Brief Report  |   May 2013
Occupational Therapy for Patients With Acute Lung Injury: Factors Associated With Time to First Intervention in the Intensive Care Unit
Victor D. Dinglas; Elizabeth Colantuoni; Nancy Ciesla; Pedro A. Mendez-Tellez; Carl Shanholtz; Dale M. Needham
Author Affiliations
  • Victor D. Dinglas, MPH, is Senior Research Program Supervisor, Division of Pulmonary and Critical Care Medicine and Outcomes after Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore
  • Elizabeth Colantuoni, PhD, is Assistant Scientist, Department of Biostatistics and OACIS Group, Johns Hopkins University, Baltimore
  • Nancy Ciesla, PT, DPT, is Research Physical Therapist, Division of Pulmonary and Critical Care Medicine and OACIS Group, Johns Hopkins University, Baltimore
  • Pedro A. Mendez-Tellez, MD, is Assistant Professor, Department of Anesthesiology and Critical Care Medicine and OACIS Group, Johns Hopkins University, Baltimore
  • Carl Shanholtz, MD, is Associate Professor, Division of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore
  • Dale M. Needham, FCA, MD, PhD, is Associate Professor, Division of Pulmonary and Critical Care Medicine, Department of Physical Medicine and Rehabilitation, and OACIS Group, Johns Hopkins University, 1830 East Monument Street, 5th Floor, Baltimore, MD 21205; dale.needham@jhmi.edu
Article Information
Cardiopulmonary Conditions / Departments
Brief Report   |   May 2013
Occupational Therapy for Patients With Acute Lung Injury: Factors Associated With Time to First Intervention in the Intensive Care Unit
American Journal of Occupational Therapy, May/June 2013, Vol. 67, 355-362. doi:10.5014/ajot.2013.007807
American Journal of Occupational Therapy, May/June 2013, Vol. 67, 355-362. doi:10.5014/ajot.2013.007807
Abstract

OBJECTIVE. Very early occupational therapy intervention in the intensive care unit (ICU) improves patients’ physical recovery. We evaluated the association of patient, ICU, and hospital factors with time to first occupational therapy intervention in ICU patients with acute lung injury (ALI).

METHOD. We conducted a prospective cohort study of 514 consecutive patients with ALI from 11 ICUs in three hospitals in Baltimore, MD.

RESULTS. Only 30% of patients ever received occupational therapy during their ICU stay. Worse organ failure, continuous hemodialysis, and uninterrupted continuous infusion of sedation were independently associated with delayed occupational therapy initiation, and hospital study site and admission to a trauma ICU were independently associated with earlier occupational therapy.

CONCLUSION. Severity of illness and ICU practices for sedation administration were associated with delayed occupational therapy. Both hospital study site and type of ICU were independently associated with timing of occupational therapy, indicating modifiable environmental factors for promoting early occupational therapy in the ICU.