Literature DB >> 22807652

What are the barriers to mobilizing intensive care patients?

I Anne Leditschke1, Margot Green, Joelie Irvine, Bernie Bissett, Imogen A Mitchell.   

Abstract

PURPOSE: Recently there has been increased interest in early mobilization of critically ill patients. Proposed benefits include improvements in respiratory function, muscle wasting, intensive care unit (ICU), and hospital length of stay. We studied the frequency of early mobilization in our intensive care unit in order to identify barriers to early mobilization.
METHODS: A 4-week prospective audit of 106 patients admitted to a mixed medical-surgical tertiary ICU (mean age 60 ± 20 years, mean APACHE II score 14.7 ± 7.8) was performed. Outcome measures included number of patient days mobilized, type of mobilization, adverse events, and reasons for inability to mobilize.
RESULTS: Patients were mobilized on 176 (54%) of 327 patient days. Adverse events occurred in 2 of 176 mobilization episodes (1.1%). In 71 (47%) of the 151 patient days where mobilization did not occur, potentially avoidable factors were identified, including vascular access devices sited in the femoral region, timing of procedures and agitation or reduced level of consciousness.
CONCLUSIONS: Critically ill patients can be safely mobilized for much of their ICU stay. Interventions that may allow more patients to mobilize include: changing the site of vascular catheters, careful scheduling of procedures, and improved sedation management.

Entities:  

Keywords:  intensive care units; mobility; physical therapy

Year:  2012        PMID: 22807652      PMCID: PMC3286497     

Source DB:  PubMed          Journal:  Cardiopulm Phys Ther J        ISSN: 1541-7891


  21 in total

1.  Development and implementation of a high-quality clinical database: the Australian and New Zealand Intensive Care Society Adult Patient Database.

Authors:  Peter J Stow; Graeme K Hart; Tracey Higlett; Carol George; Robert Herkes; David McWilliam; Rinaldo Bellomo
Journal:  J Crit Care       Date:  2006-06       Impact factor: 3.425

2.  Building consensus on ICU-acquired weakness.

Authors:  Margaret S Herridge
Journal:  Intensive Care Med       Date:  2008-10-23       Impact factor: 17.440

3.  Mobilizing patients in the intensive care unit: improving neuromuscular weakness and physical function.

Authors:  Dale M Needham
Journal:  JAMA       Date:  2008-10-08       Impact factor: 56.272

4.  Early activity is feasible and safe in respiratory failure patients.

Authors:  Polly Bailey; George E Thomsen; Vicki J Spuhler; Robert Blair; James Jewkes; Louise Bezdjian; Kristy Veale; Larissa Rodriquez; Ramona O Hopkins
Journal:  Crit Care Med       Date:  2007-01       Impact factor: 7.598

5.  Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial.

Authors:  William D Schweickert; Mark C Pohlman; Anne S Pohlman; Celerina Nigos; Amy J Pawlik; Cheryl L Esbrook; Linda Spears; Megan Miller; Mietka Franczyk; Deanna Deprizio; Gregory A Schmidt; Amy Bowman; Rhonda Barr; Kathryn E McCallister; Jesse B Hall; John P Kress
Journal:  Lancet       Date:  2009-05-14       Impact factor: 79.321

Review 6.  Bench-to-bedside review: mobilizing patients in the intensive care unit--from pathophysiology to clinical trials.

Authors:  Alex D Truong; Eddy Fan; Roy G Brower; Dale M Needham
Journal:  Crit Care       Date:  2009-07-13       Impact factor: 9.097

7.  Early exercise in critically ill patients enhances short-term functional recovery.

Authors:  Chris Burtin; Beatrix Clerckx; Christophe Robbeets; Patrick Ferdinande; Daniel Langer; Thierry Troosters; Greet Hermans; Marc Decramer; Rik Gosselink
Journal:  Crit Care Med       Date:  2009-09       Impact factor: 7.598

8.  Early intensive care unit mobility therapy in the treatment of acute respiratory failure.

Authors:  Peter E Morris; Amanda Goad; Clifton Thompson; Karen Taylor; Bethany Harry; Leah Passmore; Amelia Ross; Laura Anderson; Shirley Baker; Mary Sanchez; Lauretta Penley; April Howard; Luz Dixon; Susan Leach; Ronald Small; R Duncan Hite; Edward Haponik
Journal:  Crit Care Med       Date:  2008-08       Impact factor: 7.598

Review 9.  From space to Earth: advances in human physiology from 20 years of bed rest studies (1986-2006).

