RESUMEN
BACKGROUND: Patient mobility tasks place rehabilitation professionals (Physical and Occupational Therapists) working in hospitals at high risk for work-related musculoskeletal disorders (WMSDs). However, when investigating engagement with a Safe Patient Handling and Mobility program (SPHM), administrative records at a level one trauma hospital showed that rehabilitation professionals reported zero work-related injuries over an eight-year period. OBJECTIVE: As part of a qualitative study conducted to discover their unique work experiences, we explored some of the reasons that rehabilitation professionals might not report work-related injuries to their employers. METHODS: Using a collective case study design, six focus groups were conducted with 25 members of the rehabilitation team within a level-one trauma hospital. Focus groups were recorded; transcripts were analyzed for emergent themes using first and second cycle coding procedures. RESULTS: Participants in this study denied experiencing work-related injuries but frequently described working in pain, often attributed to patient mobility tasks. These experiences were not reported to employers. Self-management of their pain through co-worker treatment, over-the-counter medications, or informal alteration in job tasks were reported as common. CONCLUSION: Administrative injury records may underrepresent injuries among rehabilitation professionals. This may be due to their perception of work-related pain as something different than work-related injuries, or that many of these rehabilitation professionals treat their own work-related pain and symptoms rather than report them. To get a more accurate assessment of injury frequency among rehabilitation professionals, researchers should gather information directly from the participants, and should inquire about work-related pain in addition to injury.
Asunto(s)
Grupos Focales , Traumatismos Ocupacionales , Investigación Cualitativa , Humanos , Traumatismos Ocupacionales/complicaciones , Traumatismos Ocupacionales/psicología , Traumatismos Ocupacionales/rehabilitación , Masculino , Femenino , Adulto , Persona de Mediana Edad , Manejo del Dolor/métodosRESUMEN
INTRODUCTION: Passing the National Physical Therapy Examination (NPTE) is a necessary step in progressing into a professional career. The purpose of this study was to identify student factors that predicted failure on the first attempt of the NPTE in graduates of a blended Doctor of Physical Therapy (DPT) program. REVIEW OF LITERATURE: Student factors that may affect NPTE outcomes have been studied in traditional physical therapist education programs but have not been studied in blended programs. Blended instruction is a delivery format that combines distance asynchronous learning and face-to-face synchronous learning in a complementary way. SUBJECTS: Two hundred ten graduates from 6 consecutive cohorts of a DPT program taught in a blended format. METHODS: Retrospective observational cohort design. Demographic, preadmission, and in-program academic data and NPTE pass/fail status were collected. Variables were analyzed with forward stepwise logistic regression for their ability to predict first-time NPTE failure. Receiver operating characteristic curves were plotted to determine cut points of predictive variables. RESULTS: Two regression analyses were conducted. First, an analysis of all variables identified 3 significant predictors: comprehensive examination score, cumulative third-year grade point average, and Graduate Record Examination Verbal Reasoning (GRE-V) score, which explained 43.2% of the variance. The second analysis excluded variables occurring late in matriculation to identify early occurring predictors. This yielded 2 early predictive variables, GRE-V score and academic difficulty, which explained 29.5% of the variance. DISCUSSION AND CONCLUSION: To our knowledge, this is the first study of predictors of NPTE outcomes in blended DPT program graduates. Like previous studies, a mix of preadmission and in-program factors predicted first-time NPTE failure. These findings may help inform admissions policies, academic advising processes, and academic warning policies in blended programs. Future research is needed to explore factors unique to blended educational settings and the qualities of the students they attract.
Asunto(s)
Evaluación Educacional , Especialidad de Fisioterapia , Humanos , Estudios Retrospectivos , Especialidad de Fisioterapia/educación , Concesión de Licencias , Modalidades de FisioterapiaRESUMEN
BACKGROUND: Increasingly, occupational and physical therapists are using safe patient handling and mobility (SPHM) equipment, such as mechanical lifts, in rehabilitation. However, there is little guidance in the literature on how SPHM equipment can be used to assist patients to reach rehabilitation goals. The purpose of this projectwas to document and categorize common and innovative ways rehabilitation therapists use SPHM equipment in their clinical practice. OBJECTIVE: This article investigates common and innovative uses of SPHM equipment in rehabilitation practice. METHODS: Occupational, physical and kinesio therapist employed at the Veterans Health Administration wrote narratives and took photos describing rehabilitation therapy activities where they used SPHM equipment in their clinical practice. The authors used a systematic process to review and categorize the narratives and subsequent photos by using the World Health Organization's International Classification of Functioning, Disability and Health (ICF). RESULTS: Thirty narratives (13 innovative and 17 common) were coded into four categories on the ICF section of mobility. The most common category was "changing and maintaining basic body position"(21) followed by "walking and moving" (5). The category "carrying, moving and handling objects" garnered two narratives and there were no narratives for "using transportation." CONCLUSIONS: Project findings may serve as a guide for therapists who would like to enhance their use of SPHM equipment in rehabilitation. Additional research is needed to expand the use of SPHM in rehabilitation practice and evaluate the impact on patient rehabilitation outcomes and therapist safety outcomes.
Asunto(s)
Movimiento y Levantamiento de Pacientes/instrumentación , Seguridad del Paciente , Rehabilitación/instrumentación , Humanos , Terapia Ocupacional/instrumentación , Modalidades de Fisioterapia/instrumentación , Rehabilitación/métodos , Estados Unidos , United States Department of Veterans AffairsRESUMEN
Every day, thousands of physical therapists and rehabilitation nurses are required to perform physically demanding therapeutic patient handling tasks that are stressful to the caregiver and increase his or her risk of developing work-related musculoskeletal disorders (MSDs). In rehabilitation, patient handling tasks might be classified as"traditional" or "therapeutic."Traditional tasks have a practical goal, such as transferring a patient from bed to a wheelchair, and therapeutic tasks have more targeted goals such as facilitating patient function and independence. Therapeutic patient handling tasks present a greater risk for caregivers to sustain work-related MSDs than typical patient handling tasks do because caregivers are exposed to high mechanical loads on the spinal tissues for longer amounts of time. The Veterans Health Administration, Association of Rehabilitation Nurses, and the American Physical Therapy Association endorse the use of modern patient handling technology as part of a comprehensive safe patient handling program for providing therapy in rehabilitation settings. Information about patient handling technology that is effective in reducing the risk of work-related MSDs from performing therapeutic patient handling and movement tasks is also presented and discussed in this article.
Asunto(s)
Personal de Enfermería , Enfermedades Profesionales/prevención & control , Enfermería en Rehabilitación/métodos , Transporte de Pacientes/métodos , Heridas y Lesiones/prevención & control , Humanos , Enfermedades Profesionales/epidemiología , Especialidad de Fisioterapia , Factores de Riesgo , Estados Unidos , United States Occupational Safety and Health Administration , Heridas y Lesiones/epidemiologíaRESUMEN
Technology has improved and expanded the equipment options for use in patient handling. There is substantial evidence that these activities expose healthcare professionals, including nurses and physical therapists, to risk for work-related musculoskeletal disorders. There is also evidence that ergonomic use of equipment to assist with patient handling is associated with decreases in injuries among healthcare providers. The use of patient-handling equipment has additional potential for facilitating the goals of rehabilitation and improving patient outcomes. This article presents an overview of new research areas and a discussion of these topics.