The COVID-19 pandemic overwhelmed hospital systems. Frontline workers, including physical therapists, experienced multiple challenges impacting job satisfaction. The Professional Quality of Life (ProQOL) measures constructs related to workplace quality of life.
Purpose: To describe levels of compassion satisfaction and compassion fatigue (consisting of burnout and secondary trauma) among a similar cohort of acute care physical therapy staff prior to and approximately 1 year into the pandemic.
Methods: Cross-sectional online survey methodology using the ProQOL was completed. A convenience sample of acute care physical therapy professionals employed at a large Midwestern academic medical center was surveyed at separate time points in 2018 (prepandemic) and 2021 (pandemic).
Results: A total of 54 (2018) and 53 (2021) acute care physical therapy professionals completed the survey. Overall, respondents reported moderate to high levels of compassion satisfaction with low to moderate levels of burnout and secondary trauma at both periods, consistent with other previously reported health care professionals. However, the respondents exhibited a shift toward worsening compassion fatigue, with increasing levels of burnout and secondary traumatic stress, and a decreased level of compassion satisfaction.
Conclusions: Describing the professional quality of life in a cohort of acute care physical therapy professionals before and during the pandemic provides a foundation of further understanding burnout and secondary traumatic stress. Future studies could be completed longitudinally to track changes in acute care physical therapy staff and explore effective support strategies.
Although inspiratory muscle training (IMT) has been used in outpatient settings for patients who recovered from COVID-19 respiratory failure, little data exist to support earlier implementation in acute care hospitals. This study aimed to assess the safety and feasibility of IMT during the acute disease phase of COVID-19.
Design setting and patients: Sixty patients presenting with COVID-19 to a single academic medical center were randomized to control or intervention groups using systematic randomization.
Measurements: Participants in the control group had their maximal inspiratory pressure (MIP) measured at enrollment and hospital discharge. They were also asked for their rating of perceived exertion on the Revised Borg Scale for Grading Severity of Dyspnea and were scored by researchers on the Activity Measure for Post-Acute Care (AM-PAC) 6-Clicks Mobility Scale and the Intensive Care Unit Mobility Scale (IMS). Control group patients otherwise received standard care. Participants in the intervention group, in addition to the measures described previously, received inspiratory threshold trainers with the goal of doing 2 sessions daily with a physical therapist for the duration of their inpatient hospitalization. In these sessions, the patient completed 3 sets of 10 breaths with the trainer. Initial resistance was set at 30% of their MIP, with resistance increasing 1 level for the subsequent session if the patients rated their during-activity rating of perceived exertion as less than 2. Changes in functional outcome measures, amount of supplemental oxygen, hospital length of stay (LOS), discharge location, adverse events, and mortality were assessed in group comparisons.
Results: Of 60 enrolled patients, 41 (n = 19 in intervention and n = 22 in control) were included in the final data set, which required completion of the study, initial and discharge data points collected, and survival of hospitalization. Final groups were statistically similar. A total of 161 sessions of IMT were completed among the 19 patients in the intervention group. Mortality totaled 2 in the control group and 3 in the intervention group and adverse events during intervention occurred in only 3 (1.8%) sessions, all of which were minor oxygen desaturations. Sessions were unable to be completed for all potential reasons 11% of possible times. Dropout rate in the intervention group was 3 (10%). Both intervention and control groups demonstrated improved MIP, decreased supplemental oxygen requirements, improved function on the AM-PAC, and slightly decreased function on the IMS. Length of stay was shorter in the intervention group, and discharge disposition was similar between groups.
Conclusions: With a low number of recorded adverse events, similar mortality between groups, and successful completion of 161 exercise sessions, IMT may be a feasible and safe intervention for some hosp
This case report describes interprofessional collaborative practice experiences through the viewpoints of 3 acute care physical therapists who worked with patients with coronavirus disease-2019 (COVID-19) during the early months of the pandemic.
Methods: The cases presented in this case report were selected from a larger longitudinal qualitative multiple-case study investigating interprofessional collaborative practice experiences of physical therapists employed in inpatient settings prior to and during the pandemic. The cases provide detailed narrative descriptions of interprofessional collaborative practice before and during the pandemic from the perspective of 3 physical therapists working in acute care environments.
Results: The 3 physical therapists reported challenges to and opportunities for interprofessional collaborative practices that align with the 4 interprofessional educational competencies (values/ethics, roles/responsibilities, communication, and teams/teamwork).
Conclusions: The ability to provide patient-centered care through interprofessional collaborative practices was impacted by the COVID-19 pandemic. The rich narrative descriptions of our participants' experiences as members of interprofessional teams provide additional insight regarding the effect of the COVID-19 pandemic on interprofessional collaborative practice.
The purpose of this scoping review is to describe current clinical practice guidelines (CPGs) for early rehabilitation for individuals hospitalized in an intensive care unit with COVID-19 and examine practice patterns for implementation of mobility-related interventions.
Methods: PubMed, EMBASE, and CINAHL databases were searched from January 1, 2020, through April 1, 2022. Selected studies included individuals hospitalized with severe COVID-19 and provided objective criteria for clinical decision making for mobility interventions. A total of 1464 publications were assessed for eligibility and data extraction. The PRISMA-ScR Checklist and established guidelines for reporting for scoping reviews were followed.
Results: Twelve articles met inclusion criteria: 5 CPGs and 7 implementation articles. Objective clinical criteria and guidelines for implementation of early rehabilitation demonstrated variable agreement across systems. No significant adverse events were reported.
Conclusions: Sixty percent (3/5) of CPGs restrict mobility for individuals requiring ventilatory support of more than 60% Fio2 (fraction of inspired oxygen) and/or positive end-expiratory pressure (PEEP) greater than 10-cm H2O (positive end-expiratory pressure). Preliminary evidence from implementation studies may suggest that some individuals with COVID-19 requiring enhanced ventilatory support outside of established parameters may be able to safely participate in mobility-related interventions, though further research is needed to determine safety and feasibility to guide clinical decision making.
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：