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IJPR.2020.166

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Type of Article:  Original Research

Volume 8; Issue 5 (October 2020)

Page No.: 3634-3638

DOI: https://dx.doi.org/10.16965/ijpr.2020.166

REASONS FOR OMISSION OF PHYSIOTHERAPY IN A TERTIARY CARE INSTITUTE IN MUMBAI

Sanjith Saseedharan *1, Paulomi Shah 2, Vaijayanti Kadam 3.

*1 Head-Department of Critical Care, S.L. Raheja Hospital (A Fortis Associate), Mumbai, Maharashtra, India.

2Registrar, Dept of Critical Care, S. L. Raheja hospital (A Fortis Associate), Mumbai, Maharashtra, India.

3Associate Consultant, Dept of Critical Care, S. L. Raheja hospital (A Fortis Associate), Mumbai, Maharashtra, India.

Corresponding Author: Dr. Sanjith Saseedharan, Dept of critical care,S.L.Raheja Hospital(A Fortis associate), Raheja Marg,Police colony, Mahim,Mumbai, Maharashtra, India. Phone number: 02266529999,9930925503,9004479549 E-Mail: docsanjith@rediffmail.com

ABSTRACT

Background: As critical care is progressing, we are able salvage many patients, many of which in the past decades, would not have survived. A good number of these patients spend prolonged time in the intensive care unit(ICU). The after effect of which is myopathy, respiratory muscle weakness, neuropathy etc. Physiotherapy is an especially important armamentarium in the arsenal of critical care medicine which helps in the prevention of morbidity. However, there are reasons why there is omission in the performance of physiotherapy in the intensive care unit.

Purpose of study: To study the commonest reasons of omission of physiotherapy in a tertiary care hospital intensive care unit and thus help in devising methods or intervention for prevention of the same.

Methods: This study was performed by reviewing data from the charts of 240 consecutive patients admitted to a mixed medical surgical intensive care unit in Mumbai. Patients were prescribed physiotherapy by the intensive care physician a day in advance depending on the clinical indications and suitability for the same. The physiotherapist then decided the therapy for the following days and scheduled them accordingly. The reason of the omission of the  session was documented by the physiotherapist responsible for the conduct of the session. The common reasons for omission of sessions were noted for analysis.

Results: Physiotherapy was missed in 32 % of cases and this was predominantly seen in the morning hours. The most common reason (36%) was patient refusal, attributed to inadequate sleep in the night hours. The next common reason (22%) was the requirement of shifting the patient to the diagnostic room for investigations, namely imaging, and hence omission of physiotherapy. This was followed by bedside rounds by senior consultants including teaching rounds (18%) followed by the sudden deterioration of condition in 16 % of cases.

Conclusions: There are many obstacles that come in the way of the conduct of physiotherapy in large tertiary care busy intensive care units which is compounded with the lack of manpower. Like any medication assessment for the need for physiotherapy, timing of physiotherapy, the dose of physiotherapy and the actual form of therapy is a very important in improving patient care. Simple interventions can be put in place in order to avoid omission of physiotherapy.

KEY WORDS: Physiotherapy, Intensive care unit, Omission.

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Cite this article: Sanjith Saseedharan, Paulomi Shah, Vaijayanti Kadam. REASONS FOR OMISSION OF PHYSIOTHERAPY IN A TERTIARY CARE INSTITUTE IN MUMBAI. Int J Physiother Res 2020;8(5):3634-3638. DOI: 10.16965/ijpr.2020.164
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