title: Developing minimum clinical standards for physiotherapy in South African intensive care units: the nominal group technique in action.
abstract: OBJECTIVE
  Physiotherapists form an important part of the inter-professional team that cares for critically ill patients in intensive care units (ICU). No formalized clinical practice guidelines or standards exist for the educational profile or scope of practice requirements for physiotherapy within critical care, which poses a threat to physiotherapy practice and professional credibility.
  
  
  METHODS
  The aim of this paper was to describe the nominal group technique (NGT) used to identify the minimum standards of clinical practice needed by physiotherapists to ensure safe and independent practice in South African ICUs.
  
  
  RESULTS
  Twenty-five subjects participated in one of three forums. Sixty-six concepts were considered in the three domains (knowledge, skills and attitudes). Not all concepts were discussed by all three focus groups. Just over half (54% n=14) the concepts generated in the knowledge domain; a third of the concepts (35% n=7) generated in the skills domain and only 10% (n=2) of attitudes were consistently raised by all three groups. Almost two-thirds of the concepts generated (62% n=41) were considered in more than one domain. Only six concepts reached the threshold consensus level across all three focus groups, four knowledge parameters and two skills.
  
  
  CONCLUSIONS
  The NGT allowed for the cross-stimulation of ideas in an engaging yet anonymous and structured manner. The importance of discussion in reaching consensus is highlighted. Going forward, it is intended to use the concepts generated through this process as the foundation for further consensus-building activities among the wider physiotherapy and intensive care communities.
authors.affiliation: Physiotherapy Division, Department of Interdisciplinary Health Sciences, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa.
authors.forename: Susan
authors.initials: S
authors.lastname: Hanekom
authors.forename: Helena
authors.initials: H
authors.lastname: Van Aswegen
authors.forename: Natascha
authors.initials: N
authors.lastname: Plani
authors.forename: Shane
authors.initials: S
authors.lastname: Patman
mesh_terms: D000328:Adult; D003422:Critical Care / Q000458:organization & administration* / Q000592:standards; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration* / Q000592:standards; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D026741:Physical Therapy Modalities / Q000458:organization & administration* / Q000592:standards; D013019:South Africa
keywords: intensive care; nominal group technique; physical therapy; physiotherapy service; standards