Supporting Clinical Practice Behavior Change Among Neurologic Physical Therapists
| Autor: | Hallie Zeleznik, Terry Breisinger, Susan B. Perry |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Evidence-based practice Quality management business.industry Rehabilitation Behavior change Stroke Rehabilitation MEDLINE Physical Therapy Sports Therapy and Rehabilitation Physical Therapists Translational Research Biomedical Hemiparesis Gait training Evidence-Based Practice Intervention (counseling) Knowledge translation medicine Physical therapy Humans Neurology (clinical) Practice Patterns Physicians' medicine.symptom business Physical Therapy Modalities |
| Zdroj: | Journal of Neurologic Physical Therapy. 38:134-143 |
| ISSN: | 1557-0576 |
| Popis: | Background and purpose Physical therapists tend to underuse research evidence in clinical practice. Emerging research on knowledge translation activities (KTAs) provides guidance to address this problem. We describe a yearlong effort to promote clinical practice behavior change in neurologic physical therapists. Case description Physical therapy stroke and brain injury teams in an inpatient rehabilitation setting implemented a quality improvement project to encourage use of a novel, evidence-supported gait training method (nonsupported gait training [NSGT]) for patients with hemiparesis. Intervention The project consisted of multidimensional KTAs, including (1) quarterly staff meetings at which NSGT was introduced, reviewed, and discussed; (2) group and individual dialogue regarding successes, challenges, solutions, and clinical decision-making; (3) ongoing monitoring of and aggregate feedback about appropriate NSGT attempts via chart audit; and (4) ongoing reminders, role modeling, and clinical consultation. Specific staff perceptions about the approach, captured by a mid-year survey, further informed targeted problem-solving and clinical case presentations. Outcomes In the first, second, and fourth quarter, 50%, 60%, and 73% of eligible patients were trained with NSGT, respectively. A mid-year survey showed that 19% of therapists were very/moderately familiar with NSGT before the quality improvement project, versus 78% at the 6-month point. Thirty-three percent stated that they used NSGT almost always/often before the project, versus 66% at the 6-month point. Discussion Extensive multidimensional KTAs were feasible in inpatient rehabilitation and were accompanied by a moderate increase in documented and self-reported frequency of NSGT attempts. Clinical teams may benefit from adopting KTAs that best support clinical practice change. |
| Databáze: | OpenAIRE |
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