Percieved barriers to early progressive mobilization in the ICU: Multidisciplinary perspectives in an underserved population

Abstract

Early progressive mobilization is the initiation of movement when a patient is hemodynamically stable, adequately oxygenated, and minimally able to participate. Early progressive mobilization has been linked to decreased morbidity and mortality as inactivity has a profound adverse effect on the brain, skin, skeletal muscle, pulmonary and cardiovascular systems. Literature supports early progressive mobilization and physical therapy as a safe and effective intervention that can have a positive impact on functional outcomes. While the benefits of early progressive mobilization in the intensive care unit have been well documented in recent years, many intensive care units are unable to effectively integrate early progressive mobilization into their daily practice. Therefore, the purpose of this project was to determine whether an educational intervention on the Early Progressive Mobilization Protocol at an urban intensive care unit in Las Vegas, Nevada affected knowledge of, skill in, and attitudes toward implementation of the protocol in practice, as well as to determine whether there was a difference in reported compliance scores among various disciplines. A pre-test survey designed to examine these variables and the reported compliance with the Early Progressive Mobilization protocol was administered. Educational sessions were provided to participants on the Early Progressive Mobilization Protocol after the pre-test. A post-test was administered after the educational session to determine the educational impact on the identified variables. Data analysis was completed using frequency distributions. Valuable insight was gained on the potential impact of targeted educational intervention. Further study is warranted to assess the effects of routine training in intensive care units with similar protocols.

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

“…The descriptive statistics used were tables of frequency and percentage.92 nurses agreed to participate in the survey,70(76.1%)were registered nurses,2(2.2%)were trainees from nurses' college,8(8.7%) were trainees from nurses' technical institute,2(2.2%)were from the high school of nurses,10(10.9%)were other working categories in ICU.The study included nurses from the 3 ICU ,31(33.7%)from medical ICU,35(38%)from surgical ICU,26(28.3%)from mixed ICU,Table (1). Early mobilization proved to be effective and safe in many studies, despite the evidence , many surveys and studies of early mobilization practice have shown limited penetration, particularly in patients undergoing MV, and EM is not implemented in the daily practice in many ICUs [16].Knowledge of environmental barriers and personal experiences is of utmost importance for innovating and implementing a new practice [13]. Furthermore, studying attitudes of ICU workers especially nurses, variation in ICU structure, patient and family culture may be most associated with (and hence most favorable for) implementing EM practice [17].…”

Perceived barriers to early mobilization of intensive care unit patients by nurses in hospitals affiliated to Jundishapur University of Medical Sciences of Ahvaz in 2019

“…Although EM benefits for ICU patients have been well documented in recent years, many intensive care units are not able to effectively implement and integrate EM in daily exercises of the patients [ 17 ]. Therefore, the present study aimed to assess the attitude and awareness of nurses towards the benefits of EM and to understand potential barriers to EM in ICU patients hospitalized in teaching hospitals of Ahvaz.…”