ADHERENCE TO GUIDELINES FOR ACUTE REHABILITATION IN THE NORWEGIAN TRAUMA PLAN

J Rehabil Med, 2023 · DOI: 10.2340/jrm.v55.6552 · Published: April 20, 2023

Simple Explanation

Three recommendations for acute rehabilitation in the Norwegian trauma plan were evaluated in 538 adults with moderate to severe injuries. Recommendation one: Examination by a rehabilitation physician within 72 h after hospital admission. This was documented in 18% of the patients. Recommendation three: Patients are directly transferred from acute care in the trauma centre to specialized rehabilitation. This was followed for 22% of the patients.

Study Duration

1 year

Participants

538 adults with moderate and severe trauma

Evidence Level

Not specified

Key Findings

1
Adherence to the first recommendation, assessment by a physical medicine and rehabilitation physician within 72 h following admission to the intensive care unit (ICU) at the trauma centre, was documented for 18% of patients.
2
Adherence to the second recommendation, early rehabilitation in the intensive care unit, was documented for 72% of those with severe trauma and ≥ 2 days ICU stay.
3
Adherence to the third recommendation, direct transfer of patients from acute ward to a specialized rehabilitation unit, was documented in 22% of patients

Research Summary

This study investigated adherence to 3 central operational recommendations for acute rehabilitation in the Norwegian national trauma plan. Of patients who stayed 3 or more days in the ICU, assessment by a physical medicine and rehabilitation physician within 72 h after admission was documented in 18% of patients. Otherwise, compliance with the guidelines is poor. This applies especially to assessments by a physical medicine and rehabilitation physician within 72 h after admission registered in medical records.

Practical Implications

Systematic Integration

Findings indicate a need for more systematic integration of rehabilitation in the acute treatment phase after trauma.

Early Specialist Assessment

Systematic early specialist assessment of rehabilitation needs is a way to secure an effective treatment process.

Address Unmet Needs

Moderately injured patients may experience significant loss of function; therefore, this group probably has unmet needs for rehabilitation.

Study Limitations

1
Adults with psycho-social and/or drug problems more often left the hospital early against medical advice or were more often non-responders.
2
Unrecorded informal assessments led to some understatement of the percentage of patients assessed by a physical medicine and rehabilitation physician.
3
A low rate may also be due to limited resources.

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