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本研究の目的は，専従理学療法士が不在である日の集中治療室（ICU）看護師によるリハビリテーションの実態把握と今後の課題を明らかにすることである。対象は2018年9月から2019年6月までにA病院集中治療室に入室し，専従理学療法士により早期離床・リハビリテーションプロトコルに従って人工呼吸管理中で端座位以上のリハビリテーションを実施した症例を医療記録より後方視的に抽出した。結果として，専従理学療法士が不在の場合でも看護師はポジショニングを含むリハビリテーションを業務の一環として25のセッションが実施できていた。また，マンパワー不足などで専従理学療法士によるリハビリテーションが行えない場合でも，看護師が患者状態を把握し，体位呼吸療法などのリハビリテーションを行うことでバイタルサインが変動するリスクを回避し，患者の安全を守ることができていた。Objective: This study is to understand the actual situation of rehabilitation by intensive care unit (ICUs) nurses on days when a full-time physical therapist is not available and to identify future issues.Method: The subjects were patients admitted to the ICU in Hospital A between September 2018 and June 2019, and were under ventilator management and underwent rehabilitation by a full-time physical therapist, in the end-sitting position or higher according to the early weaning and rehabilitation protocol. The subjects were selected retrospectively from the medical records.Results and Discussion: The results indicated that nurses were able to perform rehabilitation, including positioning, as part of their duties, even in the absence of a full-time physical therapist. In addition, even when rehabilitation by full-time physical therapists could not be performed, due to lack of manpower or other reasons, nurses were able to assess the condition of patients and provide rehabilitation, such as positional breathing therapy, to protect patient safety and avoid the risk of fluctuations in vital signs. |
