Pub Date : 2021-07-01DOI: 10.1097/jat.0000000000000170
{"title":"Amended List of Reviewers for 2020","authors":"","doi":"10.1097/jat.0000000000000170","DOIUrl":"https://doi.org/10.1097/jat.0000000000000170","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47177742","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}
Pub Date : 2021-06-28DOI: 10.1097/JAT.0000000000000177
J. Skrzat, Michael Pechulis, Marcel DiFiore, Amanda Fink, George Fischer, Marian Jordan, Erika M Lebron, Alyssa Rieger
Purpose: To determine whether Functional Status Score for the Intensive Care Unit (FSS-ICU) scores acquired within 24 hours of medical-surgical intensive care unit (MSICU) discharge differ among postacute care discharge dispositions in a nonsurgical patient population. Methods: A retrospective medical record review for data collection was conducted over 12 months for patients in an MSICU. FSS-ICU scores were collected within 24 hours of MSICU discharge. Subjects were categorized into 4 postacute care discharge dispositions: home, subacute rehabilitation (SAR), inpatient rehabilitation (IP), or other. A 1-way analysis of variance and post hoc analyses were performed. Results: One hundred fifteen subjects were included. FSS-ICU scores acquired within 24 hours of MSICU discharge were significantly different (P < .001) between postacute care discharge dispositions. Post hoc analysis showed a statistically significant difference between home and SAR (P < .001), home and IP (P < .001), and home and other (P = .005). Conclusions: A difference was found in FSS-ICU scores acquired within 24 hours of MSICU discharge between home and all other postacute care discharge dispositions in a nonsurgical patient population. An FSS-ICU score less than 27 at MSICU discharge indicates that discharge planning to a postacute care discharge disposition other than home may be warranted.
{"title":"FSS-ICU Scores at ICU Discharge Differ Across Postacute Care Dispositions","authors":"J. Skrzat, Michael Pechulis, Marcel DiFiore, Amanda Fink, George Fischer, Marian Jordan, Erika M Lebron, Alyssa Rieger","doi":"10.1097/JAT.0000000000000177","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000177","url":null,"abstract":"Purpose: To determine whether Functional Status Score for the Intensive Care Unit (FSS-ICU) scores acquired within 24 hours of medical-surgical intensive care unit (MSICU) discharge differ among postacute care discharge dispositions in a nonsurgical patient population. Methods: A retrospective medical record review for data collection was conducted over 12 months for patients in an MSICU. FSS-ICU scores were collected within 24 hours of MSICU discharge. Subjects were categorized into 4 postacute care discharge dispositions: home, subacute rehabilitation (SAR), inpatient rehabilitation (IP), or other. A 1-way analysis of variance and post hoc analyses were performed. Results: One hundred fifteen subjects were included. FSS-ICU scores acquired within 24 hours of MSICU discharge were significantly different (P < .001) between postacute care discharge dispositions. Post hoc analysis showed a statistically significant difference between home and SAR (P < .001), home and IP (P < .001), and home and other (P = .005). Conclusions: A difference was found in FSS-ICU scores acquired within 24 hours of MSICU discharge between home and all other postacute care discharge dispositions in a nonsurgical patient population. An FSS-ICU score less than 27 at MSICU discharge indicates that discharge planning to a postacute care discharge disposition other than home may be warranted.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41784420","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}
Pub Date : 2021-06-24DOI: 10.1097/jat.0000000000000175
P. Ohtake
{"title":"2021 Academy of Acute Care Physical Therapy Annual Lecture Award","authors":"P. Ohtake","doi":"10.1097/jat.0000000000000175","DOIUrl":"https://doi.org/10.1097/jat.0000000000000175","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41642848","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}
Pub Date : 2021-06-24DOI: 10.1097/jat.0000000000000174
K. E. Brueilly
{"title":"Response to the April 29, 2021, Letter to the Editor","authors":"K. E. Brueilly","doi":"10.1097/jat.0000000000000174","DOIUrl":"https://doi.org/10.1097/jat.0000000000000174","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47201105","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}
Pub Date : 2021-06-09DOI: 10.1097/JAT.0000000000000169
John Corsino
Physical therapists practicing on hospital units or in emergency departments must be prepared to do more than simply treat vestibular disorders diagnosed by other providers; we need to help care teams identify the source of a dizzy patient's complaints. Because the consequences of delayed or erroneous diagnosis may be catastrophic for the dizzy patient, the evaluating therapist's responsibility is to minimize the likelihood of inaccuracy in the diagnostic process. Practice standards, which involve both examination techniques and reasoning frameworks, are not widely used. Therapists who apply these standards can reduce diagnostic error. Understanding the strategies described within is essential for therapists who evaluate acutely dizzy patients and contribute diagnostic information to care teams.
