Early mobility in the intensive care unit: evaluation of a mobility protocol and the effect on patient outcomes
Mansur, Molly. 2018. Early mobility in the intensive care unit: evaluation of a mobility protocol and the effect on patient outcomes -- In Proceedings: 14th Annual Symposium on Graduate Research and Scholarly Projects. Wichita, KS: Wichita State University, p. 40
INTRODUCTION: Intensive care unit (ICU) interventions for early rehabilitation are linked with decreased length of stay (LOS) and days on mechanical ventilation (MV), as much as 47%, and is safe and well-tolerated by patients. Early mobility protocols focus on rehabilitation from the onset of critical illness, yet protocol adoption is inconsistent. PURPOSE: This project evaluated the implementation of an early mobility protocol to increase mobility in ICU patients, and to decrease ICU LOS, hospital LOS, and days on MV. METHODS: A descriptive, retrospective design was used, 6-weeks before and after protocol implementation, using aggregate medical record data for LOS, MV, and mobility activities. The protocol was an evidence-based tool to transition patients from supine to an upright ambulating position. Data was analyzed using descriptive statistics and independent t-tests. RESULTS: The sample included 50 individuals before (mean age 65±15) and 32 after protocol implementation (67.1±12.53). Hospital LOS was greater before protocol implementation (11.42±13.10) compared to afterwards (8.75±5.86), and similar for other variables. Two outlying cases were removed for hospital LOS and data reanalyzed. There were non-significant differences for decreased hospital (t=0.301, p=0.76) and ICU LOS (t=0.642, p=0.52), and days on MV (t=0.351, p=0.727). The number of active mobility activities improved slightly from 2 activities pre- to 4 activities post-protocol. CONCLUSION: Use of a mobility protocol is an important intervention, but staff support is key to a successful practice change. Recommendations for future projects include a longer timeframe for key variables, and further education and support of nurses for the practice change.
Presented to the 14th Annual Symposium on Graduate Research and Scholarly Projects (GRASP) held at the Rhatigan Student Center, Wichita State University, April 27, 2018.
Research completed in the School of Nursing, College of Health Professionals