Safety of a Nurse-Driven Mobility Protocol in a Surgical Trauma Intensive Care Unit

Abstract

Background: Traumatically injured patients are often admitted with complex multisystem injuries requiring a lengthy stay in the intensive care unit (ICU). Mobilizing patients in the ICU has been shown to reduce the adverse effects of immobility and can reduce the patient's length of stay in the hospital. However, little information is available about the safety of mobilizing traumatically injured patients. Local Problem: This quality improvement project was designed to determine whether a nurse-driven mobility protocol could lead to more frequent mobilization of traumatically injured patients. We also sought to determine patient outcomes, measured by the length of stay, adverse effects, and days on mechanical ventilation. Methods: A multidisciplinary group developed a nurse-driven early mobility protocol. Nurses were trained on mobilization practices for injured patients; they then mobilized eligible patients on their unit for the subsequent 6 months. Results: Nurses mobilized close to 80% of eligible patients in the surgical trauma ICU (STICU) during the implementation period, which was an 87.14% increase in patient mobilization from the preimplementation period. No mobility-associated adverse effects were observed for the patients who were mobilized in the STICU. No significant change in length of stay or ventilator-days occurred. Conclusion: Interdisciplinary planning led by physical therapists can ensure that a nurse-driven mobility protocol is a safe and effective method to mobilize patients earlier and more frequently. Future studies should consider a broader range of traumatically injured patients and the long-term effects of mobilization in the STICU.