Abstract
Background Early mobilisation of patients in the intensive care unit (ICU) is associated with positive health benefits. Research literature lacks insight into the current status of ICU physical therapy (PT) practice in the Kingdom of Saudi Arabia. Aim To determine the current standard of ICU PT practice, attitude, and barriers. Methods A questionnaire was e-mailed to physiotherapists (PTs) working in the hospital. The questions pertained to experience, qualification, barriers, and most frequently encountered case scenarios in the ICU. Results The response rate was 28.1% (124/442). Frequent cases referred to the PTs were traumatic paraplegia (n = 111, 89%) and stroke (n = 102, 82.3%) as compared to congestive heart failure (n = 20, 16.1%) and pulmonary infections (n = 7, 5.6%). The preferred treatment of choice among PTs was chest physiotherapy (n = 102, 82.2%) and positioning (n = 73, 58.8%), whereas functional electrical stimulation (n = 12, 9.6%) was least preferred irrespective of the condition. Perceived barriers in the ICU PT management were of low confidence in managing cases (n = 89, 71.7%) followed by inadequate training (n = 53, 42.7%), and the least quoted barrier was a communication gap between the critical care team members (n = 8, 6.4%). Conclusion PTs reported significant variation in the choice of treatment for different clinical cases inside ICU. The main barriers in the ICU setting were low confidence and inadequate training.
Highlights
Patients admitted to the intensive care unit (ICU) experience multiple complications, mandating multidisciplinary teamwork [1]. e physical therapist (PT) plays an important role in promoting short-term functional independence, reducing the hospital stay, improving quality of life, and early weaning of the patient from a ventilator [2]. e most common physical therapy (PT) treatment strategies in ICU include bed-side mobility exercises, ambulation, chest therapy, and weaning a patient from the ventilator [3].e Diploma PT program was launched in the early 1980s in the Kingdom of Saudi Arabia (KSA)
KSA has witnessed a marked rise in the number of universities offering Bachelor, Master’s, and few Ph.D. in PT program [4]. e National Commission for Academic Accreditation and Assessment (NCAAA) [5] monitors and accredits programs offered at colleges and universities in KSA
Government hospitals are categorized into primary, secondary, and tertiary hospitals. e primary hospital provides basic medical care, whereas a tertiary hospital is equipped with latest and sophisticated medical equipment. e number of qualified PTs working in the hospitals and rehabilitation centres has grown considerably in the last few decades, reaching from 231 in 1994 to 2552 in 2018 as per the data published in World Physiotherapy webpage, Critical Care Research and Practice and only 17.1% (440) are members of the Saudi Physical erapy Association. is increased number of PTs in KSA is partially because of the mushrooming of universities and colleges across KSA
Summary
Patients admitted to the intensive care unit (ICU) experience multiple complications, mandating multidisciplinary teamwork [1]. e physical therapist (PT) plays an important role in promoting short-term functional independence, reducing the hospital stay, improving quality of life, and early weaning of the patient from a ventilator [2]. e most common physical therapy (PT) treatment strategies in ICU include bed-side mobility exercises, ambulation, chest therapy, and weaning a patient from the ventilator [3].e Diploma PT program was launched in the early 1980s in the Kingdom of Saudi Arabia (KSA). E number of qualified PTs working in the hospitals and rehabilitation centres has grown considerably in the last few decades, reaching from 231 in 1994 to 2552 in 2018 as per the data published in World Physiotherapy webpage (https://world.physio/membership/saudi-arabia), Critical Care Research and Practice and only 17.1% (440) are members of the Saudi Physical erapy Association. Ere is no scientific literature available about the current PT practice in ICU in KSA hospitals. Erefore, the purpose of this study was to determine the current PT ICU practice and its associated barriers in KSA hospitals. Mobilisation of patients in the intensive care unit (ICU) is associated with positive health benefits. Research literature lacks insight into the current status of ICU physical therapy (PT) practice in the Kingdom of Saudi Arabia. PTs reported significant variation in the choice of treatment for different clinical cases inside ICU. e main barriers in the ICU setting were low confidence and inadequate training
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