Carrie M Goodson1,2, Lisa Aronson Friedman1,2, Earl Mantheiy1,2, Kevin Heckle1,2, Annette Lavezza1,3, Amy Toonstra1,3, Ann M Parker1,2, Jason Seltzer3, Michael Velaetis4, Mary Glover4, Caroline Outten4, Kit Schwartz5, Antionette Jones4, Sarah Coggins3, Erik H Hoyer1,6, Kitty S Chan1,7, Dale M Needham1,2,6. 1. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 2. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 3. Physical Medicine and Rehabilitation, Johns Hopkins Hospital, Baltimore, MD, USA. 4. Medical Intensive Care Unit, Johns Hopkins Hospital, Baltimore, MD, USA. 5. Respiratory Therapy, Johns Hopkins Hospital, Baltimore, MD, USA. 6. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 7. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Abstract
PURPOSE: Early mobilization in the intensive care unit (ICU) can improve patient outcomes but has perceived barriers to implementation. As part of an ongoing structured quality improvement project to increase mobilization of medical ICU patients by nurses and clinical technicians, we adapted the existing, validated Patient Mobilization Attitudes & Beliefs Survey (PMABS) for the ICU setting and evaluated its performance characteristics and results. MATERIALS AND METHODS: The 26-item PMABS adapted for the ICU (PMABS-ICU) was administered as an online survey to 163 nurses, clinical technicians, respiratory therapists, attending and fellow physicians, nurse practitioners, and physician assistants in one medical ICU. We evaluated the overall and subscale (knowledge, attitude, and behavior) scores and compared these scores by respondent characteristics (clinical role and years of work experience). RESULTS: The survey response rate was 96% (155/163). The survey demonstrated acceptable discriminant validity and acceptable internal consistency for the overall scale (Cronbach α: 0.82, 95% confidence interval: 0.76-0.85), with weaker internal consistency for all subscales (Cronbach α: 0.62-0.69). Across all respondent groups, the overall barrier score (range: 1-100) was relatively low, with attending physicians perceiving the lowest barriers (median [interquartile range]: 30 [28-34]) and nurses perceiving the highest (37 [31-40]). Within the first 10 years of work experience, greater experience was associated with a lower overall barrier score (-0.8 for each additional year; P = 0.02). CONCLUSIONS: In our medical ICU, across 6 different clinical roles, there were relatively low perceived barriers to patient mobility, with greater work experience over the first 10 years being associated with lower perceived barriers. As part of a structured quality improvement project, the PMABS-ICU may be valuable in assisting to identify specific perceived barriers for consideration in designing mobility interventions for the ICU setting.
PURPOSE: Early mobilization in the intensive care unit (ICU) can improve patient outcomes but has perceived barriers to implementation. As part of an ongoing structured quality improvement project to increase mobilization of medical ICU patients by nurses and clinical technicians, we adapted the existing, validated Patient Mobilization Attitudes & Beliefs Survey (PMABS) for the ICU setting and evaluated its performance characteristics and results. MATERIALS AND METHODS: The 26-item PMABS adapted for the ICU (PMABS-ICU) was administered as an online survey to 163 nurses, clinical technicians, respiratory therapists, attending and fellow physicians, nurse practitioners, and physician assistants in one medical ICU. We evaluated the overall and subscale (knowledge, attitude, and behavior) scores and compared these scores by respondent characteristics (clinical role and years of work experience). RESULTS: The survey response rate was 96% (155/163). The survey demonstrated acceptable discriminant validity and acceptable internal consistency for the overall scale (Cronbach α: 0.82, 95% confidence interval: 0.76-0.85), with weaker internal consistency for all subscales (Cronbach α: 0.62-0.69). Across all respondent groups, the overall barrier score (range: 1-100) was relatively low, with attending physicians perceiving the lowest barriers (median [interquartile range]: 30 [28-34]) and nurses perceiving the highest (37 [31-40]). Within the first 10 years of work experience, greater experience was associated with a lower overall barrier score (-0.8 for each additional year; P = 0.02). CONCLUSIONS: In our medical ICU, across 6 different clinical roles, there were relatively low perceived barriers to patient mobility, with greater work experience over the first 10 years being associated with lower perceived barriers. As part of a structured quality improvement project, the PMABS-ICU may be valuable in assisting to identify specific perceived barriers for consideration in designing mobility interventions for the ICU setting.
