- Title
- What factors affect implementation of early rehabilitation into intensive care unit practice? A qualitative study with clinicians
- Creator
- Parry, Selina; Remedios, Louisa; Denehy, Linda; Knight, Laura; Beach, Lisa; Rollinson, Thomas; Berney, Sue; Puthucheary, Zudin; Morris, Peter; Granger, Catherine
- Date
- 2017
- Type
- Text; Journal article
- Identifier
- http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/188093
- Identifier
- vital:17208
- Identifier
-
https://doi.org/10.1016/j.jcrc.2016.11.005
- Identifier
- ISSN:0883-9441 (ISSN)
- Abstract
- Purpose To identify the barriers and enablers that influence clinicians' implementation of early rehabilitation in critical care. Materials and methods Qualitative study involving 26 multidisciplinary participants who were recruited using purposive sampling. Four focus groups were conducted using semistructured questions to explore attitudes, beliefs, and experiences. Data were transcribed verbatim and thematic analysis was performed. Results Six themes emerged, as follows: (1) the clinicians' expectations and knowledge (including rationale for rehabilitation, perceived benefits, and experience), (2) the evidence for and application of rehabilitation (including beliefs regarding when to intervene), (3) patient factors (including prognosis, sedation, delirium, cooperation, motivation, goals, and family), (4) safety considerations (including physiological stability and presence of devices or lines), (5) environmental influences (staffing, resources, equipment, time, and competing priorities), and (6) culture and teamwork. Key strategies identified to facilitate rehabilitation included addressing educational needs for all multidisciplinary team members, supporting junior nursing staff, and potential expansion of physiotherapy staffing hours to closer align with the 24-hour patient care model. Conclusions Key barriers to implementation of early rehabilitation in critical care are diverse and include both clinician- and health care system–related factors. Research targeted at bridging this evidence-practice gap is required to improve provision of rehabilitation. © 2016 Elsevier Inc.
- Publisher
- W.B. Saunders
- Relation
- Journal of Critical Care Vol. 38, no. (2017), p. 137-143
- Rights
- All metadata describing materials held in, or linked to, the repository is freely available under a CC0 licence
- Rights
- Copyright © 2016 Elsevier Inc.
- Rights
- Open Access
- Subject
- 3202 Clinical sciences; 4201 Allied health and rehabilitation science; 4205 Nursing; Barriers; Implementation, recovery of function; Intensive care; Qualitative; Rehabilitation
- Full Text
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