Early Mobilization in Trauma ICU Decreases Length of Stay and Complications.

Matthews, Helen M.; Clark, Diane; Lowman, John; Sheils, K.

doi:10.1097/01592394-201001020-00010

Cited by 4 publications

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“…Similar research studies show that nursing knowledge and skill in achieving EM are essential. 9 Implementation of a program [39][40][41][42][43][44][45][46][47] and education of staff 39,46 are important factors in EM for critically ill patients in ICU. Doherty et al 48 and Garzo et al 49 suggested that better definitions of care roles may allow for more targeted surveys of attitudes and behaviors that may improve EM practice.…”

Section: Comparisons With Other Studies and Implicationsmentioning

confidence: 99%

Management of early mobilization in intensive care units: a multicenter cross-sectional study

Zhu

Xia

2018

Frontiers of Nursing

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Objective The aim of this study was to assess the management of early mobilization (EM) in Chinese intensive care units (ICUs). Methods This survey used a cross-sectional, observational design. A total of 65 tertiary and secondary hospitals were enrolled by convenience sampling and investigated using self-designed questionnaires. Results We identified 69 ICUs in Jiangsu, China (response rate: 94.2%). 74.2% (1,004/1,353) of the nurses and nursing managers from 65 ICUs reported mobility practice. For the mobility level, 98.1% (1,327) reported use of in-bed exercise, 5.7% (77) sitting on a side of bed, 21.7% (294) transfer to chair, and 2.4% (33) walking. The most frequently reported barriers to early mobility were unplanned extubation, nursing resource, and absence of physical therapist. Nurses’ educational backgrounds, nursing experience, the lack of nursing resources, absence of physician, and the weakness of patient were the factors that influenced ICU early rehabilitation (P<0.01). Conclusions Although implementation rates for EM in critically ill patients are high, the activity level is generally poor in most of the involved ICUs.

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Section: Comparisons With Other Studies and Implicationsmentioning

confidence: 99%

Management of early mobilization in intensive care units: a multicenter cross-sectional study

Zhu

Xia

2018

Frontiers of Nursing

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“…The mean posttest scores increased by 25 points (95% CI, [20][21][22][23][24][25][26][27][28][29][30], suggesting that 95% of ICU nurses would score 20 to 30 points higher on the posttest after receiving this educational intervention. Although the intervention was effective in increasing the nurses' knowledge, the overall goal of the education was to effectively implement mobility in the ICU.…”

Section: Discussionmentioning

confidence: 99%

“…8 Implementation of a program 23,25,27,30,38,39,[41][42][43][44] and education of staff 25,42 are important factors in mobilizing ICU patients. Although many studies support the use of mobility protocols to effectively mobilize patients in the ICU, research on the effects of education on mobilization in the ICU is lacking.…”

Section: Major Fi Ndingsmentioning

confidence: 99%

“…Fitzgibbon 42 found that before an educational intervention, 40% of nurses understood the concepts of early mobility, and 30% of nurses performed passive range-of-motion exercises on patients. After the educational intervention, 98% of nurses understood concepts of early mobility, and 100% performed passive range-of-motion exercises on their patients.Recent research 15,17,23,[26][27][28][29][30]32,[35][36][37][39][40][41] on ICU mobility suggests that patients who are critically ill should engage in daily, early exercise to achieve better outcomes. Although implementing mobility in ICU patients should be done cautiously, mobility is safe and feasible.…”

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confidence: 99%

“…Although implementing mobility in ICU patients should be done cautiously, mobility is safe and feasible. 16,[18][19][20]27,30,31,33,34,[36][37][38][39][40][41] On the basis of the literature review, key stakeholders in the medical-surgical ICU project decided that the nursing education on ICU mobility should address the benefi ts of mobility, the adverse effects of immobility, and instructions on overcoming barriers to mobility.According to the theory of adult education of Malcolm Knowles, 45 adults engage in learning on the basis of their current life or job situation and tend to approach educational activities from a performance-centered perspective. Adult learners need to understand why specifi c material is being taught, but instruction should be task oriented, with learning activities based on the context of the task being taught.…”

