Authors (including presenting author) :
Wong CY (1), Ng LY (1)
Affiliation :
(1) Physiotherapy Department, Prince of Wales Hospital
Introduction :
Non-invasive ventilation (NIV) is recognized as an effective treatment for some respiratory conditions such as respiratory failure and cardiogenic pulmonary oedema caused by chronic pulmonary disease or heart failure.
Objectives :
The current program (mobile team) is a multi-disciplinary enhanced service for patients who require NIV which aims to (1) facilitate weaning, (2) promote early mobilization, and (3) reduce the risk of deconditioning.
Methodology :
In the period of October 2020 to September 2021, patients who require NIV were automatically included in the mobile team program. Patients were categorized into categories 1-3 based on their premorbid mobility levels (Category 1 for good premorbid mobility level and prognosis, category 2 for fair premorbid mobility level and prognosis, category 3 for bed/ chair-bound patients with poor prognosis). Patients who were in categories 1 and 2 were offered daily physiotherapy treatments (including weekends and holidays) with an additional session during weekdays. Treatments include chest physiotherapy, limbs mobilization exercises, and out of bed mobilization if indicated. A case conference was held once a week in which respiratory specialists, nurses, and physiotherapists would discuss the rehabilitation and weaning plans for patients with difficult weaning. The outcome measures included mobility level, handgrip, length of stay (LOS) in hospital, and discharge destinations.
Result & Outcome :
Results Total attendance was 2972 within the above period, while 26% were classified in category 1, 51% in category 2, and 23% in category 3. Regarding the patients within category 1-2, 20-33% were able to initiate walking while they were in the mobile team. The mean LOS using NIV was found to be 5.1 +/- 3.8 days in category 1 patients and 7.61 +/- 6.9 days in category 2 patients, which was shorter than the mean proposed LOS (10 days). The handgrip strength of patients in categories 1-2 was also found improved (p<0.05) . Regarding the discharge destinations, more than half of the patients in category 1 were able to discharge home directly. In conclusion, early physiotherapy intervention in mobile team has positive outcomes in facilitating the weaning process of NIV patients; this helps to reduce the LOS and promote early discharge from hospital.
