RESUMEN
Introduction: National guidelines suggest recommended staffing levels for therapies. The aim of this study was to capture information on existing staffing levels, roles and responsibilities and service structures. Methods: An observational study using online surveys distributed to 245 critical care units across the United Kingdom (UK). Surveys consisted of a generic and five profession specific surveys. Results: Eight hundred sixty-two responses were received from 197 critical care units across the UK. Of those that responded, over 96% of units had input from dietetics, physiotherapy and SLT. Whereas only 59.1% and 48.1% had an OT or psychology service respectively. Units with ring fenced services had improved therapist to patient ratios. Discussion: There is significant variation in access to therapists for patients admitted to critical care in the UK, with many services not having services for core therapies such as psychology and OT. Where services do exist, they fall below the recommended guidance.
RESUMEN
INTRODUCTION: Therapists are increasing recognised as core members of the critical care multiprofessional team. Each therapy profession provides specialist assessments and interventions, but also work collaboratively across the rehabilitation pathway. Despite inclusion in several national guidance documents, there remains a lack of evidence regarding the perceived role of therapists working within critical care, the unique contributions of each profession and opinion on the day-to-day tasks and responsibilities of each therapy profession. METHOD: A descriptive qualitative methodology was used involving seven focus groups. Purposeful sampling was used to recruit therapists via professional specialist interest groups. All focus groups were uniprofessional and discussions based on a predesigned framework. Data were analysed thematically. RESULTS: Participants (n=65) from across the UK were recruited to seven focus groups with an average of 18.3 years postgraduate clinical experience of which 11.6 years was within critical care. Three core themes were generated from 875 codes and 237 potential subthemes. The final themes were (1) professional characteristics; (2) multidisciplinary team and (3) staffing. An additional theme of 'COVID-19 pandemic' was also identified. Findings were similar across all profession groups particularly regarding the need for holistic, patient-centred care. Expected variation was observed for professional characteristics especially regarding specific assessments and interventions. DISCUSSION: Therapy services are an essential component to the delivery of critical care especially regarding recovery and rehabilitation. Through three core themes, this qualitative study has provided new evidence of the perceptions and opinions of the role that therapists undertake within critical care.