation and identify practice patterns that simultaneously optimize outcomes considered important by both patients and organizations.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"12 1","pages":"165 - 184"},"PeriodicalIF":0.5,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43681773","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}

引用次数: 5

Body Weight–Supported Treadmill Training in the Acute Care Setting 体重——在急性护理环境中支持跑步机训练

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Journal of Acute Care Physical Therapy Pub Date : 2020-12-14 DOI: 10.1097/JAT.0000000000000155

Roxanne L. Bakowski (White), L. Hill, P. Goslar

{"title":"Body Weight–Supported Treadmill Training in the Acute Care Setting","authors":"Roxanne L. Bakowski (White), L. Hill, P. Goslar","doi":"10.1097/JAT.0000000000000155","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000155","url":null,"abstract":"Purpose: While previous studies have investigated the use of body weight–supported treadmill training (BWSTT) at various stages post-stroke, a greater focus has been on subacute and chronic stroke populations and less on how this training intervention could be implemented in the acute stages post-stroke. The purpose of our study is to demonstrate the safety and feasibility of implementing BWSTT in the very early acute phase following ischemic stroke. Methods: One-hundred and two subjects participated in BWSTT in addition to conventional therapy sessions while in the acute care hospital. Training was initiated, on average, 3.15 days from diagnosis to the initial treadmill session. Outcome measures included heart rate, blood pressure, Mobility Scale for Acute Stroke, Trunk Control Test, gait speed, and the SF-12v2. Results: Three hundred and six sessions were completed with 102 participants. Of the sessions completed, 13 were stopped due to blood pressure measurements above set parameters and did not return to within parameters during provided rest breaks. One thousand one hundred and nineteen systolic blood pressures (SBPs) were obtained during the study. Twenty-eight SBPs fell below 100, with 2 of the 28 resulting in an adverse event. Three total adverse events occurred out of 306 individual sessions, including 2 vasovagal events and an age-indeterminate peroneal tendon tear. The adverse events noted were transient and without harmful effects, and patients could complete future BWSTT sessions. Therefore, we consider 3 stopped sessions out of 306, 0.98%, as an acceptable rate of adverse events for future studies in BWSTT in patients with very early poststroke. Conclusions: BWSTT is a safe and feasible intervention to assist with higher-level physical activity in the acute stroke population during the early recovery stages.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":"12 1","pages":"122 - 138"},"PeriodicalIF":0.5,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45160062","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}

引用次数: 1

The Role of Physical and Occupational Therapy in Pressure Injury Prevention 物理和职业治疗在压力损伤预防中的作用

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Journal of Acute Care Physical Therapy Pub Date : 2020-12-14 DOI: 10.1097/jat.0000000000000154

Stephanie Slayton, Michelle Deppisch, Lynda Kennepp, Steve Parent-Lew, Barbara Samson, Kristen Thurman

引用次数: 0

Frailty in Acute Care: Not Just Your Grandparents' Medical Condition 急性护理中的虚弱:不仅仅是你祖父母的医疗状况

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Journal of Acute Care Physical Therapy Pub Date : 2020-10-15 DOI: 10.1097/JAT.0000000000000152

Emelia Exum

引用次数: 1

The Challenge of Transforming CSM 2021 转型CSM 2021的挑战

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Journal of Acute Care Physical Therapy Pub Date : 2020-10-01 DOI: 10.1097/JAT.0000000000000151

S. Gorman

引用次数: 0

Multidisciplinary Diagnostic Reconciliation as a Domain of Hospital Physical Therapist Practice 多学科诊断和解作为医院物理治疗师实践的领域

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Journal of Acute Care Physical Therapy Pub Date : 2020-10-01 DOI: 10.1097/jat.0000000000000133

John Corsino

引用次数: 1