Early mobilization implementation for critical ill patients: A cross-sectional multi-center survey about knowledge, attitudes, and perceptions of critical care nurses

Abstract

Objective To explore critical care clinicians’ knowledge, attitudes and perceptions toward early mobilization of critically ill patients in ICUs. Design A cross-sectional national survey was conducted. From January to August 2020, ICU nurses in 11 hospitals were surveyed by using a questionnaire on the knowledge, attitudes and perceptions of ICU early mobilization. Results Totally 512 nurses completed the questionnaire. The respondents’ mean score for knowledge of early mobilization was 6.89 ± 2.91. The level of knowledge was good in 2.5% (13/512), fair in 52.3% (268/512). The attitudes toward early mobilization were positive in 31.4% (161/512). In terms of perceived implementation of ICU early mobilization, 42.9% (220/512) of nurses did not believe that this should be a top priority in intensive care. The attitudes of nurses from different ICUs were significantly different ( F = 3.58 , P < 0.05). The knowledge (7.34 ± 2.78 vs. 6.49 ± 2.97, t = 3.37, P < 0.001) and attitudes (3.82 ± 0.58 vs. 3.52 ± 0.56, t = 5.63, P < 0.001) of nurses who had early mobilization related training were higher than those of nurses who had no training. Conclusions The importance of early ICU early mobilization is increasingly recognized by critical care providers. However, there is still a gap in the knowledge, attitudes and perceptions of ICU early mobilization among nurses. In future studies, it is necessary to further systematically identify the reasons leading to the gaps in these aspects and implement targeted interventions around these gaps. Meanwhile, more nurses should be encouraged to participate in decision-making to ensure the efficient and quality implementation of ICU early mobilization practices.

ICU quasi‐speciality nurses' knowledge, attitudes and practices regarding early mobilization: A cross‐sectional survey

“…For example, the questionnaire in the study by Lin et al (2020) just has six items on mechanical ventilation patients' EM‐related knowledge, and they adopt different methods of scoring, which are different from ours. In addition, only 37.7% (183 of 485) of the participants in the present study had received EM training, which was lower than what has been reported elsewhere (Anekwe et al, 2019; Zhang et al, 2021). A lack of EM knowledge or a low level of EM knowledge could cause poor EM implementation (Potter et al, 2021).…”

“…This finding was similar to that of Wang et al (2020) and Zhang et al (2019), who found that most respondents showed positive attitudes towards EM. However, Zhang et al (2021) reported that only 31.4% of the respondent nurses held positive attitudes towards EM. Furthermore, in the study by Wang et al (2020), 60.8% of nurses support the routine implementation of EM for ICU patients.…”

“…nurses, physicians, respiratory therapists and physiotherapists) knowledge and awareness could impact EM's clinical practice (Anekwe et al, 2019; Costa et al, 2017). Thus, many scholars are concerned about the care providers' knowledge, attitudes and practice (KAP) regarding EM in ICU (Lin et al, 2020; Wang et al, 2020; Zhang et al, 2021). Most studies outside of China have revealed EM's benefits, and participants hold positive attitudes but insufficient knowledge about and practice of EM (Akhtar & Deshmukh, 2021; Fontela et al, 2018; Koo et al, 2016; Lin et al, 2020).…”

“…Studies on ICU nurses from China's first‐tier cities (i.e. cities with a population of more than ten million) (Wang et al, 2020; Zhang et al, 2021) and Nanchang city (Cha et al, 2018) have shown variations regarding these nurses' KAP towards EM. For instance, a survey of 11 hospitals in first‐tier cities found that only 2.5% of ICU nurses had good knowledge regarding EM, but 31.4% of nurses had positive attitudes towards EM (Zhang et al, 2021).…”

“…cities with a population of more than ten million) (Wang et al, 2020; Zhang et al, 2021) and Nanchang city (Cha et al, 2018) have shown variations regarding these nurses' KAP towards EM. For instance, a survey of 11 hospitals in first‐tier cities found that only 2.5% of ICU nurses had good knowledge regarding EM, but 31.4% of nurses had positive attitudes towards EM (Zhang et al, 2021). Guizhou Province lies in southwest China, and its gross domestic product was at the 22nd rank amongst 31 provinces in China in 2021, indicating the underdevelopment of this area.…”