{"title":"Maximizing Effectiveness of Examination of Patients With Acute Dizziness in the Emergency Department","authors":"John Corsino","doi":"10.1097/JAT.0000000000000169","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000169","url":null,"abstract":"Physical therapists practicing on hospital units or in emergency departments must be prepared to do more than simply treat vestibular disorders diagnosed by other providers; we need to help care teams identify the source of a dizzy patient's complaints. Because the consequences of delayed or erroneous diagnosis may be catastrophic for the dizzy patient, the evaluating therapist's responsibility is to minimize the likelihood of inaccuracy in the diagnostic process. Practice standards, which involve both examination techniques and reasoning frameworks, are not widely used. Therapists who apply these standards can reduce diagnostic error. Understanding the strategies described within is essential for therapists who evaluate acutely dizzy patients and contribute diagnostic information to care teams.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47504480","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}
Pub Date : 2021-04-20DOI: 10.1097/JAT.0000000000000166
Megan J. Sabatke, Ashley M. Young, A. Johnson, J. Darbee, K. Mayer
Objective: The purpose of this study was to describe the effect of acute care curriculum changes on a university's doctor of physical therapy (DPT) graduates by aggregating quantitative data from 2 academic surveys. Methods: This was a retrospective study describing physical therapist students' perspective, confidence, and employment in acute care physical therapy using data from 2 academic surveys administered to graduates from a DPT program. Results: From 2010 to 2018, 569 students graduated from the DPT program with a median of 100% (interquartile range 97%-100.5%) response rate for the self-assessment survey and a median of 38% (interquartile range 33%-48%) completion of the graduate outcome survey. The majority of DPT graduates self-reported being at or above expected level of competence with cardiopulmonary and complex patients, which appeared to increase from 77.4% and 88.7% in 2012 to 97% and 100% in 2018, respectively. Similar increasing trends were noted with the number of first jobs in the acute care setting (+5.4%) and interest (+9.1%) in the acute care setting, but not as consistently. DPT graduates' level of comfort in the acute care setting did not change over time. Conclusions: Curricular changes devised to enhance acute care physical therapy training in a program's DPT curriculum may have led to graduates reporting increased competency in the unique skill set needed to work in this setting. DPT programs require the continued assessment of educational requirements and competencies to fulfill the growing need for physical therapists in the acute care setting.
{"title":"Strengthening the Acute Care Curriculum","authors":"Megan J. Sabatke, Ashley M. Young, A. Johnson, J. Darbee, K. Mayer","doi":"10.1097/JAT.0000000000000166","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000166","url":null,"abstract":"Objective: The purpose of this study was to describe the effect of acute care curriculum changes on a university's doctor of physical therapy (DPT) graduates by aggregating quantitative data from 2 academic surveys. Methods: This was a retrospective study describing physical therapist students' perspective, confidence, and employment in acute care physical therapy using data from 2 academic surveys administered to graduates from a DPT program. Results: From 2010 to 2018, 569 students graduated from the DPT program with a median of 100% (interquartile range 97%-100.5%) response rate for the self-assessment survey and a median of 38% (interquartile range 33%-48%) completion of the graduate outcome survey. The majority of DPT graduates self-reported being at or above expected level of competence with cardiopulmonary and complex patients, which appeared to increase from 77.4% and 88.7% in 2012 to 97% and 100% in 2018, respectively. Similar increasing trends were noted with the number of first jobs in the acute care setting (+5.4%) and interest (+9.1%) in the acute care setting, but not as consistently. DPT graduates' level of comfort in the acute care setting did not change over time. Conclusions: Curricular changes devised to enhance acute care physical therapy training in a program's DPT curriculum may have led to graduates reporting increased competency in the unique skill set needed to work in this setting. DPT programs require the continued assessment of educational requirements and competencies to fulfill the growing need for physical therapists in the acute care setting.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42809184","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}
Pub Date : 2021-04-01DOI: 10.1097/JAT.0000000000000168
Traci L. Norris
