What are the barriers to nurses mobilising adult patients in intensive care units? An integrative review

Popoola, Melissa; Dingle, Maria; MacLaren, Julie-Ann; Dyson, Judith

doi:10.1016/j.aucc.2021.09.002

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…Research gaps and sources do not really help, but they have to be overcome by a joint effort of clinicians and researchers. Nurses also identified barriers to implementing protocols of rehabilitation, and they included staffing levels, lack of resources, poor care coordination, concerns about personal and team safety, lack of knowledge or training, invasive lines and medical instability, fear of dislodgement, neurological limitations and sedation, low priority, presence of endotracheal tubes, poor communication such as contradictory information which is a definite source of disbelief and loss of confidence, inadequate equipment, increased workload, fatigue, self-injury and time [6,35].…”

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confidence: 99%

Rehabilitation in the ICU

Chiș,

Copotoiu

2023

Physical Therapy - Towards Evidence-Based Practice

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Prolonged stay in the ICU comes with a variety of sequelae evolving toward chronic conditions rendering rehabilitation a challenge for the medical staff and patients’ families. Functional impairment is physical (touching mainly mobility: weakness, atrophy), cognitive or beyond (dysphagia, chronic pain, risk of falls). Properly identifying the risk factors means addressing them in a preventive manner. The curative approach, due to fragmented trajectories and the controversies related to early mobilization and the dose of physical rehabilitation, is still subject to debate. Possible barriers to implementing rehabilitation protocols were identified as well as future research themes regarding new targets for interventions to be tested in large-scale randomized controlled trials.

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Section: Author Detailsmentioning

confidence: 99%

Rehabilitation in the ICU

Chiș,

Copotoiu

2023

Physical Therapy - Towards Evidence-Based Practice

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Effects of the High-Intensity Early Mobilization on Long-Term Functional Status of Patients with Mechanical Ventilation in the Intensive Care Unit

Zhang,

Wang,

et al. 2024

Critical Care Research and Practice

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Objective. Intensive care unit (ICU)-acquired weakness often occurs in patients with invasive mechanical ventilation (IMV). Early active mobility may reduce ICU-acquired weakness, improve functional status, and reduce disability. The aim of this study was to investigate whether high-intensity early mobility improves post-ICU discharge functional status of IMV patients. Methods. 132 adult patients in the ICU who were undergoing IMV were randomly assigned into two groups with a ratio of 1 : 1, with one group received high-intensity early mobility (intervention group, IG), while the other group received conventional treatment (control group, CG). The functional status (Barthel Index (BI)), capacity of mobility (Perme score and ICU Mobility Scale (IMS)), muscle strength (Medical Research Council sum scores (MRC-SS)), mortality, complication, length of ICU stay, and duration of IMV were evaluated at ICU discharge or after 3-month of ICU discharge. Results. The patient’s functional status was improved (BI scores 90.6 ± 18.0 in IG vs. 77.7 ± 27.9 in CG; p=0.005), and capacity of mobility was increased (Perme score 17.6 ± 7.1 in IG vs. 12.2 ± 8.5 in CG, p<0.001; IMS 4.7 ± 2.6 in IG vs. 3.0 ± 2.6 in CG, p<0.001). The IG had a higher muscle strength and lower incidence of ICU-acquired weakness (ICUAW) than that in the CG. The incidence of mortality and delirium was also lower than CG at ICU discharge. However, there were no differences in terms of length of ICU stay, duration of IMV, ventilator-associated pneumonia, and venous thrombosis. Conclusions. High-intensity early mobility improved the patient’s functional status and increased capacity of mobility with IMV. The benefits to functional status remained after 3 month of ICU discharge. Other benefits included higher muscle strength, lower incidence of ICUAW, mortality, and delirium in IG.

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What are the barriers to nurses mobilising adult patients in intensive care units? An integrative review

Cited by 2 publications

References 40 publications

Rehabilitation in the ICU

Rehabilitation in the ICU

Effects of the High-Intensity Early Mobilization on Long-Term Functional Status of Patients with Mechanical Ventilation in the Intensive Care Unit

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