Minimum standards of clinical practice for physiotherapists working in critical care units in Ireland: a modified Delphi technique

Abstract

INTRODUCTION: Physiotherapists in Irish hospitals with critical care units deliver physiotherapy services 24 hours a day, seven days a week. There is a perceived lack of consistency in the level of clinical competence, required skills and content of training between hospitals, compounded by the absence of a national policy, procedure or clinical framework for physiotherapists working in critical care. The study aimed to identify the minimum standards of clinical practice expected of physiotherapists working in critical care settings in Ireland. METHODS: A modified Delphi technique was used to survey a panel of senior and clinical specialist physiotherapists working in critical care units in Ireland to obtain consensus of items. The questionnaire of 214 items was completed over three rounds. Items were determined ‘Essential/Not Essential/Unsure’ by participants. Items that did not reach consensus were included in the subsequent round with additional items suggested by participants. RESULTS: 25/46(54%) physiotherapists completed the first round, with 17 and 13 completing round 2 and round 3 respectively. A total of 220 items were included, 120 of which were deemed essential for a minimum standards of independent clinical practice in Irish critical care units. Fifty-six items were considered not essential while consensus was not reached on 44 items. CONCLUSIONS: This study identified 120 items of knowledge and clinical skills considered essential as a minimum standard by physiotherapists working in Irish critical care units. Further discussion is required to determine how these results can be applied to guide clinical practice for physiotherapists working in critical care in Ireland.