{"title":"Making a Connection","authors":"Traci L. Norris","doi":"10.1097/JAT.0000000000000168","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000168","url":null,"abstract":"","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41738024","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}
Pub Date : 2021-02-02DOI: 10.1097/JAT.0000000000000162
T. Simmons, Stephanie A Miller, E. Moore, S. J. Stikeleather
Background: Bed rest during acute hospitalization is associated with new-onset mobility impairments in community-dwelling older adults, resulting in discharge to skilled nursing facilities rather than home. Purpose: The purpose of this retrospective study is to determine whether the number of physical therapy (PT) visits is related to discharge disposition following an acute hospitalization for urinary tract infection (UTI) in the older adult population. Methods: Medical records over a 3-year period of 523 community-dwelling older adults (65 years and older) admitted from home functionally independent were reviewed. Demographic and patient characteristics, including age, gender, living status, length of stay (LOS), discharge disposition, and the number of PT visits, were collected. Multinomial regression was conducted to determine predictors of disposition. Results: The multinomial logistic regression model was statistically significant, χ2(2) = 6.90, P = .032. Older age, longer LOS with fewer PT visits during acute hospitalization, and a higher comorbidity score were significant predictors of hospital discharge to subacute rehabilitation facilities than those who were able to return home with home health PT. These variables were not predictors of the disposition for younger patients with fewer comorbidities. Limitations: Due to the retrospective nature of this study, assessment of potential preexisting levels of frailty, standardized delivery of PT, and level of activity outside of PT could not be performed. Conclusions: Reduced frequency of physical therapist intervention for older adults hospitalized with UTI was associated with discharge to rehabilitation in a skilled nursing facility compared with those of similar age with increased PT intervention frequency.
背景:在社区居住的老年人中，急性住院期间卧床休息与新发行动障碍有关，导致他们出院到专业护理机构而不是回家。目的:本回顾性研究的目的是确定老年人急性尿路感染(UTI)住院后物理治疗(PT)就诊次数是否与出院处置有关。方法:回顾了523名在社区居住的老年人(65岁及以上)3年的医疗记录。收集人口统计学和患者特征，包括年龄、性别、生活状况、住院时间(LOS)、出院处置和PT就诊次数。采用多项回归来确定倾向的预测因子。结果:多项logistic回归模型差异有统计学意义，χ2(2) = 6.90, P = 0.032。与那些能够回家接受家庭健康PT的患者相比，年龄较大、LOS较长、急性住院期间较少的PT就诊和较高的合并症评分是亚急性康复机构出院的重要预测因素。这些变量不是合并症较少的年轻患者的倾向预测因素。局限性:由于本研究的回顾性性质，无法评估潜在的先前存在的虚弱水平，PT的标准化交付和PT之外的活动水平。结论:与年龄相近但PT干预频率增加的老年人相比，因UTI住院的老年人物理治疗师干预频率减少与在专业护理机构康复出院相关。
{"title":"Physical Therapy and Discharge Disposition Following Acute Hospitalization for UTI in Community-Dwelling Older Adults","authors":"T. Simmons, Stephanie A Miller, E. Moore, S. J. Stikeleather","doi":"10.1097/JAT.0000000000000162","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000162","url":null,"abstract":"Background: Bed rest during acute hospitalization is associated with new-onset mobility impairments in community-dwelling older adults, resulting in discharge to skilled nursing facilities rather than home. Purpose: The purpose of this retrospective study is to determine whether the number of physical therapy (PT) visits is related to discharge disposition following an acute hospitalization for urinary tract infection (UTI) in the older adult population. Methods: Medical records over a 3-year period of 523 community-dwelling older adults (65 years and older) admitted from home functionally independent were reviewed. Demographic and patient characteristics, including age, gender, living status, length of stay (LOS), discharge disposition, and the number of PT visits, were collected. Multinomial regression was conducted to determine predictors of disposition. Results: The multinomial logistic regression model was statistically significant, χ2(2) = 6.90, P = .032. Older age, longer LOS with fewer PT visits during acute hospitalization, and a higher comorbidity score were significant predictors of hospital discharge to subacute rehabilitation facilities than those who were able to return home with home health PT. These variables were not predictors of the disposition for younger patients with fewer comorbidities. Limitations: Due to the retrospective nature of this study, assessment of potential preexisting levels of frailty, standardized delivery of PT, and level of activity outside of PT could not be performed. Conclusions: Reduced frequency of physical therapist intervention for older adults hospitalized with UTI was associated with discharge to rehabilitation in a skilled nursing facility compared with those of similar age with increased PT intervention frequency.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44897715","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}
Pub Date : 2021-01-13DOI: 10.1097/JAT.0000000000000161
K. Mayer, Traci Norris, Sowmya Kumble, N. Morelli, S. Gorman, P. Ohtake