Entities:
Keywords:
barriers; early mobility; multiprofessional; quality improvement; rehabilitation; survey
Authors: Timothy D Girard; Waleed Alhazzani; John P Kress; Daniel R Ouellette; Gregory A Schmidt; Jonathon D Truwit; Suzanne M Burns; Scott K Epstein; Andres Esteban; Eddy Fan; Miguel Ferrer; Gilles L Fraser; Michelle Ng Gong; Catherine L Hough; Sangeeta Mehta; Rahul Nanchal; Sheena Patel; Amy J Pawlik; William D Schweickert; Curtis N Sessler; Thomas Strøm; Kevin C Wilson; Peter E Morris Journal: Am J Respir Crit Care Med Date: 2017-01-01 Impact factor: 21.405
Authors: John W Devlin; Yoanna Skrobik; Céline Gélinas; Dale M Needham; Arjen J C Slooter; Pratik P Pandharipande; Paula L Watson; Gerald L Weinhouse; Mark E Nunnally; Bram Rochwerg; Michele C Balas; Mark van den Boogaard; Karen J Bosma; Nathaniel E Brummel; Gerald Chanques; Linda Denehy; Xavier Drouot; Gilles L Fraser; Jocelyn E Harris; Aaron M Joffe; Michelle E Kho; John P Kress; Julie A Lanphere; Sharon McKinley; Karin J Neufeld; Margaret A Pisani; Jean-Francois Payen; Brenda T Pun; Kathleen A Puntillo; Richard R Riker; Bryce R H Robinson; Yahya Shehabi; Paul M Szumita; Chris Winkelman; John E Centofanti; Carrie Price; Sina Nikayin; Cheryl J Misak; Pamela D Flood; Ken Kiedrowski; Waleed Alhazzani Journal: Crit Care Med Date: 2018-09 Impact factor: 7.598
Authors: Karen K Y Koo; Karen Choong; Deborah J Cook; Margaret Herridge; Anastasia Newman; Vincent Lo; Gordon Guyatt; Fran Priestap; Eileen Campbell; Karen E A Burns; FranÇois Lamontagne; Maureen O Meade Journal: CMAJ Open Date: 2016-08-18
Authors: Dale M Needham; Amy W Wozniak; Catherine L Hough; Peter E Morris; Victor D Dinglas; James C Jackson; Pedro A Mendez-Tellez; Carl Shanholtz; E Wesley Ely; Elizabeth Colantuoni; Ramona O Hopkins Journal: Am J Respir Crit Care Med Date: 2014-05-15 Impact factor: 21.405
Authors: Carol L Hodgson; Michael Bailey; Rinaldo Bellomo; Susan Berney; Heidi Buhr; Linda Denehy; Belinda Gabbe; Megan Harrold; Alisa Higgins; Theodore J Iwashyna; Rebecca Papworth; Rachael Parke; Shane Patman; Jeffrey Presneill; Manoj Saxena; Elizabeth Skinner; Claire Tipping; Paul Young; Steven Webb Journal: Crit Care Med Date: 2016-06 Impact factor: 7.598
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
Authors: Erik H Hoyer; Daniel L Young; Lisa M Klein; Julie Kreif; Kara Shumock; Stephanie Hiser; Michael Friedman; Annette Lavezza; Alan Jette; Kitty S Chan; Dale M Needham Journal: Phys Ther Date: 2018-02-01
Authors: Eddy Fan; David W Dowdy; Elizabeth Colantuoni; Pedro A Mendez-Tellez; Jonathan E Sevransky; Carl Shanholtz; Cheryl R Dennison Himmelfarb; Sanjay V Desai; Nancy Ciesla; Margaret S Herridge; Peter J Pronovost; Dale M Needham Journal: Crit Care Med Date: 2014-04 Impact factor: 7.598
Authors: Prerna Gupta; Jennifer L Martin; Dale M Needham; Sitaram Vangala; Elizabeth Colantuoni; Biren B Kamdar Journal: Heart Lung Date: 2020-02-24 Impact factor: 2.210
Authors: Ann M Parker; Narges Akhlaghi; Albahi M Malik; Lisa Aronson Friedman; Earl Mantheiy; Kelsey Albert; Mary Glover; Sherry Dong; Annette Lavezza; Jason Seltzer; Dale M Needham Journal: Aust Crit Care Date: 2021-06-18 Impact factor: 3.265