Accuracy of Assignment of Orthopedic Inpatients to Receive Weekend Physical Therapy Services in an Acute Care Hospital

2006 ◽  
Vol 58 (3) ◽  
pp. 221-232
Author(s):  
Lisa Taylor ◽  
Kristen Goodman ◽  
Daniela Soares ◽  
Heather Carr ◽  
Gina Peixoto ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Therapy Services ◽  
To Receive ◽  
Physical Therapy Services

scholarly journals Early Physical Therapist Interventions for Patients With COVID-19 in the Acute Care Hospital: A Case Report Series

2020 ◽  
Author(s):  
Sabrina Eggmann ◽  
Angela Kindler ◽  
Andrea Perren ◽  
Natalie Ott ◽  
Frauke Johannes ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Critically Ill ◽  
Acute Care ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Treatment Strategies ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Potential Treatment ◽  
Prone Positioning

Abstract Objective The aim of this case series was to describe the experience of Swiss physical therapists in the treatment of patients with COVID-19 during their acute care hospital stay and to discuss challenges and potential strategies in the clinical management of these patients. Methods We report 11 cases of patients with COVID-19 from five Swiss hospitals that illustrate the various indications for physical therapy, clinical challenges, potential treatment methods and short-term response to treatment. Results Physical therapists actively treated patients with COVID-19 on wards and in the ICU. Interventions ranged from patient education, to prone positioning, to early mobilization and respiratory therapy. Patients were often unstable with quick exacerbation of symptoms and a slow and fluctuant recovery. Additionally, many patients who are critically ill developed severe weakness, post-extubation dysphagia, weaning failure or presented with anxiety or delirium. In this setting, physical therapy was challenging and required specialized and individualized therapeutic strategies. Most patients adopted the proposed treatment strategies and lung function and physical strength improved over time. Conclusion Physical therapists clearly have a role in the COVID-19 pandemic. Based on our experience in Switzerland, we recommend that physical therapists routinely screen and assess patients for respiratory symptoms and exercise tolerance on acute wards. Treatment of patients who are critically ill should start as soon as possible to limit further sequelae. More research is needed for awake prone positioning, early breathing exercises as well as post-COVID rehabilitation. Impact To date there are few data on the physical therapist management of patients with COVID-19. This article is among the first to describe the role of physical therapists in the complex pandemic environment and to describe the potential treatment strategies for countering the various challenges in the treatment of these patients.

Pediatric End-of-Life Care for Taiwanese Children Who Died As a Result of Cancer From 2001 Through 2006

2011 ◽  
Vol 29 (7) ◽  
pp. 890-894 ◽  
Author(s):  
Siew Tzuh Tang ◽  
Yen-Ni Hung ◽  
Tsang-Wu Liu ◽  
Dong-Tsamn Lin ◽  
Yueh-Chih Chen ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
Acute Care ◽  
Pediatric Cancer ◽  
Hospice Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Pediatric Cancer Patients ◽  
Eol Care ◽  
To Receive

Purpose Patterns of aggressive end-of-life (EOL) care have not been extensively explored in a pediatric cancer population, especially outside Western countries. The purpose of this population-based study was to examine trends in aggressive pediatric EOL cancer care in Taiwan. Methods Retrospective cohort study that used administrative data among 1,208 pediatric cancer decedents from 2001 through 2006. Results Taiwanese pediatric cancer patients who died in 2001 through 2006 received aggressive EOL care. The majority of these patients in their last month of life continued to receive chemotherapy (52.5%), used intensive care (57.0%), underwent intubation (40.9%), underwent mechanical ventilation (48.2%), or spent greater than 14 days (69.5%) in hospital, and they died in an acute care hospital (78.8%). Of these pediatric cancer patients, one in four received cardiopulmonary resuscitation in the month before they died, and only 7.2% received hospice care. Among those who received hospice care, 21.8% started such care within the last 3 days of life. This pattern of aggressive EOL care did not change over the study period except for significantly decreased intubation in the last month of life. Conclusion Continued chemotherapy and heavy use of life-sustaining treatments in the last month of life coupled with lack of hospice care to support Taiwanese pediatric cancer patients dying at home may lead to multiple unplanned health care encounters, prolonged hospitalization at EOL, and eventual death in an acute care hospital for the majority of these patients. Future research should design interventions that enable Taiwanese pediatric cancer patients to receive EOL care that best meets the individual or the parental needs and preferences.

scholarly journals Determining Current Physical Therapist Management of Hip Fracture in an Acute Care Hospital and Physical Therapists' Rationale for This Management

