• Selina M Parry, Louisa Remedios, Linda Denehy, Laura D Knight, Lisa Beach, Thomas C Rollinson, Sue Berney, Zudin A Puthucheary, Peter Morris, and Catherine L Granger.
• Department of Physiotherapy, The University of Melbourne, Level 7 Alan Gilbert Bldg, 161 Barry St, Parkville 3010, Victoria, Australia. Electronic address: selina.parry@unimelb.edu.au.
• J Crit Care. 2017 Apr 1; 38: 137-143.

PurposeTo identify the barriers and enablers that influence clinicians' implementation of early rehabilitation in critical care.Materials And MethodsQualitative study involving 26 multidisciplinary participants who were recruited using purposive sampling. Four focus groups were conducted using semistructured questions to explore attitudes, beliefs, and experiences. Data were transcribed verbatim and thematic analysis was performed.ResultsSix themes emerged, as follows: (1) the clinicians' expectations and knowledge (including rationale for rehabilitation, perceived benefits, and experience), (2) the evidence for and application of rehabilitation (including beliefs regarding when to intervene), (3) patient factors (including prognosis, sedation, delirium, cooperation, motivation, goals, and family), (4) safety considerations (including physiological stability and presence of devices or lines), (5) environmental influences (staffing, resources, equipment, time, and competing priorities), and (6) culture and teamwork. Key strategies identified to facilitate rehabilitation included addressing educational needs for all multidisciplinary team members, supporting junior nursing staff, and potential expansion of physiotherapy staffing hours to closer align with the 24-hour patient care model.ConclusionsKey barriers to implementation of early rehabilitation in critical care are diverse and include both clinician- and health care system-related factors. Research targeted at bridging this evidence-practice gap is required to improve provision of rehabilitation.Copyright © 2016 Elsevier Inc. All rights reserved.

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