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A Qualitative Study on Clinical Decision Making Regarding the Use of Vital Signs in Physical Therapy
Title
A Qualitative Study on Clinical Decision Making Regarding the Use of Vital Signs in Physical Therapy.
Creator
Basskin, Allison, Thistle, Virginia G., Marieb College of Health & Human Services
Abstract / Description
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...
Show moreIntroduction 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.
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Date Issued
2016
Identifier
Basskin_fgcu_1743_10163
Format
Document (PDF)
Screening For Stress Urinary Incontinence (SUI) By Florida Physical Therapists: Practice Survey
Title
Screening For Stress Urinary Incontinence (SUI) By Florida Physical Therapists: Practice Survey.
Creator
Mathew, Merryn, Balboa, Scarlett, Marieb College of Health & Human Services
Abstract / Description
Introduction: Stress urinary incontinence (SUI) is involuntary loss of urine during exertion, and is the most common form of incontinence in women between 25 to 66 years of age. It affects between 24% to 64% of women, and results in decreased quality of life, financial burden, and has been linked with low back pain and hip dysfunction. Objective: The purpose of this study was to determine the prevalence of SUI screening practices among Florida physical therapists providing direct patient care...
Show moreIntroduction: Stress urinary incontinence (SUI) is involuntary loss of urine during exertion, and is the most common form of incontinence in women between 25 to 66 years of age. It affects between 24% to 64% of women, and results in decreased quality of life, financial burden, and has been linked with low back pain and hip dysfunction. Objective: The purpose of this study was to determine the prevalence of SUI screening practices among Florida physical therapists providing direct patient care to adult females aged 18 and older. Additional survey questions were used to identify screening methods, likelihood of screening based on practitioner characteristics, confidence in treating individuals with SUI, and perceived barriers to SUI screening within the clinical environment. Methods: Data were collected using an anonymous online survey created to examine screening patterns and perceptions of physical therapists regarding their role in identification and treatment of SUI. Participants were recruited through electronic mail, flyers, and web announcements using professional channels. Responses were analyzed using Checkbox analysis tool and SPSS Predictive Analytics Software, version 23, Armonk, NY: IBM Corp. Results: Sixty-four physical therapists who met the inclusion criteria responded to the survey.; 34.4% (n=22) said they screen for SUI. Among those who reported screening for SUI, 21.9% (n=14) said they provide treatment for patients with SUI, while 9.4% (n=6) refer these patients to other clinicians. Conclusions: Our study showed that more than 60% of physical therapists who responded to this survey do not screen for SUI when working with adult females. A majority of survey respondents reported lack of knowledge and experience as the primary reason for not treating patients with SUI. Treatment of SUI is within PT’s scope of practice; therefore, PTs should promote better recognition and access to care for women with SUI based on its known prevalence, availability of effective treatment outcomes, impact on health care and personal costs to the patient, and potential for improved quality of life by reducing activity-limiting symptoms.
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Date Issued
2017
Identifier
Mathew_fgcu_1743_10242
Format
Document (PDF)
Self-Reported Use of Vital Signs in the Adult Outpatient Physical Therapy Setting
Title
Self-Reported Use of Vital Signs in the Adult Outpatient Physical Therapy Setting.
Creator
Peters, Joshua James, Marieb College of Health & Human Services
Abstract / Description
Physical Therapists (PTs) are responsible for ensuring the safety of each patient being treated. Measuring vital signs allows clinicians to screen for undiagnosed conditions, monitor existing conditions, and facilitate patient safety through prevention. The purpose of this study was to survey PTs regarding their use of vital signs in the clinical setting. Participants (N=45) included licensed PTs currently practicing in adult outpatient clinics in the state of Florida. Participants were...
Show morePhysical Therapists (PTs) are responsible for ensuring the safety of each patient being treated. Measuring vital signs allows clinicians to screen for undiagnosed conditions, monitor existing conditions, and facilitate patient safety through prevention. The purpose of this study was to survey PTs regarding their use of vital signs in the clinical setting. Participants (N=45) included licensed PTs currently practicing in adult outpatient clinics in the state of Florida. Participants were recruited via the Florida Physical Therapy Association's (FPTA) website. The survey assessed the frequency of heart rate (HR), blood pressure (BP), and pulse oximetry (SpO2) measurement in the six months prior to taking the survey; beliefs about the importance of measuring vitals, reasons for not measuring vitals, and information pertaining to the demographics of the respondents. Only 28.9% (n=13) of respondents (N=45) reported that their clinic had a policy regarding the measurement of vital signs and few believed it was important to measure vitals on each patient at every visit ("Extremely Important"; HR n=4, BP n=4, SpO2 n=3). When asked the reasons for not measuring vitals, the most frequently chosen responses were "not important for my patient population" (40.0%; n=18) and "lack of time" (22.2%; n=10). This study provides useful information about the gaps between the American Physical Therapy Association's (APTA) recommendations for measuring vitals and current clinical practices.
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Date Issued
2014
Identifier
Peters_fgcu_1743_10073
Format
Document (PDF)
USING FUNCTIONAL MOVEMENT SCREEN (FMS) TO PREDICT INJURY IN CROSSFIT® ATHLETES
Title
USING FUNCTIONAL MOVEMENT SCREEN (FMS) TO PREDICT INJURY IN CROSSFIT® ATHLETES.
Creator
LaFontaine, Emily Jean, Serenko, Jessica, Marieb College of Health & Human Services
Abstract / Description
Background: CrossFit® training has become an increasingly popular trend in the fitness world, with the potential to be an effective form of training for athletes involved in a variety of sports. One criticism of CrossFit® training, however, has been that the relatively intense CrossFit® workouts put athletes at a significant risk of injury. The Functional Movement Screen (FMS) is a system that challenges and assesses an individual’s fundamental movement patterns to measure the stability and...
Show moreBackground: CrossFit® training has become an increasingly popular trend in the fitness world, with the potential to be an effective form of training for athletes involved in a variety of sports. One criticism of CrossFit® training, however, has been that the relatively intense CrossFit® workouts put athletes at a significant risk of injury. The Functional Movement Screen (FMS) is a system that challenges and assesses an individual’s fundamental movement patterns to measure the stability and mobility of the entire body. Since any area of the body that is not performing under optimal stability or mobility is at risk for injury, it is the goal of FMS to pinpoint any weaknesses within a dynamic and functional setting. Many movement patterns required in CrossFit® utilize components of the individual FMS test positions. Objective: To determine if a correlation exists between the FMS and increased risk for injury during CrossFit® training. Methods: A cohort study was conducted on 24 CrossFit® athletes from a CrossFit® affiliate in Southwest Florida, ages 20 to 49. The athletes were assessed using the FMS screen, then observed for ten weeks tracking for injuries. Results: After running statistical analysis on our data, it could not be determined whether FMS scores were a valid predictor of increased risk of injury in CrossFit® athletes. Conclusion: Further research should be conducted to determine the validity of using the FMS to determine CrossFit® athletes that are at increased risk of injury. Due to limitations of having a small sample size, only tracking volunteers from a single location over a short window of time, using self-reported data, and participants having an inconsistent understanding of injury despite being given a standard definition to be used for the study, the researchers were not able to determine a statistically significant relationship between incidence of injury of FMS scores in CrossFit® athletes.
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Date Issued
2017-04-26
Identifier
LaFontaine_fgcu_1743_10233
Format
Document (PDF)