Expert physiotherapists' clinical decision-making in acute care. Part one

Abstract

In the current health care climate physiotherapists working in acute hospitals are not exempt from evidence-based practice pressures. Clinicians are required to incorporate clinical expertise with patient values and the best available evidence. As physiotherapists are ideally placed to intervene in the management of acutely ill inpatients, who are at a high-risk of complications, the decision-making process for the commonly performed task of mobilization requires understanding. Presented in part one of this series are the indicators expert Australian acute care physiotherapists' used in decision-making to determine patient capacity for mobilization. Part two presents and applies study findings to functional outcome evaluation. A focused ethnography using an in-depth interview with 12 acute care physiotherapists was employed to address this. Interview transcripts were analysed thematically. No single indicator was used in participants' decision-making to determine patients' capacity for mobilization. Rather, numerous indicators were incorporated throughout a fluid, individualized and task-specific assessment and treatment process.