Authors:  A Pavy-Le Traon; M Heer; M V Narici; J Rittweger; J Vernikos
Journal:  Eur J Appl Physiol       Date:  2007-07-28       Impact factor: 3.078

10.  Physiotherapy in intensive care is safe: an observational study.

Authors:  Litsa Zeppos; Shane Patman; Susan Berney; Julie A Adsett; Julie M Bridson; Jennifer D Paratz
Journal:  Aust J Physiother       Date:  2007
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  44 in total

Review 1.  Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies.

Authors:  Selina M Parry; Laura D Knight; Bronwen Connolly; Claire Baldwin; Zudin Puthucheary; Peter Morris; Jessica Mortimore; Nicholas Hart; Linda Denehy; Catherine L Granger
Journal:  Intensive Care Med       Date:  2017-02-16       Impact factor: 17.440

2.  Feasibility and Efficacy of Function-Focused Care for Orthopedic Trauma Patients.

Authors:  Barbara Resnick; Chris Wells; Elizabeth Galik; Lauren Holtzman; Shijun Zhu; Elise Gamertsfelder; Terry Laidlow; Marie Boltz
Journal:  J Trauma Nurs       Date:  2016 May-Jun       Impact factor: 1.010

3.  Mobility therapy and central or peripheral catheter-related adverse events in an ICU in Brazil.

Authors:  Natália Pontes Lima; Gregório Marques Cardim da Silva; Marcelo Park; Ruy Camargo Pires-Neto
Journal:  J Bras Pneumol       Date:  2015 May-Jun       Impact factor: 2.624

4.  Physical Therapist Practice in the Intensive Care Unit: Results of a National Survey.

Authors:  Daniel Malone; Kyle Ridgeway; Amy Nordon-Craft; Parker Moss; Margaret Schenkman; Marc Moss
Journal:  Phys Ther       Date:  2015-06-04

5.  Safety and Efficacy of Mobility Interventions in Patients with Femoral Catheters in the ICU: A Prospective Observational Study.

Authors:  Christiane Perme; Theresa Nalty; Chris Winkelman; Ricardo Kenji Nawa; Faisal Masud
Journal:  Cardiopulm Phys Ther J       Date:  2013-06

6.  A quality improvement project sustainably decreased time to onset of active physical therapy intervention in patients with acute lung injury.

Authors:  Victor D Dinglas; Ann M Parker; Dereddi Raja S Reddy; Elizabeth Colantuoni; Jennifer M Zanni; Alison E Turnbull; Archana Nelliot; Nancy Ciesla; Dale M Needham
Journal:  Ann Am Thorac Soc       Date:  2014-10

7.  Barriers to early mobility of hospitalized general medicine patients: survey development and results.

Authors:  Erik H Hoyer; Daniel J Brotman; Kitty S Chan; Dale M Needham
Journal:  Am J Phys Med Rehabil       Date:  2015-04       Impact factor: 2.159

8.  Early Rehabilitation in the Intensive Care Unit: Preventing Physical and Mental Health Impairments.

Authors:  Ann Parker; Thiti Sricharoenchai; Dale M Needham
Journal:  Curr Phys Med Rehabil Rep       Date:  2013-12

Review 9.  Identifying Barriers to Delivering the Awakening and Breathing Coordination, Delirium, and Early Exercise/Mobility Bundle to Minimize Adverse Outcomes for Mechanically Ventilated Patients: A Systematic Review.

Authors:  Deena Kelly Costa; Matthew R White; Emily Ginier; Milisa Manojlovich; Sushant Govindan; Theodore J Iwashyna; Anne E Sales
Journal:  Chest       Date:  2017-04-21       Impact factor: 9.410

Review 10.  Early Mobilization and Rehabilitation of Patients Who Are Critically Ill.

Authors:  Mohamed D Hashem; Ann M Parker; Dale M Needham
Journal:  Chest       Date:  2016-03-18       Impact factor: 9.410

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