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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)
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)