Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay
Objective: The aim of this study was to evaluate the effectiveness of implementing a physical therapy guideline for patients undergoing upper abdominal surgery (UAS) in reducing the incidence of atelectasis and length of hospital stay in the postoperative period. Materials and methods: A âbefore and...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2014-03-01
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| Series: | Revista Portuguesa de Pneumologia |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0873215913001062 |
| _version_ | 1818129108417118208 |
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| author | S. Souza Possa C. Braga Amador A. Meira Costa E. Takahama Sakamoto C. Seiko Kondo A.L. Maida Vasconcellos C.M. Moran de Brito W. Pereira Yamaguti |
| author_facet | S. Souza Possa C. Braga Amador A. Meira Costa E. Takahama Sakamoto C. Seiko Kondo A.L. Maida Vasconcellos C.M. Moran de Brito W. Pereira Yamaguti |
| author_sort | S. Souza Possa |
| collection | DOAJ |
| description | Objective: The aim of this study was to evaluate the effectiveness of implementing a physical therapy guideline for patients undergoing upper abdominal surgery (UAS) in reducing the incidence of atelectasis and length of hospital stay in the postoperative period. Materials and methods: A âbefore and afterâ study design with historical control was used. The âbeforeâ period included consecutive patients who underwent UAS before guideline implementation (intervention). The âafterâ period included consecutive patients after guideline implementation. Patients in the pre-intervention period were submitted to a program of physical therapy in which the treatment planning was based on the individual experience of each professional. On the other hand, patients who were included in the post-intervention period underwent a standardized program of physical therapy with a focus on the use of additional strategies (EPAP, incentive spirometry and early mobilization). Results: There was a significant increase in the use of incentive spirometry and positive expiratory airway pressure after guideline implementation. Moreover, it was observed that early ambulation occurred in all patients in the post-intervention period. No patient who adhered totally to the guideline in the post-intervention period developed atelectasis. Individuals in the post-intervention period presented a shorter length of hospital stay (9.2 ± 4.1 days) compared to patients in the pre-intervention period (12.1 ± 8.3 days) (p < 0.05). Conclusion: The implementation of a physical therapy guideline for patients undergoing UAS resulted in reduced incidence of atelectasis and reduction in length of hospital stay in the postoperative period. Resumo: Objetivo: O objetivo deste estudo foi avaliar a eficácia da implementação de uma diretriz de fisioterapia para doentes submetidos a cirurgia abdominal superior (UAS) na redução da incidência de atelectasia e no tempo de internamento no pós-operatório. Materiais e Métodos: Foi usado um desenho de estudo de âantes e depois com controlo histórico. O perÃodo âantesâ incluiu doentes consecutivos que foram submetidos a UAS antes da implementação da diretriz (intervenção). O perÃodo âdepoisâ incluiu doentes consecutivos após a implementação da diretriz. Os doentes no perÃodo pré-intervenção foram submetidos a um programa de fisioterapia onde o planeamento do tratamento foi baseado na experiência individual de cada profissional. Por outro lado, os doentes que foram incluÃdos no perÃodo pós-intervenção foram submetidos a um programa padronizado de fisioterapia com um foco no uso de estratégias adicionais (EPAP, espirometria de incentivo e mobilização precoce). Resultados: Ocorreu um aumento significativo do uso de espirometria de incentivo e pressão expiratória positiva nas vias aéreas após a implementação das diretrizes. Além disso, observou-se que ocorreu o levantamento precoce em todos os doentes durante o perÃodo pós-intervenção. Nenhum doente que aderiu totalmente à diretriz no perÃodo pós-intervenção desenvolveu atelectasia. Os indivÃduos no perÃodo pós-intervenção apresentaram um menor tempo de internamento hospitalar (9.2 ± 4.1 dias) em comparação com os doentes no perÃodo pré-intervenção (12.1 ± 8.3 dias) (p < 0.05). Conclusão: A implementação de uma diretriz de fisioterapia para doentes submetidos a UAS resultou na redução da incidência de atelectasia e na redução do tempo de internamento no pós-operatório. Keywords: Physical therapy modalities, Early ambulation, Guideline, Pulmonary atelectasis, Hospitalization, Postoperative care, Palavras-chave: Modalidades de fisioterapia, Deambulação precoce, Orientação, Atelectasia pulmonar, Internamento, Cuidados pós-operatórios |
| first_indexed | 2024-12-11T07:43:54Z |
| format | Article |
| id | doaj.art-678ee6dfe8834b8b9e4bf7fa562f7d1d |
| institution | Directory Open Access Journal |
| issn | 0873-2159 |
| language | English |
| last_indexed | 2024-12-11T07:43:54Z |
| publishDate | 2014-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Revista Portuguesa de Pneumologia |