2011 ◽  
Vol 91 (10) ◽  
pp. 1490-1502 ◽  
Author(s):  
Susie Thomas ◽  
Shylie Mackintosh ◽  
Julie Halbert
Keyword(s):  
Hip Fracture ◽  
Physical Therapy ◽  
Acute Care ◽  
Best Practice ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Acute Care Hospital ◽  
Early Mobilization ◽  
Care Hospital ◽  
Retrospective Case

Background Physical therapy has an important role in hip fracture rehabilitation to address issues of mobility and function, yet current best practice guidelines fail to make recommendations for specific physical therapy interventions beyond the first 24 hours postsurgery. Objectives The aims of this study were: (1) to gain an understanding of current physical therapist practice in an Australian acute care setting and (2) to determine what physical therapists consider to be best practice physical therapist management and their rationale for their assessment and treatment techniques. Design and Methods Three focus group interviews were conducted with physical therapists and physical therapist students, as well as a retrospective case note audit of 51 patients who had undergone surgery for hip fracture. Results Beyond early mobilization and a thorough day 1 postoperative assessment, great variability in what was considered to be best practice management was displayed. Senior physical therapists considered previous clinical experience to be more important than available research evidence, and junior physical therapists modeled their behavior on that of senior physical therapists. The amount of therapy provided to patients during their acute inpatient stay varied considerably, and none of the patients audited were seen on every day of their admission. Conclusions Current physical therapist management in the acute setting for patients following hip fracture varies and is driven by system pressures as opposed to evidence-based practice.

Outcomes of Patients Receiving Physical Therapy at a Long Term Acute Care Hospital (LTACH)

2011 ◽  
Vol 2 (3) ◽  
pp. 120
Author(s):  
A. Thrush ◽  
M. Rozek ◽  
J. Dekerlegand ◽  
K. OʼDonnell ◽  
S. Klunk
Keyword(s):  
Physical Therapy ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital

scholarly journals Predictors of the Use of Physical Therapy Services Among Patients With Rheumatoid Arthritis

2011 ◽  
Vol 91 (1) ◽  
pp. 65-76 ◽  
Author(s):  
Maura D. Iversen ◽  
Ritu K. Chhabriya ◽  
Nancy Shadick
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Therapy ◽  
Disease Activity ◽  
Service Use ◽  
College Education ◽  
Therapy Services ◽  
To Receive ◽  
Therapy Service ◽  
Physical Therapy Services

Background Although physical therapy is a proven and recommended intervention for managing rheumatoid arthritis (RA), few studies have explored correlates of physical therapy service use among people with RA. Objective The purposes of this study were: (1) to describe physical therapy use among people with RA and (2) to identify biopsychosocial factors associated with physical therapy use. It was expected that use of physical therapy services would be lower than previously reported, considering recent medical advancements, and that including contextual factors may lead to identification of new factors associated with physical therapy use. Design This was a cohort study. Methods Of 1,032 patients prospectively recruited from a large hospital registry, 772 completed baseline and laboratory assessments, received a physical examination, and completed a 1-year follow-up survey regarding physical therapy service use. Measures included: demographics (ie, age, sex, marital status, race, employment, disability status, insurance, income, comorbidities, and education), disease duration, RA medications, self-efficacy (assessed with the Arthritis Self-Efficacy Scale), social support (assessed with the Berkman-Syme Social Network Index), function (assessed with the Multi-Dimensional Health Assessment Questionnaire), and disease activity (assessed with the Rheumatoid Arthritis Disease Activity Index). Self-reported use of physical therapy (yes/no) was assessed at the 1-year follow-up. A staged regression approach, based on a theoretical model, was used to select and enter variables into the regression to develop a parsimonious set of predictors. Results The patients were well educated and had modestly high incomes, and most had health insurance. Approximately 15.3% of the patients used physical therapy services during the designated follow-up period. Using multivariable modeling, the most significant predictors of physical therapy service use were moderate to high disease activity (odds ratio [OR]=1.4, 95% confidence interval [CI]=1.1–1.8), less than a college education (OR=0.5, 95% CI=0.2–0.8), greater social networks (OR=2.1, 95% CI=1.3–3.5), and being on disability (OR=2.4, 95% CI=1.3–4.6). Limitations The limitations of this study were use of a convenience sample and the potential for misclassification of physical therapy service use. Conclusions Patients with less than college education were less likely to receive physical therapy services, and those with more active disease, those who were on disability, and those who had greater social networks were more likely to receive physical therapy services.

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