Early Mobilization in the Intensive Care Unit to Improve Long-Term Recovery

Paton, Michelle; Lane, Rebecca; Hodgson, Carol

doi:10.1016/j.ccc.2018.06.005

Cited by 25 publications

(17 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…6 It can promote neuromuscular function recovery, prevent and treat ICU-acquired weakness, reduce the duration of ICU delirium, prevent deep vein thrombosis, reduce the time and frequency of ventilator use and ventilator-associated pneumonia risk, promote intestinal peristalsis, prevent intestinal adhesion and constipation, improve patient ability to self-care, and reduce the duration of ICU stay. [7][8][9][10][11][12] However, early mobilization is not widely implemented for critically ill patients. A survey in China showed that the rate of early mobilization in mechanically ventilated patients was 19.15%, while that in non-mechanically ventilated patients was 23.5%.…”

Section: Introductionmentioning

confidence: 99%

“…There is currently no standardized definition of ICU early mobilization, and it is commonly defined as facilitating ICU patients to perform therapeutic exercise as soon as possible 6 . It can promote neuromuscular function recovery, prevent and treat ICU‐acquired weakness, reduce the duration of ICU delirium, prevent deep vein thrombosis, reduce the time and frequency of ventilator use and ventilator‐associated pneumonia risk, promote intestinal peristalsis, prevent intestinal adhesion and constipation, improve patient ability to self‐care, and reduce the duration of ICU stay 7‐12 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intensive care unit nurses' knowledge, attitudes, and perceived barriers regarding early mobilization of patients

Wang

Xiao

Jia

et al. 2020

Nursing in Critical Care

View full text Add to dashboard Cite

Background: It has been recommended that critically ill patients start mobilization as early as possible. However, the clinical utilization rate of early mobilization remains low in the intensive care unit (ICU), and respiratory therapists and nurses are the primary practitioners of early mobilization in China. Aim: The aim of this study is to investigate the knowledge, attitudes, and perceived barriers of ICU nurses regarding the early mobilization of ICU patients. Design: A descriptive and cross-sectional design was used. Methods: A cross-sectional design was used, with an e-questionnaire for ICU nurses (n = 227) to assess knowledge and attitudes regarding early mobilization via the "Tencent WeChat" app on their smart phones. Results: As the primary implementers of the early mobilization of ICU patients in China, more than half of ICU nurses passed the knowledge test (scored ≥20/25 points) and had positive attitudes (scored 45/55 points) regarding early mobilization. Nurses had good knowledge (more than 96.5%) of the benefits and stopping indications of early mobilization; however, they had a poor understanding (less than 51.1%) of the population in which early mobilization is applicable and monitoring indicators during early mobilization, and 39.2% of nurses did not support routine implementation of early mobilization for patients in the ICU. The major barriers that they perceived were very heavy workload (76.8%), insufficient equipment and devices (50.2%), lack of written protocols or guidelines (50.2%), inadequate training (47.1%), potential work risks (42.3%), and limited staffing (41.4%). Conclusions: Although over half of ICU nurses exhibited relatively comprehensive knowledge of and positive attitudes to early mobilization, some misunderstandings, negativity, and barriers remain. Relevance to clinical practice: Training programmes should be conducted continuously, especially focused on common misunderstandings and negative attitudes. Organizational support is required to overcome barriers to the implementation of early mobilization.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intensive care unit nurses' knowledge, attitudes, and perceived barriers regarding early mobilization of patients

Wang

Xiao

Jia

et al. 2020

Nursing in Critical Care

View full text Add to dashboard Cite

show abstract

“…Recently, barriers to and strategies for early mobilization in the ICU and analysis of outcomes have been reported. 18 , 19 , 20 ) However, to our knowledge, studies with protocol and cancellation criteria in Japan that particularly examined the safety and course of early mobilization and active exercise in the early phase in the ICU are limited. 21 ) Consequently, we aimed to investigate the risk management and the specific method for early mobilization and active exercise for ICU patients using protocol and cancellation criteria within multidisciplinary rounds.…”

Section: Introductionmentioning

confidence: 99%

The Safety and Effect of Early Mobilization in the Intensive Care Unit According to Cancellation Criteria

