Perceived barriers for early mobilization of patients admitted to the intensive care unit (ICU)

Mostafa, Basma; Salem, Somya; Abdelhameed, Shaimaa

doi:10.21608/jicem.2022.136081.1002

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…[41] Staff limitations, time constraints, insu cient planning and coordination, and inadequate staff training were among other challenges identi ed. [42] Our study data aligns with from the UK, highlighting physiological instability, insu cient sta ng, required sedation, lack of resources and equipment, failure to recognize patient readiness, and limited funds as key impediments. [35]Additionally, the patient's medical condition, potential dislodgment of devices, and the presence of an endotracheal tube were reported barriers from a Canadian perspective.…”

Section: Discussionsupporting

confidence: 75%

Early Mobilization in Pediatric Critical Care: Exploring the Gap between Theory and Practice in Saudi Arabia

Al-Harbi

2023

Preprint

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Background:Advancements in critical care have improved survival rates for children in PICUs, but many survivors suffer long-term morbidity and lower quality of life due to ICU-acquired weakness, cognitive impairment, and immobility-related issues. Early mobilization (EM) is a promising intervention to reduce these negative consequences. This study evaluates the knowledge, views, and practices of physicians and care providers regarding EM in Saudi Arabia's pediatric critical care units. Study Design: A survey was conducted from July 2020 to February 2021 to gather information on early mobilization practices for critically ill children in the pediatric intensive care unit in Saudi Arabia. The survey was sent to 110 doctors, 200 nurses, 30 respiratory therapists, and 20 physiotherapists. The survey aimed to explore rehabilitation aspects, including the challenges faced during early mobilization, suitable timing and types of rehabilitation, and healthcare personnel workload. Results:A survey with a 72.78% response rate, primarily from registered nurses (65.7%), indicated strong support for early mobilization in Pediatric Intensive Care Unit (PICU) patient care among healthcare professionals. Over 80% of respondents considered it crucial or important. However, institutional and healthcare provider-level barriers exist, including lack of equipment (63.5%), medical instability (67.3%), endotracheal intubation (65.4%), and limited staff (56.4%). Concerns about safety (47.4%) and insufficient physical space (38.9% physicians, 24.7% non-physicians) were also raised. Routine bed rest orders upon PICU admission were more common among non-physicians (26.8%) compared to physicians (12.5%). As illness severity increased, clinicians' comfort with early mobilization decreased. Most common rehabilitation interventions were respiratory physiotherapy and passive range of motion (77.8%). Healthcare professionals in Saudi Arabia regularly use daily sedation interruptions in pediatric ICUs. However, only 38.7% of respondents referred patients with suspected ICU-acquired weakness to outpatient clinics for long-term rehabilitation. Conclusion: Early mobilization is crucial in pediatric critical care in Saudi Arabia, but its implementation faces challenges. Healthcare institutions must navigate these challenges with strategic intent and a multidisciplinary ethos. Future research should focus on optimal timelines and interventions tailored to specific pediatric cohorts. This approach can improve patient outcomes and elevate the caliber of pediatric critical care, refining healthcare quality and providing a blueprint for excellence globally.

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Section: Discussionsupporting

confidence: 75%

Early Mobilization in Pediatric Critical Care: Exploring the Gap between Theory and Practice in Saudi Arabia

Al-Harbi

2023

Preprint

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“…This list was enlarged by Nardo et al (2021) to include disease severity, medical orders, human resources, and the availability of mobilization equipment [ 18 ]. Staffing difficulties, time constraints, inadequate planning and coordination, and a lack of staff training were also mentioned [ 31 ]. Our research aligns with Thompson et al’s findings in the UK.…”

Section: Discussionmentioning

confidence: 99%

Early Mobilization in Pediatric Critical Care: Exploring the Gap Between Theory and Practice in Saudi Arabia

Al Harbi

2024

Med Sci Monit

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Background Because of advancements in critical care, Pediatric Intensive Care Units (PICUs) have experienced improved survival rates. However, PICU-acquired frailty and cognitive deficits continue to be issues. In PICUs, early mobilization is emerging as a useful technique. The present study assesses early mobilization awareness, opinions, and practices among pediatric critical care providers in Saudi Arabia. Material/Methods From July 2020 to February 2021, a survey was undertaken in Saudi Arabia, targeting 110 physicians, 200 nurses, 30 respiratory therapists, and 20 physiotherapists. It concentrated on emergency medicine practices, operational issues, initiation time, rehabilitation modalities, and PICU staff strain. Results The results showed that 64.7% of the 266 respondents were nurses, usually working in 5- to 15-bed ICUs providing medical and surgical treatment. Early mobilization was evaluated as highly significant by 40.6% of the respondents. Equipment constraints (63.5%), patient medical instability (67.3%), endotracheal intubation complications (65.4%), and personnel limits (56.4%) were major challenges. Non-physicians cited space constraints 38.9% of the time, whereas physicians cited safety concerns 47.4% of the time. Respiratory physiotherapy and passive range-of-motion exercises were the most used rehabilitation techniques (77.8%). Only 38.7% of patients with ICU-acquired weakness were referred for outpatient therapy. Conclusions The study emphasizes the importance of early mobilization in Saudi Arabian pediatric critical care while also recognizing considerable limitations. Addressing these difficulties necessitates a multidisciplinary, strategic approach. Future research should strive to standardize practices to enhance patient outcomes and develop standards in pediatric critical care.

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Perceived barriers for early mobilization of patients admitted to the intensive care unit (ICU)

Abstract: Conclusion:Early mobilization protocols can be implemented in ICUs after adequate addressing of potential barriers that can face healthcare workers, prepare the ICU environment with equipment and trained personnel.

Cited by 2 publications

References 18 publications

Early Mobilization in Pediatric Critical Care: Exploring the Gap between Theory and Practice in Saudi Arabia

Early Mobilization in Pediatric Critical Care: Exploring the Gap between Theory and Practice in Saudi Arabia

Early Mobilization in Pediatric Critical Care: Exploring the Gap Between Theory and Practice in Saudi Arabia

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