Minimum standards of clinical practice for physiotherapists working in critical care settings in Australia and New Zealand: A modified Delphi technique

Objective: Achieving competency in critical care in entry-level physiotherapy courses across Australia and New Zealand is not essential, and accredited training for qualified physiotherapists working in critical care units is lacking. As a result, practice standards and training may vary. The objective was to establish consensus-based minimum clinical practice standards for physiotherapists working in critical care settings in Australia and New Zealand. Design: A modified Delphi technique, which consisted of three rounds of questionnaires, was used to obtain consensus on items. Setting: Australian and New Zealand critical care settings. Participants: A panel (n = 61) was invited from a pool of eligible physiotherapists throughout Australia and New Zealand (n = 93). Eligibility criteria were defined a-priori on the basis of possession of expertise and experience in the practice and teaching of critical care physiotherapy clinical skills. Main Outcome Measure: Questionnaires were disseminated electronically (either via email, or SurveyMonkey^®). Items were designated by participants as being ‘Essential/Unsure/Not Essential’. Consensus for inclusion was achieved when items were ranked ‘Essential’ by more than 70% of participants. Results: Fifty physiotherapists consented and participated in the initial Delphi round, of whom 45 (90%) completed all rounds. Consensus was reached on 199 (89%) items. The panel agreed that 132 (58%) items were ‘Essential’ items for inclusion in the final framework. Conclusions: This is the first study to develop a consensus framework of minimum standards of practice for physiotherapists working in critical care. The clinical utility of this framework now requires assessment.