Sakai

Hoshino

Okawa

et al. 2020

PRM

View full text Add to dashboard Cite

Objective: The aim of this study was to investigate the effect and risk management of early mobilization in the intensive care unit (ICU) with multidisciplinary collaboration and daily goal planning. Methods: Rehabilitation of ICU patients in our hospital between April 1, 2019, and September 30, 2019, was investigated retrospectively. The following factors were evaluated: age and sex of the subjects; diseases; the total number of early mobilization therapy sessions done at a lowered goal level; the clinical course of the step-down sessions; reasons for lowering goal levels that corresponded to the cancellation criteria from the officially issued guidelines of the Japanese Association of Rehabilitation Medicine, the expert consensus on ICU, or other reasons for step down; and the rate of planned goals that were achieved. Results: Of the 1908 overall rehabilitation sessions carried out during the period of investigation, 9.6% had the planned level lowered; changes in vital signs accounted for 54.6% of the reasons for lowering the level. Of the step-down sessions, 92.3% corresponded with the cancellation criteria of rehabilitation. Early mobilization in the ICU in accordance with daily goal planning via collaboration within the multidisciplinary team during rounds was accomplished in 90.4% of sessions. No serious mobilization-related adverse events were noted during the study period. Conclusion: Early mobilization should be performed with daily goal planning by a multidisciplinary team during rounds and should be governed by the cancellation criteria of rehabilitation.

show abstract

“…2,[4][5][6] Observational studies and small randomized clinical trials have shown that early mobilization (ie, starting within 72 h of ICU admission) is an important and feasible strategy to prevent ICU-acquired weakness, with improved functional outcomes at hospital discharge, increased ventilator-free days, and reduction in the duration of delirium. 7,8 However, recent systematic reviews have not demonstrated this significant effect on functional recovery or quality of life. 2,9 A speaking valve is a one-way valve that blocks air flow from exhalation in a tracheostomized patient and redirects it through to the upper airway to enable functional use of the glottis.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Speaking Valves on ICU Mobility of Individuals With Tracheostomy

et al. 2019

View full text Add to dashboard Cite

BACKGROUND: Early mobilization is part of the rehabilitation process for critically ill patients and is currently considered a means of preventing ICU-acquired muscle deterioration and worsening of physical function. We sought to determine whether the use of speaking valves in tracheostomized patients would improve their mobility. We evaluated the changes in mobility performance with the use of speaking valves in tracheostomized subjects. METHODS: We performed a cohort study of a series of subjects who were tracheostomized and were being weaned from mechanical ventilation between April 2016 and May 2018. The subjects were those able to tolerate a speaking valve for a minimum of 30 min. Demographic data, comorbidities, cause of ICU admission, days in the ICU, duration of mechanical ventilation before tracheostomy, and days free from mechanical ventilation before tracheostomy were collected. Mobility status was evaluated using daily measurements of the Perme Intensive Care Unit Mobility Score. RESULTS: During the study period, 63 patients were tracheostomized. Patients with deficiencies in language (n ‫؍‬ 2) or cognitive deficits (n ‫؍‬ 36) and patients in exclusive palliative care (n ‫؍‬ 7) were excluded. Eighteen subjects were enrolled in the study. The mean age of the subjects was 64.6 ؎ 14.2 y (55.5% were male), and the most common reason for ICU admission was pneumonia (n ‫؍‬ 7; 38.8%). Perme scores increased from 11.3 (interquartile range 10.1-12.0) on the day before initiation of the speaking valve to 18.2 (IQR 16.2-20.1) immediately after the initiation of a speaking valve (P < .01). These changes were maintained during all periods of speaking valve use. CONCLUSIONS: The use of speaking valves in tracheostomized subjects improved mobility.

show abstract

Early Mobilization in the Intensive Care Unit to Improve Long-Term Recovery

Cited by 25 publications

References 62 publications

Intensive care unit nurses' knowledge, attitudes, and perceived barriers regarding early mobilization of patients

Intensive care unit nurses' knowledge, attitudes, and perceived barriers regarding early mobilization of patients

The Safety and Effect of Early Mobilization in the Intensive Care Unit According to Cancellation Criteria

The Effect of Speaking Valves on ICU Mobility of Individuals With Tracheostomy

Contact Info

Product

Resources

About