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Implementation of a Progressive Mobilization Program in a Medical-Surgical Intensive Care Unit

Messer

Comer

Forst

2015

Critical Care Nurse

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BACKGROUND Current literature supports implementation of progressive mobility protocols in intensive care units. Education can help nurses overcome barriers to mobility and increase knowledge about the positive effects of mobility. OBJECTIVE To evaluate the effect of education for a progressive mobilization program for intensive care nurses on knowledge and performance. METHODS A pretest-posttest evaluation was conducted for 41 nurses, and a chart review was performed before and after implementation of the educational intervention to evaluate changes in knowledge and mobilization. RESULTS Scores after the educational intervention were significantly higher than scores before the intervention (t = 2.02; P < .001). Overall mobilization (P = .04) and dangling (P = .01) increased significantly after the education. No significant increases occurred in ambulating or getting patients up to a chair. CONCLUSIONS Mobilization education was effective and increased nurses' knowledge about the benefits of mobility for critically ill patients. The educational program also affected how nurses performed mobility interventions. Although provision of education had positive effects on patients' mobility, leadership and coaching are still important components in implementing change. (Critical Care Nurse. 2015;35[5]:28-42) ©2015 American Association of Critical-Care Nurses doi: http://dx.doi.org/10.4037/ccn2015469 R esearch on early and progressive mobility is currently challenging the traditional standard of care that patients who are critically ill and treated with mechanical ventilation must remain bedfast for days or weeks. 1 Survival of critically ill patients has improved since the mid-1990s, but many of these patients experience long-term disabilities 2 and require rehabilitation after discharge from the intensive care unit (ICU). 1 In the ICU, the focus of care has been the short-term goal of survival, with little attention given to the functional and cognitive impairment of patients.1 One study 3 revealed that the quality of life of ICU patients was largely reduced 6 years after ICU admission; approximately half of the patients still had health problems, including cognitive dysfunction and problems with mobility. The traditional ICU standard of care for patients treated with mechanical ventilation has included deep sedation and prolonged immobility. RN, MSN, CCRN, 10 Firestone Dr, Arden, NC 28704 (e-mail: april.messer@msj .org).To purchase electronic or print reprints, contact the American Association of CriticalCare Nurses, 101 Columbia, Aliso Viejo, CA 92656. Phone, (800) 899-1712 or (949) 362-2050 (ext 532); fax, (949) 362-2049; e-mail, reprints@aacn.org. culture shift in ICU care to include strategies to mobilize ICU patients, 1,2,5,6 many ICUs in the United States have not changed their practice to include mobility of patients. 2,7,8 Nurses are often the key providers of mobility for patients who are critically ill. Barriers to mobility in the ICU include, but are not limited to, clinicians' fear and lack...

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Integrating a Mobility Champion in the Intensive Care Unit

Bruce

Forry

2018

Dimens Crit Care Nurs

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In recent years, early progressive mobilization programs have become mainstays in intensive care units (ICUs). Significant evidence exists that early mobility programs decrease length of stay, reduce time on the ventilator, and decrease the development of delirium in ICU patients. Yet, current literature still describes many barriers to performing early mobility, such as the time required, staffing pressures, and increased workload. Our critical care leaders found that defining and implementing a dedicated mobility champion team member was successful in improving the effectiveness of our early mobility program. This article describes how to define the mobility champion role, consider options for the person in the role, and integrate this new role into the ICU team.

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Early Mobilization in Trauma ICU Decreases Length of Stay and Complications.

Cited by 4 publications

References 0 publications

Management of early mobilization in intensive care units: a multicenter cross-sectional study

Management of early mobilization in intensive care units: a multicenter cross-sectional study

Implementation of a Progressive Mobilization Program in a Medical-Surgical Intensive Care Unit

Integrating a Mobility Champion in the Intensive Care Unit

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