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A Qualitative Study on Clinical Decision Making Regarding the Use of Vital Signs in Physical Therapy

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Date Issued:
2015
Abstract:
Introduction Clinical decision making is an integral component of patient care. Vital signs are a component of the clinical decision making process each visit. These include body temperature, blood pressure, heart rate, respiratory rate, and pulse oximetry. Measuring vital signs allows physical therapists to screen for red flags, monitor a patient’s cardiovascular response to exercise, and incorporate relevant information into the plan of care. Previous studies have shown that physical therapists do not always objectively measure vital signs each visit. With physical therapists emerging as autonomous practitioners, it is important to understand which factors strongly influence the clinical decision making of physical therapists to take vital signs. Methods Seventeen practicing physical therapists were given a questionnaire by phone, email, or in person. The questionnaire contained three sections including demographic data, clinical decision making questions, and two risk-based scenarios in which participants were asked to indicate whether or not they would assess vital signs. Results The primary factors cited in response to source of reference of assessing vital signs included clinical experience, education, and patient presentation. The primary factors included by physical therapists in response to the decision to treat or refer based on abnormal vital signs included patient history, clinical experience, various parameters, and contacting the physician. Several different themes emerged with respect to clinical decision making that included utilizing ACSM guidelines, clinical experience, physician’s protocol, education, patient presentation, criteria proposed by the cardiopulmonary section of the APTA, and facility policies and procedures. In addition, there did not appear to be an agreement by participants on the definition of abnormal vital signs seen clinically. Conclusion The variation of factors that influenced the decision making process by the participants may be reflective of the lack of guidelines and the broad understanding of the need and benefit of objectively assessing vital signs.
Title: A Qualitative Study on Clinical Decision Making Regarding the Use of Vital Signs in Physical Therapy.
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Name(s): Thistle, Virginia
Type of Resource: text
Issuance: single unit
Date Issued: 2015
Physical Form: Dissertation
Extent: 43 pgs.
Language(s): English
Abstract: Introduction Clinical decision making is an integral component of patient care. Vital signs are a component of the clinical decision making process each visit. These include body temperature, blood pressure, heart rate, respiratory rate, and pulse oximetry. Measuring vital signs allows physical therapists to screen for red flags, monitor a patient’s cardiovascular response to exercise, and incorporate relevant information into the plan of care. Previous studies have shown that physical therapists do not always objectively measure vital signs each visit. With physical therapists emerging as autonomous practitioners, it is important to understand which factors strongly influence the clinical decision making of physical therapists to take vital signs. Methods Seventeen practicing physical therapists were given a questionnaire by phone, email, or in person. The questionnaire contained three sections including demographic data, clinical decision making questions, and two risk-based scenarios in which participants were asked to indicate whether or not they would assess vital signs. Results The primary factors cited in response to source of reference of assessing vital signs included clinical experience, education, and patient presentation. The primary factors included by physical therapists in response to the decision to treat or refer based on abnormal vital signs included patient history, clinical experience, various parameters, and contacting the physician. Several different themes emerged with respect to clinical decision making that included utilizing ACSM guidelines, clinical experience, physician’s protocol, education, patient presentation, criteria proposed by the cardiopulmonary section of the APTA, and facility policies and procedures. In addition, there did not appear to be an agreement by participants on the definition of abnormal vital signs seen clinically. Conclusion The variation of factors that influenced the decision making process by the participants may be reflective of the lack of guidelines and the broad understanding of the need and benefit of objectively assessing vital signs.
Identifier: Thistle_fgcu_1743_10153 (IID)
Note(s): Degree Awarded: Doctorate in Physical Therapy
Subject(s): clinical decision making
vital signs
Persistent Link to This Record: http://purl.flvc.org/fgcu/fd/Thistle_fgcu_1743_10153
Use and Reproduction: All rights reserved.
Owner Institution: FGCU