Association between specialist staff and team activities and intensive care unit rehabilitation practices: A cross-sectional survey in Japan

Objective: This cross-sectional study aimed to investigate rehabilitation practices in intensive care units (ICUs) for patients with acute respiratory failure and other diagnoses and examine the association with specialist staffing and team activities, adjusting for patient characteristics and organizational structures. Methods: Nurse managers in ICUs across Japan participated in a questionnaire survey on rehabilitation practices for individual patients and organizational variables. The highest degree of rehabilitation practice (using the ICU mobility score >1) on the survey day was measured for each patient. Results: A total of 92 nurse managers completed the questionnaire, and data from 405 inpatients were analyzed. Approximately 40% of the patients did not receive rehabilitation on the survey day, and 50% of the patients admitted to the ICU for more than 2 days (n = 295) did not receive early rehabilitation within 2 days of ICU admission. Mixed-effects multivariate analysis showed that a higher degree of rehabilitation on the survey day was associated with the adoption of mandatory critical care consultation for patients admitted to the ICU by dedicated physicians (adjusted odds ratio: 1.88, 95% confidence interval: 1.06-3.30). The outcomes were not associated with the presence of dedicated physical therapists in the ICU, the number of nurses specialized in critical care per 10 ICU beds, or the measured team activities. Conclusions: Our results indicate that ICU rehabilitation practices may be insufficient in Japan. A higher degree of ICU rehabilitation on the survey day was associated with the participation of ICU physicians in the treatment of ICU patients.