| spelling | doaj.art-678ee6dfe8834b8b9e4bf7fa562f7d1d2022-12-22T01:15:29ZengElsevierRevista Portuguesa de Pneumologia0873-21592014-03-012026977Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stayS. Souza Possa0C. Braga Amador1A. Meira Costa2E. Takahama Sakamoto3C. Seiko Kondo4A.L. Maida Vasconcellos5C.M. Moran de Brito6W. Pereira Yamaguti7Rehabilitation Service, Hospital SÃrio-Libanês, São Paulo, SP, Brazil; School of Medicine, University of São Paulo, São Paulo, BrazilRehabilitation Service, Hospital SÃrio-Libanês, São Paulo, SP, BrazilRehabilitation Service, Hospital SÃrio-Libanês, São Paulo, SP, BrazilRehabilitation Service, Hospital SÃrio-Libanês, São Paulo, SP, BrazilRehabilitation Service, Hospital SÃrio-Libanês, São Paulo, SP, Brazil; Rehabilitation Service, Federal University of São Paulo, São Paulo, BrazilRehabilitation Service, Hospital SÃrio-Libanês, São Paulo, SP, Brazil; Physical Therapy Service, Hospital SÃrio-Libanês, São Paulo, BrazilRehabilitation Service, Hospital SÃrio-Libanês, São Paulo, SP, BrazilRehabilitation Service, Hospital SÃrio-Libanês, São Paulo, SP, Brazil; Corresponding author.Objective: The aim of this study was to evaluate the effectiveness of implementing a physical therapy guideline for patients undergoing upper abdominal surgery (UAS) in reducing the incidence of atelectasis and length of hospital stay in the postoperative period. Materials and methods: A âbefore and afterâ study design with historical control was used. The âbeforeâ period included consecutive patients who underwent UAS before guideline implementation (intervention). The âafterâ period included consecutive patients after guideline implementation. Patients in the pre-intervention period were submitted to a program of physical therapy in which the treatment planning was based on the individual experience of each professional. On the other hand, patients who were included in the post-intervention period underwent a standardized program of physical therapy with a focus on the use of additional strategies (EPAP, incentive spirometry and early mobilization). Results: There was a significant increase in the use of incentive spirometry and positive expiratory airway pressure after guideline implementation. Moreover, it was observed that early ambulation occurred in all patients in the post-intervention period. No patient who adhered totally to the guideline in the post-intervention period developed atelectasis. Individuals in the post-intervention period presented a shorter length of hospital stay (9.2 ± 4.1 days) compared to patients in the pre-intervention period (12.1 ± 8.3 days) (p < 0.05). Conclusion: The implementation of a physical therapy guideline for patients undergoing UAS resulted in reduced incidence of atelectasis and reduction in length of hospital stay in the postoperative period. Resumo: Objetivo: O objetivo deste estudo foi avaliar a eficácia da implementação de uma diretriz de fisioterapia para doentes submetidos a cirurgia abdominal superior (UAS) na redução da incidência de atelectasia e no tempo de internamento no pós-operatório. Materiais e Métodos: Foi usado um desenho de estudo de âantes e depois com controlo histórico. O perÃodo âantesâ incluiu doentes consecutivos que foram submetidos a UAS antes da implementação da diretriz (intervenção). O perÃodo âdepoisâ incluiu doentes consecutivos após a implementação da diretriz. Os doentes no perÃodo pré-intervenção foram submetidos a um programa de fisioterapia onde o planeamento do tratamento foi baseado na experiência individual de cada profissional. Por outro lado, os doentes que foram incluÃdos no perÃodo pós-intervenção foram submetidos a um programa padronizado de fisioterapia com um foco no uso de estratégias adicionais (EPAP, espirometria de incentivo e mobilização precoce). Resultados: Ocorreu um aumento significativo do uso de espirometria de incentivo e pressão expiratória positiva nas vias aéreas após a implementação das diretrizes. Além disso, observou-se que ocorreu o levantamento precoce em todos os doentes durante o perÃodo pós-intervenção. Nenhum doente que aderiu totalmente à diretriz no perÃodo pós-intervenção desenvolveu atelectasia. Os indivÃduos no perÃodo pós-intervenção apresentaram um menor tempo de internamento hospitalar (9.2 ± 4.1 dias) em comparação com os doentes no perÃodo pré-intervenção (12.1 ± 8.3 dias) (p < 0.05). Conclusão: A implementação de uma diretriz de fisioterapia para doentes submetidos a UAS resultou na redução da incidência de atelectasia e na redução do tempo de internamento no pós-operatório. Keywords: Physical therapy modalities, Early ambulation, Guideline, Pulmonary atelectasis, Hospitalization, Postoperative care, Palavras-chave: Modalidades de fisioterapia, Deambulação precoce, Orientação, Atelectasia pulmonar, Internamento, Cuidados pós-operatórioshttp://www.sciencedirect.com/science/article/pii/S0873215913001062 |
| spellingShingle | S. Souza Possa C. Braga Amador A. Meira Costa E. Takahama Sakamoto C. Seiko Kondo A.L. Maida Vasconcellos C.M. Moran de Brito W. Pereira Yamaguti Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay Revista Portuguesa de Pneumologia |
| title | Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay |
| title_full | Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay |
| title_fullStr | Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay |
| title_full_unstemmed | Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay |
| title_short | Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay |
| title_sort | implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay |
| url | http://www.sciencedirect.com/science/article/pii/S0873215913001062 |
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