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Acceptability of a physiotherapy-led intensive prone positioning service in intensive care: A qualitative study with

Stacey Haughton1, Krisha Saravanan2, Luke A McDonald3

  • 1Department of Physiotherapy, Austin Health, Melbourne, Victoria, Australia.

Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses
|February 1, 2025
PubMed

Insights

A physiotherapy-led prone positioning service was acceptable and improved intensive care unit (ICU) care during COVID-19. Trust in the physiotherapy team was crucial for acceptance by nurses and doctors.

Area of Science:

  • Critical Care Medicine
  • Physiotherapy
  • Healthcare Management

Background:

  • The COVID-19 pandemic increased the need for prone positioning in intensive care units (ICUs).
  • A physiotherapy-led intensive prone positioning (PhLIP) service was implemented to support medical and nursing staff.
  • This initiative aimed to alleviate pressure on healthcare professionals during the pandemic.

Purpose of the Study:

  • To evaluate the acceptability of the PhLIP service.
  • To explore perspectives from ICU nurses, doctors, and delivering physiotherapists.
  • To understand the factors influencing the adoption of this innovative service.

Main Methods:

  • Qualitative evaluation using semistructured interviews and focus groups.
  • Guided by the Theoretical Framework of Acceptability (TFA).
  • Involved 19 interviews and 4 focus groups with doctors, nurses, and physiotherapists.

Main Results:

  • The PhLIP service was highly valued, improving care quality and ICU efficiency.
  • It was perceived to reduce risks for both patients and staff.
  • Clinician empowerment was noted, but the service was also physically and mentally demanding.
  • Trust in the physiotherapy team significantly influenced acceptance by medical and nursing staff.

Conclusions:

  • The PhLIP service was deemed acceptable and enhanced clinical care and efficiency.
  • ICUs should carefully consider team expertise and confidence when implementing similar services.
  • Trust in healthcare providers is a critical factor in the acceptability of new interventions.
Abstract

Keywords:
AcceptabilityCOVIDCOVID-19Critical careICUPhysiotherapyProne positioningTFATheoretical framework of acceptabilityWorkforce

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