Article 1

Physiotherapists play a significant role in helping patients manage pain and facilitate recovery. This is a science-based profession and physiotherapists focus on managing long-term illnesses and improving functional status (Baidya, Acharya & Coppieters, 2016).  In Intensive Care Unit, physiotherapists play the role of positioning, limb exercise, trachea suctioning and more.  However, it is important to understand the level of evidence in physiotherapy. The purpose of this article is to evaluate the treatment skills and therapeutic intervention in ICU (Baidya, Acharya & Coppieters, 2016)..

Method

            A cross-sectional survey was used and   86 physiotherapists   working in ICU over 2 years and who were qualified with Certificate, Bachelor and Masters were  included.  Questionnaire was used together with reliability analysis. Physiotherapists’ were asked to answer the questions which were based on PT staffing, demographic in primary hospital, mechanically ventilated patients in ICU (Baidya,  Acharya  & Coppieters, 2016).. Statistical method were used where data collected was recorded in Microsoft Excel and descriptive statistics was used to summarize the data.  Chi-square test and ANOVA test were used to   analyze different clinical scenarios.

 Results

            Out of 86 physiotherapists, 11 did not participate and 23 failed to offer response.  Thus, final analysis was made from 52 physiotherapists who participated.  25% were government physiotherapists, 19.2% were worked in semi-government hospitals and 55.8% were private (Baidya, Acharya & Coppieters, 2016). It was found that many physiotherapists in all hospitals offered PT after physician consultation or   there were ‘blanker referral’ which allowed the PT to be done. The services were based on chest PT, positioning and therapeutic exercise or   there were ‘blanker referral’ which allowed the PT to be done.  Finally the study shows that the main role of the physiotherapists was positioning, rotational therapy, and exercise among others (Baidya, Acharya & Coppieters, 2016).

Article 2

 Patients in emergency department face the challenges of pain after traumatic condition.  Studies have found that children experience much pain than adults since they do not get adequate treatment or in other words there is inadequate pain management (Ramira, Instone & Clark, 2016). Long-term effect contributes to pain sensitivity, chronic pain ailment, anti-social behaviors and more. To solve this problem,  health care organization  have  tried to manage pain but the article  assert that  nurses should  apply evidence-based approach  in order  to improve patients’ outcome. In the study, quality improvement project was designed to help nurses improve pain management. Six hundred children aged 3months to 6years   were used for project review before and after the improvement projects.  Project team used literature review where the key term used was inadequate pain management. The literature recommended the use of education   as an effective strategy   for improving nurses’ knowledge and management practices (Ramira, Instone & Clark, 2016). After gaining evidence, the Institution Review Board approved the project and project team   used pain education to address the issue.  Pain education started on July 2011 and topic included were pathophysiology of pain medication and more.  Final data analysis was done on Feb 2012.

 Results

 Nurses who participated in pain educated were full time and part time workless on emergency department.   Nurses conducted pain assessment on pre- and post-intervention.  It was found that there was project effectiveness since ANOVA results showed that nurses improved pain documentation from 17% to 93% (Ramira, Instone & Clark, 2016).  Nurses’ documentation showed big improvement since there was 58 % change.  The project shows that pain education provides nurses with skills and knowledge on pain management. In addition, pain education programs help nurses improve decision and confidence I on managing pain. Thus, improved knowledge is a special tool for better documentation of pain, pain medication and reduction (Ramira, Instone & Clark, 2016).

 

 

 

 

Reference

 

 Baidya, S., Acharya, R. S., & Coppieters, M. W. (2016). Physiotherapy practice patterns in Intensive Care

Units of Nepal: A multicenter survey. Indian Journal Of Critical Care Medicine, 20(2), 84-90.

doi:10.4103/0972-5229.175939

 

 

Ramira, M. L., Instone, S., & Clark, M. J. (2016). Quality Improvement. Pediatric Pain Management: An

Evidence-Based Approach. Pediatric Nursing, 42(1), 39-49.