849

Bybee, Jillian; Sorce, Lauren R.; Ciolino, Jody D.; Bone, Meredith

doi:10.1097/01.ccm.0000474677.05252.3a

Cited by 2 publications

(1 citation statement)

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“…5 Recently, the need to establish EM protocols has become widely accepted in pediatric intensive care unit (PICUs). 6 7 8 9 10 11 12 13 14 15 16 The 2022 SCCM PANDEM Guidelines suggests “performing EM to minimize the effects of immobility in critically ill pediatric patients”. 17 Evidence shows that effective EM can reduce delirium and mitigate ICU-AW.…”

Section: Introductionmentioning

confidence: 99%

Barriers to Adherence of Early Mobilization Protocols in the Pediatric Intensive Care Units

Rodriguez,

Hollis,

Kalinowski

et al. 2023

J Pediatr Intensive Care

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Children who survive critical illness suffer many sequelae of prolonged hospitalization. National guidelines recommend pediatric intensive care units (PICUs) employ ICU care bundles to combat acquired delirium, pain, and weakness. While the use of early mobility (EM) protocols has increased in PICUs, there remain challenges with adherence. The aim of this study is to better understand perceived barriers to EM in the PICU before and after introducing an EM protocol. We hypothesized that providers would be most concerned about the safety of EM. This pre–post-survey study was conducted at a single-center tertiary PICU. A total of 94 PICU providers were included in this study, including nurses, physicians, and therapists. Responses were collected anonymously. Survey respondents consented to participation. The initial survey was conducted prior to enacting an EM protocol to gauge knowledge and opinions surrounding EM. Based on the results, education regarding EM was performed by a multidisciplinary team. An EM protocol “Move Jr.” was initiated. Four months postinitiation, a follow-up survey was sent to the same cohort of providers to determine knowledge of the protocol, changes in opinions, as well as barriers to the implementation of EM. While providers believed that EM was beneficial for patients and were interested in implementing an EM protocol, the initial top three perceived barriers to EM were risk of inadvertent extubation, risk of inadvertent loss of central lines, and time constraints. Four months after the initiation of the EM protocol, a follow-up survey revealed that the top three perceived barriers of EM had changed to time constraints, increased workload, and level of sedation. After 4 months, the change in perceived barriers suggests greater acceptance of the safety of EM but challenges in application. Survey responses describe a desire to perform EM exercises but difficulty finding time. Understanding of the protocol also differed among providers. Greater collaboration among providers could lead to more cohesive therapy plans. There was a clear benefit in educating providers to consider EM as a priority in patient care.

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Section: Introductionmentioning

confidence: 99%

Barriers to Adherence of Early Mobilization Protocols in the Pediatric Intensive Care Units

Rodriguez,

Hollis,

Kalinowski

et al. 2023

J Pediatr Intensive Care

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Risk Assessment and Early Mobilization Pathway Following Pediatric Tracheostomy: A Pilot Study

et al. 2020

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Objectives/Hypothesis To confirm the standard of care pertaining to postoperative mobilization practices following initial tracheostomy, to establish face validity of novel early mobilization tools, and to conduct a safety and feasibility pilot study. Study Design Multi‐institutional survey and prospective cohort study. Methods Experts at our tertiary‐care children's hospital developed an Early Pediatric Mobility Pathway for tracheostomy patients utilizing a novel risk‐assessment tool. Surveys were distributed to professional colleagues in similar children's hospitals to establish face validity and incorporate respondent feedback. Additional surveys were disseminated to tertiary‐care children's hospitals across the country to establish the current standard of care, and a pilot study was conducted. Results Seventy‐seven percent of respondents from tertiary hospitals across the country confirmed the standard of care to defer mobilization until the first trach change. Greater than 83% of the respondents used to establish face validity of the tools agreed with the clinical components and scoring structure. The safety and feasibility of early mobilization prior to initial trach change was confirmed with a pilot of 10 pediatric patients without any adverse events. Conclusions Mobilization of pediatric patients prior to initial trach change is feasible and can be safe when risk factors are assessed by a multidisciplinary team. Level of Evidence 4 Laryngoscope, 131:E653–E658, 2021

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849

Cited by 2 publications

References 0 publications

Barriers to Adherence of Early Mobilization Protocols in the Pediatric Intensive Care Units

Barriers to Adherence of Early Mobilization Protocols in the Pediatric Intensive Care Units

Risk Assessment and Early Mobilization Pathway Following Pediatric Tracheostomy: A Pilot Study

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