Abstract
Background:
Immobility has undesirable effects on the healing process which can prolong the length of stay for being ventilated and being in ICU. Recent studies show that patients benefit from being mobilized while being mechanically ventilated and it is a feasible and an effective treatment plan.
Methods:
A survey was distributed by providing an email link to the respiratory therapy, physical therapy, and critical care nurse managers. The survey examined the use of early mobilization (EM) on the mechanically ventilated patient in the intensive care unit.
Results:
25 participants, in the respiratory therapy department, physical therapy department and registered nurses in critical care, took part in the survey. The results showed that 64% of the participants received no training or education on EM, 16% had received training but no regular planned activity was being taken to institute EM, 20% received training and EM was being done by prescription, and 0% responded that training had been done and EM was being used by protocol.52% responded that they would rate their use of EM as Poor or Fair. 20% responded that their use of EM rated Very good or Excellent See Table 1 for the other perceived barriers and for the self-evaluation of the use of EM.
Conclusions:
The respondents in this survey do not have protocols in place to implement EM. Some steps are being taken to initiate EM into the health care plan for select patients but lack of full support, lack of time, training and equipment, and concern for safety present major barriers to robust use of EM.
EM: Barriers and Self-evaluation
A. What do you feel are the personnel barriers to engaging EM?
%
* Lack of medical staff support
28%
* Lack of administrative support
8%
* Lack of training and education in EM
60%
* Staffing not adequate to accommodate EM
72%
* Lack of support from other needed disciplines (RN, PT, MD, RT)
40%
B. What do you feel are the equipment barriers to engaging EM?
* Lack of portable ventilators
56%
* Lack of I.V. poles
40%
* Issues with monitoring (A-lines, BP cuffs, heart monitors)
68%
C. What do you feel are the patient-related barriers to engaging EM?
* Patient condition
72%
* Patient cooperation
24%
* Concerns for patient safety
84%
* Family not agreeing to the activity
8%
What is your overall rating of the use of EM at your institution using the following categories?
Number of respondents
* Poor
6
* Fair
7
* Good
6
* Very Good
2
* Excellent
3
* Not Applicable
1
Get full access to this article
View all access options for this article.