Quality improvement intervention to stimulate early mobilisation of critically ill children

Adel, Tabitha Zanen-van den; Dijk, Monique van; Heer, Mariska de; Hoekstra, Sjoukje; Steenhorst, Judith; Rosmalen, Joost van; Verbruggen, Sascha; Toussaint-Duyster, Leontien; Ista, Erwin

doi:10.1111/nicc.12761

Cited by 5 publications

(20 citation statements)

References 35 publications

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“…These results are consistent with the results from earlier studies. 9,17,21,26 In our study and earlier studies, the most important barriers to early mobilisation are patient-related factors: hemodynamic instability, the risk of dislocation of endotracheal tubes and vascular catheters and the level of sedation of the patient. It has been shown that early mobilisation of critically ill children is safe and feasible when these patient-related barriers are accounted for in guidelines that clearly state the way in which certain children preferably should be mobilised.…”

Section: Discussionsupporting

confidence: 60%

“…9 Early mobilisation of critically ill children has been proven safe and feasible, with the potential to shorten both hospital and PICU length of stay. [10][11][12][13][14][15][16][17]…”

Section: Introductionmentioning

confidence: 99%

“…23 To date, limited information is available about what barriers PICU staff perceive regarding early mobilisation programmes in Dutch PICUs. 17…”

Section: Introductionmentioning

confidence: 99%

“…Early mobilisation encompasses interventions that aim to maintain or restore musculoskeletal strength in critically ill patients within 72 h of their admission, including those patients on invasive mechanical ventilation 9 . Early mobilisation of critically ill children has been proven safe and feasible, with the potential to shorten both hospital and PICU length of stay 10–17 …”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is essential to understand the perceived barriers of PICU staff regarding early mobilisation in relation to the context in which they are embedded 23 . To date, limited information is available about what barriers PICU staff perceive regarding early mobilisation programmes in Dutch PICUs 17 …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Barriers and perceived benefits of early mobilisation programmes in Dutch paediatric intensive care units

Geven

Maaskant

Woensel

et al. 2022

Nursing in Critical Care

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Background: Early mobilisation of critically ill adults has been proven effective and is safe and feasible for critically ill children. However, barriers and perceived benefits of paediatric intensive care unit (PICU) staff involvement in mobilising critically ill children are largely unknown. In this study, we explored the barriers and perceived benefits regarding early mobilisation of critically ill children as perceived by PICU staff.Methods: A cross-sectional survey study among staff from seven PICUs in the Netherlands has been carried out.Results: Two hundred and fifteen of the 641 health care professionals (33.5%) who were invited to complete a questionnaire responded, of whom 159 (75%) were nurses, 40 (19%) physicians, and 14 (6%) physical therapists. Respondents considered early mobilisation potentially beneficial to shorten the duration of mechanical ventilation (86%), improve wake/sleep rhythm (86%) and shorten the length of stay in the PICU (85%). However, staff were reluctant to mobilize patients on extracorporeal membrane oxygenation (ECMO) (63%), and patients with traumatic brain injury (49%). Perceived barriers to early mobilisation were hemodynamic instability (78%), risk of dislocation of lines/tubes (74%), and level of sedation (62%). In total, 40.3% of PICU nurses stated that physical therapists provided enough support in their PICU, but 84.6% of the physical therapists believed support was sufficient. Conclusion:Participating PICU staff considered early mobilisation as potentially beneficial in improving patient outcomes, although barriers were noted in certain patient groups.Relevance to Practice: We identified barriers to early mobilisation which should be addressed in implementation research projects in order to make early mobilisation in critically ill children work.

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Section: Discussionsupporting

confidence: 60%

“…9 Early mobilisation of critically ill children has been proven safe and feasible, with the potential to shorten both hospital and PICU length of stay. [10][11][12][13][14][15][16][17]…”

Section: Introductionmentioning

confidence: 99%

“…23 To date, limited information is available about what barriers PICU staff perceive regarding early mobilisation programmes in Dutch PICUs. 17…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Barriers and perceived benefits of early mobilisation programmes in Dutch paediatric intensive care units

Geven

Maaskant

Woensel

et al. 2022

Nursing in Critical Care

Self Cite

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The Use of Quality Improvement in the Physical Therapy Literature: A Scoping Review

Crick¹,

Rethorn²,

Beauregard³

et al. 2023

J Healthc Qual

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Introduction: Quality improvement (QI) is a useful methodology for improving healthcare, often through iterative changes. There is no prior review on the application of QI in physical therapy (PT). Purpose and Relevance: To characterize and evaluate the quality of the QI literature in PT. Methods: We searched four electronic databases from inception through September 1, 2022. Included publications focused on QI and included the practice of PT. Quality was assessed using the 16-point QI Minimum Quality Criteria Set (QI-MQCS) appraisal tool. Results: Seventy studies were included in the review, 60 of which were published since 2014 with most (n = 47) from the United States. Acute care (n = 41) was the most prevalent practice setting. Twenty-two studies (31%) did not use QI models or approaches and only nine studies referenced Revised Standards for QI Reporting Excellence guidelines. The median QI-MQCS score was 12 (range 7–15). Conclusions/Implications: Quality improvement publications in the PT literature are increasing, yet there is a paucity of QI studies pertaining to most practice settings and a lack of rigor in project design and reporting. Many studies were of low-to-moderate quality and did not meet minimum reporting standards. We recommend use of models, frameworks, and reporting guidelines to improve methodologic rigor and reporting.

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Introduction to this special issue on rehabilitation during and after critical care

Vollam

Efstathiou

2023

Nursing in Critical Care

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Quality improvement intervention to stimulate early mobilisation of critically ill children

Cited by 5 publications

References 35 publications

Barriers and perceived benefits of early mobilisation programmes in Dutch paediatric intensive care units

Barriers and perceived benefits of early mobilisation programmes in Dutch paediatric intensive care units

The Use of Quality Improvement in the Physical Therapy Literature: A Scoping Review

Introduction to this special issue on rehabilitation during and after critical care

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