TY - JOUR
T1 - Clinical validation of expert consensus statements for respiratory physiotherapy management of invasively ventilated adults with community-acquired pneumonia
T2 - A qualitative study
AU - van der Lee, Lisa
AU - Hill, Anne-Marie
AU - Patman, Shane
N1 - Copyright © 2020 Elsevier Ltd. All rights reserved.
PY - 2020/10
Y1 - 2020/10
N2 - OBJECTIVES: To conduct multidisciplinary peer-review of expert consensus statements for respiratory physiotherapy for invasively ventilated adults with community-acquired pneumonia, to determine clinical acceptability for development into a clinical practice guideline.RESEARCH METHODOLOGY: A qualitative study was undertaken using focus groups (n = 3) conducted with clinician representatives from five Australian states. Participants were senior intensive care physiotherapists, nurses and consultants. Thematic analysis was used, with a deductive approach to confirm clinical validity, and inductive analysis to identify new themes relevant to the application of the 38 statements into practice.SETTING: Adult intensive care.FINDINGS: Senior intensive care clinicians from physiotherapy (n = 16), medicine (n = 6) and nursing (n = 4) participated. All concurred that the consensus statements added valuable guidance to practice; twenty-nine (76%) were deemed relevant and applicable for the intensive care setting without amendment, with modifications suggested for remaining nine statements to enhance utility. Overarching themes of patient safety, teamwork and communication and culture were identified as factors influencing clinical application. Cultural differences in practice, particularly related to patient positioning, was evident between jurisdictions. Participants raised practicality and safety concerns for two statements related to the use of head-down patient positioning.CONCLUSION: Multidisciplinary peer-review established clinical validity of expert consensus statements for implementation with invasively ventilated adults with community-acquired pneumonia.
AB - OBJECTIVES: To conduct multidisciplinary peer-review of expert consensus statements for respiratory physiotherapy for invasively ventilated adults with community-acquired pneumonia, to determine clinical acceptability for development into a clinical practice guideline.RESEARCH METHODOLOGY: A qualitative study was undertaken using focus groups (n = 3) conducted with clinician representatives from five Australian states. Participants were senior intensive care physiotherapists, nurses and consultants. Thematic analysis was used, with a deductive approach to confirm clinical validity, and inductive analysis to identify new themes relevant to the application of the 38 statements into practice.SETTING: Adult intensive care.FINDINGS: Senior intensive care clinicians from physiotherapy (n = 16), medicine (n = 6) and nursing (n = 4) participated. All concurred that the consensus statements added valuable guidance to practice; twenty-nine (76%) were deemed relevant and applicable for the intensive care setting without amendment, with modifications suggested for remaining nine statements to enhance utility. Overarching themes of patient safety, teamwork and communication and culture were identified as factors influencing clinical application. Cultural differences in practice, particularly related to patient positioning, was evident between jurisdictions. Participants raised practicality and safety concerns for two statements related to the use of head-down patient positioning.CONCLUSION: Multidisciplinary peer-review established clinical validity of expert consensus statements for implementation with invasively ventilated adults with community-acquired pneumonia.
KW - Community-Acquired Infections/physiopathology
KW - Consensus
KW - Focus Groups/methods
KW - Humans
KW - Interviews as Topic/methods
KW - Physical Therapy Modalities/standards
KW - Pneumonia/physiopathology
KW - Qualitative Research
KW - Respiration, Artificial/instrumentation
KW - Validation Studies as Topic
U2 - 10.1016/j.iccn.2020.102854
DO - 10.1016/j.iccn.2020.102854
M3 - Article
C2 - 32448631
SN - 0964-3397
VL - 60
SP - 102854
JO - Intensive and Critical Care Nursing
JF - Intensive and Critical Care Nursing
M1 - 102854
ER -