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Improving Outcomes for Critically Ill Cardiovascular Patients Through Increased Physical Therapy Staffing.

ABSTRACT: OBJECTIVE:To examine the effect of increasing physical therapy (PT) staff in a cardiovascular intensive care unit (CVICU) on temporal measures of PT interventions and on outcomes important to patients and hospitals. DESIGN:Retrospective pre/post subgroup analysis from a quality improvement initiative. SETTING:Academic medical center. PARTICIPANTS:Cardiovascular patients in either a baseline (N=52) or quality improvement period (N=62) with a CVICU length of stay (LOS) ?7 days and use of any one of the following: mechanical ventilation, continuous renal replacement therapy, or mechanical circulatory support. INTERVENTIONS:The 6-month quality improvement initiative increased CVICU-dedicated PT staff from 2 to 4. MAIN OUTCOME MEASURES:Changes in physical therapy delivery were examined using the frequency and daily duration of PT intervention. Post-CVICU LOS was the primary outcome. CVICU LOS, mobility change, and discharge level of care were secondary outcomes. A secondary analysis of hospital survivors was also conducted. RESULTS:Compared to those in the baseline period, cardiovascular patients in the quality improvement period participated in PT for an additional 9.6 minutes (95% confidence interval [CI]: 1.9, 17.2) per day for all patients and 15.1 minutes (95% CI: 7.6, 22.6) for survivors. Post-CVICU LOS decreased 2.2 (95% CI: -6.0, 1.0) days for all patients and 2.6 days (95% CI: -5.3, 0.0) for survivors. CVICU LOS decreased 3.6 days (95% CI: -6.4, -0.8) for all patients and 3.1 days (95% CI: -6.4, -0.9) for survivors. Differences in mobility change and discharge level of care were not significant. CONCLUSIONS:Additional CVICU-dedicated PT staff was associated with increased PT treatment and reductions in CVICU and post-CVICU LOS. The effects of each were greatest for hospital survivors.

SUBMITTER: Johnson JK

PROVIDER: S-EPMC6348132 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Improving Outcomes for Critically Ill Cardiovascular Patients Through Increased Physical Therapy Staffing.

Johnson Joshua K JK Lohse Bryan B Bento Haley A HA Noren Christopher S CS Marcus Robin L RL Tonna Joseph E JE

Archives of physical medicine and rehabilitation 20180830 2

<h4>Objective</h4>To examine the effect of increasing physical therapy (PT) staff in a cardiovascular intensive care unit (CVICU) on temporal measures of PT interventions and on outcomes important to patients and hospitals.<h4>Design</h4>Retrospective pre/post subgroup analysis from a quality improvement initiative.<h4>Setting</h4>Academic medical center.<h4>Participants</h4>Cardiovascular patients in either a baseline (N=52) or quality improvement period (N=62) with a CVICU length of stay (LOS) ...[more]

PMID: 30172645

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Improving Outcomes for Critically Ill Cardiovascular Patients Through Increased Physical Therapy Staffing.

Publications

Improving Outcomes for Critically Ill Cardiovascular Patients Through Increased Physical Therapy Staffing.

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