Early mobilization of critically ill adults: a survey of knowledge, perceptions and practices of Canadian physicians and physiotherapists

Koo, Karen K. Y.; Choong, Karen; Cook, Deborah J.; Herridge, Margaret S.; Newman, Anastasia; Lo, Vincent; Guyatt, Gordon; Priestap, Fran; Campbell, Eileen; Burns, Karen E. A.; Lamontagne, François; Meade, Maureen O.

doi:10.9778/cmajo.20160021

Cited by 73 publications

(104 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most of the nurses reported that they have not gone through patient early mobilization training which was consistent with the results reported by Koo et al [35]. It was doubtful whether non-mobilization trained nurses able to provide optimum care for patient early mobilization.…”

Section: Discussionsupporting

confidence: 82%

Patient early mobilization: A Malaysia's study of nursing practices

Leong¹,

Chong²,

Rahman³

2017

J Intensive Crit Care

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 82%

Patient early mobilization: A Malaysia's study of nursing practices

Leong¹,

Chong²,

Rahman³

2017

J Intensive Crit Care

View full text Add to dashboard Cite

show abstract

“…The barriers to EM most frequently cited by physicians were the unavailability of professionals on the team and of sufficient time to routinely mobilize patients, excessive sedation and delirium. ( 15 , 17 ) Risk of musculoskeletal self-injury and excessive stress at work were also mentioned by nurses and physical therapists as barriers to EM.…”

Section: Discussionmentioning

confidence: 99%

“…These barriers were also reported by members of multi-professional teams in the United States ( 15 ) and Canada. ( 17 ) Time and the professionals required to mobilize critically ill patients might be considerable hindrances to EM in the ICU. In addition, they represent a frequently reported concern in regard to the improvement of the quality of care needed to facilitate the acceptance of mobilization.…”

Section: Discussionmentioning

confidence: 99%

“…( 12 - 14 ) These studies identified personal and patient safety and lack of clinical comprehension as potentially relevant hindrances to the performance of EM. Recent studies ( 15 - 17 ) found that the need of a larger number of professionals, insufficient working hours and the staff's culture regarding mobilization, including a lack of resources, prioritization and leadership, are among the main interdisciplinary barriers to the performance of EM.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical attitudes and perceived barriers to early mobilization of critically ill patients in adult intensive care units

Fontela

Forgiarini

Friedman

2018

Revista Brasileira De Terapia Intensiva

View full text Add to dashboard Cite

ObjectiveTo investigate the knowledge of multi-professional staff members about the early mobilization of critically ill adult patients and identify attitudes and perceived barriers to its application.MethodsA cross-sectional study was conducted during the second semester of 2016 with physicians, nursing professionals and physical therapists from six intensive care units at two teaching hospitals. Questions were answered on a 5-point Likert scale and analyzed as proportions of professionals who agreed or disagreed with statements. The chi-square and Fisher's exact tests were used to investigate differences in the responses according to educational/training level, previous experience with early mobilization and years of experience in intensive care units.ResultsThe questionnaire was answered by 98 out of 514 professionals (response rate: 19%). The acknowledged benefits of early mobilization were maintenance of muscle strength (53%) and shortened length of mechanical ventilation (83%). Favorable attitudes toward early mobilization included recognition that its benefits for patients under mechanical ventilation exceed the risks for both patients and staff, that early mobilization should be routinely performed via nursing and physical therapy protocols, and readiness to change the parameters of mechanical ventilation and reduce sedation to facilitate the early mobilization of patients. The main barriers mentioned were the unavailability of professionals and time to mobilize patients, excessive sedation, delirium, risk of musculoskeletal self-injury and excessive stress at work.ConclusionThe participants were aware of the benefits of early mobilization and manifested attitudes favorable to its application. However, the actual performance of early mobilization was perceived as a challenge, mainly due to the lack of professionals and time, excessive sedation, delirium, risk of musculoskeletal self-injury and excessive stress at work.

show abstract

“…Another example is the approach of early mobilization in critically ill adults (20). In a survey in academic ICUs in Canada (20) both physicians and physiotherapists underestimated the incidence of ICUAW and felt inadequately trained to mobilize patients receiving mechanical ventilation.…”

Section: Exclusion Criteriamentioning

confidence: 99%

Effect of physiotherapy on regaining independent walking in patients with intensive-care-unit-acquired muscle weakness: A cohort study

Thomas¹,

Mehrholz²,

Bodechtel³

et al. 2019

J Rehabil Med

View full text Add to dashboard Cite

The aim of this study was to describe physiotherapeutic interventions during post-acute inpatient rehabilitation of chronic critically ill patients with intensive-care-unitacquired muscle weakness, and to determine the relationship of such interventions with patients' recovery of walking ability. The study included 150 patients with chronic critical illness and acquired muscle weakness, and documented what interventions physiotherapists applied during rehabilitation and how well patients regained walking function. The most frequent interventions in the first 2 weeks of rehabilitation in patients who regained walking ability were: practicing walking, sit-to-stand training, and balance training while sitting. In those who did not regain walking ability the most frequent interventions were: passive-assistive movements, sit-to-stand training, and balance training while sitting. The time spent walking in physiotherapy was correlated with walking function. Physiotherapy in the rehabilitation of chronically critically ill patients with intensive-care-unit-acquired muscle weakness may be correlated with achieving independent walking. Objectives: To describe physiotherapeutic interventions used in the post-acute inpatient rehabilitation of chronic critically ill patients with intensive-careunit-acquired muscle weakness, and to determine the influence of such interventions on patients' ability to walk. Methods: Chronic critically ill patients with intensive-care-unit-acquired muscle weakness who were in post-acute and rehabilitation units were included in a cohort study. During post-acute rehabilitation, the patients' functional status at baseline, all daily physiotherapeutic interventions, and ability to walk were documented. Results: A total of 150 patients were investigated. In patients who regained walking ability, the most frequent interventions in the first 2 weeks of postacute rehabilitation were practicing walking, sit-tostand training, and balance training while sitting (total time per week: 48.03 (standard deviation (SD) 41.10), 20.13 (SD 21.12), and 12.37 (SD 26.95) min, respectively). The most frequent interventions in those who did not regain walking ability were passive-assistive movements, sit-to-stand training, and balance training while sitting (total time per week: 15.29 (SD 22.93), 15.15 (SD 22.75), and 14.85 (SD 16.99) min, respectively). The time spent walking increased the chance of regaining walking ability (adjusted hazard ratio = 1.017 per min walking, p < 0.0001). Conclusion: These results suggest that physiotherapy interventions in the rehabilitation of chronic critically ill patients with intensive-care-unit-acquired muscle weakness may stimulate walking function.

show abstract

Early mobilization of critically ill adults: a survey of knowledge, perceptions and practices of Canadian physicians and physiotherapists

Cited by 73 publications

References 28 publications

Patient early mobilization: A Malaysia's study of nursing practices

Patient early mobilization: A Malaysia's study of nursing practices

Clinical attitudes and perceived barriers to early mobilization of critically ill patients in adult intensive care units

Effect of physiotherapy on regaining independent walking in patients with intensive-care-unit-acquired muscle weakness: A cohort study

Contact Info

Product

Resources

About