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

Abstract

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.

Implementing early rehabilitation and mobilisation for children in UK paediatric intensive care units: the PERMIT feasibility study

“…We compared and contrasted safety and tolerance criteria identified through our literature-based work and supplemented these with examples from adult ERM literature. 53,97,98 Through discussion between the core intervention development team and clinical members of the wider PERMIT research team, we initially considered and ruled out three approaches to specifying safety and tolerance criteria:…”

Implementation of an early mobility protocol in the neuroscience ICU

“…Intervention An early mobility screening tool and protocol was developed and implemented. The screening tool (Figure 1) was developed from a literature review conducted by the Early Mobility Team to assist nurses in assessing the patient's eligibility for early mobilization, including exclusion, caution, and safe criteria for early mobility (Hernandez et al, 2021;Olkowski & Shah, 2017;Lang et al, 2020;Sakai et al, 2020). A screening tool visual aid was posted at nursing stations for easy accessibility.…”