Purpose: This study's primary objective is to determine the current use of outcome measures (OMs) by physical therapists practicing in acute care settings. Secondarily, this study aims to establish whether physical therapists support the development of a core OM set for use in acute care settings. Methods: An investigator-developed online survey (Qualtrics) was distributed to acute care physical therapy stakeholders, including practicing clinicians, educators, and administrators. The survey contained 4 sections with 28 questions: (1) acute care physical therapy practice patterns; (2) use of OMs in practice; (3) the development of a core OM set; and (4) demographic, education, and experience in the physical therapy profession. Descriptive statistics were used to assess response frequency and rationale for the use of specific OMs. Results: A convenience sample of 170 acute physical therapy stakeholders completed the survey. Respondents represented 38 states, with most respondents (n = 153; 90%) practicing in one or more acute care specialty areas. The majority of respondents (n = 145; 83%) reported using an OM more than 50% of the time in their practice. Physical function was the main construct (n = 163; 96%) respondents assessed with an OM. Acute care physical therapists primarily used OMs to track response to interventions (n = 134; 79%) and develop a care plan (n = 91; 54%). Length of time required to complete an OM and its clinical utility were the most common rationales for selecting an OM (n = 150, 88%; n = 147, 86%, respectively). Strong support was found for developing a core OM set for acute physical therapist practice (n = 147; 86%). The preferred methods for the organization of a core OM set, in rank order, were by diagnosis, International Classification of Functioning, Disability, and Health (ICF) framework, domains of health, and settings/location. Conclusion: Most physical therapists participating in this study of practice in acute care reported using OMs in their daily practice. This survey confirms the desire to develop a core OM set with high clinical utility for use in acute care settings.
{"title":"Acute Care Physical Therapy Practice Analysis Identifies the Need for a Core Outcome Measurement Set","authors":"K. Mayer, Traci Norris, Sowmya Kumble, N. Morelli, S. Gorman, P. Ohtake","doi":"10.1097/JAT.0000000000000161","DOIUrl":"https://doi.org/10.1097/JAT.0000000000000161","url":null,"abstract":"Purpose: This study's primary objective is to determine the current use of outcome measures (OMs) by physical therapists practicing in acute care settings. Secondarily, this study aims to establish whether physical therapists support the development of a core OM set for use in acute care settings. Methods: An investigator-developed online survey (Qualtrics) was distributed to acute care physical therapy stakeholders, including practicing clinicians, educators, and administrators. The survey contained 4 sections with 28 questions: (1) acute care physical therapy practice patterns; (2) use of OMs in practice; (3) the development of a core OM set; and (4) demographic, education, and experience in the physical therapy profession. Descriptive statistics were used to assess response frequency and rationale for the use of specific OMs. Results: A convenience sample of 170 acute physical therapy stakeholders completed the survey. Respondents represented 38 states, with most respondents (n = 153; 90%) practicing in one or more acute care specialty areas. The majority of respondents (n = 145; 83%) reported using an OM more than 50% of the time in their practice. Physical function was the main construct (n = 163; 96%) respondents assessed with an OM. Acute care physical therapists primarily used OMs to track response to interventions (n = 134; 79%) and develop a care plan (n = 91; 54%). Length of time required to complete an OM and its clinical utility were the most common rationales for selecting an OM (n = 150, 88%; n = 147, 86%, respectively). Strong support was found for developing a core OM set for acute physical therapist practice (n = 147; 86%). The preferred methods for the organization of a core OM set, in rank order, were by diagnosis, International Classification of Functioning, Disability, and Health (ICF) framework, domains of health, and settings/location. Conclusion: Most physical therapists participating in this study of practice in acute care reported using OMs in their daily practice. This survey confirms the desire to develop a core OM set with high clinical utility for use in acute care settings.","PeriodicalId":42472,"journal":{"name":"Journal of Acute Care Physical Therapy","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41684622","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}
Pub Date : 2021-01-13DOI: 10.1097/JAT.0000000000000160
Bahitha Uthup, Adele Myszenski, N. Saigh, Preethy S. Samuel
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.
{"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":null,"pages":null},"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}
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