Interdisciplinary health team’s experience in mobilising postoperative orthopaedic patients with altered mental status in a private hospital setting: a phenomenological study

Abstract

Achievement of patients’ pre-morbid functional level or improvement of their functional ability is a major postoperative goal for orthopaedic surgical patients. A change in a patient’s mental state has a multifactorial aetiology which can impact patient outcomes and influence the delivery of care. Patient mobilisation is a role shared by both nurses and physiotherapists. Mobilising orthopaedic patients with altered mental status require both professional groups to work in close collaboration. The study aims to enhance the understanding of the experience of nurses and physiotherapists in mobilising postoperative orthopaedic patients who have altered mental status using the hermeneutic phenomenological research methodology. It also seeks to explore the differences/ similarities of their experience, describe any challenges encountered, interpret and give meaning to their experience, contribute to literature, and impact health practices. Three nurses and three physiotherapists were recruited through purposive sampling. Data was analysed using Burnard’s 14 stages of thematic content analysis. Four main categories emerged from the study: altruism, interprofessional specialist practice, patient dynamics and challenges. The findings of this study demonstrated that nurses and physiotherapists experience numerous challenges from both patient and resources related factors that influence the mobilisation of this patient group with the potential to impact the relationship between the two professional groups. Nurses and physiotherapists maintain a symbiotic relationship; their interprofessional collaboration enables achievement of mobilisation goals and their experience of the phenomenon is comparable. Patient and staff safety takes precedence over mobilisation. Participants believe that safety risks can be mitigated by having adequate resources, competence, and teamwork. The study recommends an evaluation of the resources and strategies required to ensure that this patient group are mobilised optimally to improve patient outcomes and experience.