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Developing a mobility protocol for early mobilization of patients in a surgical/trauma ICU.

Zomorodi M, Topley D, McAnaw M - Crit Care Res Pract (2012)

Bottom Line: As technology and medications have improved and increased, survival rates are also increasing in intensive care units (ICUs), so it is now important to focus on improving the patient outcomes and recovery.Frequently, a critically ill patient only receives movement from nurses; such as, being turned side to side, pulled up in bed, or transferred from bed to a stretcher for a test.The implementation of an early mobility protocol that can be used by critical care nurses is important for positive patient outcomes minimizing the functional decline due to an ICU stay.

View Article: PubMed Central - PubMed

Affiliation: Chapel Hill School of Nursing, University of North Carolina, Chapel Hill, NC 27599-7460, USA.

ABSTRACT
As technology and medications have improved and increased, survival rates are also increasing in intensive care units (ICUs), so it is now important to focus on improving the patient outcomes and recovery. To do this, ICU patients need to be assessed and started on an early mobility program, if stable. While the early mobilization of the ICU patients is not without risk, the current literature has demonstrated that patients can be safely and feasibly mobilized, even while requiring mechanical ventilation. These patients are at a high risk for muscle deconditioning due to limited mobility from numerous monitoring equipment and multiple medical conditions. Frequently, a critically ill patient only receives movement from nurses; such as, being turned side to side, pulled up in bed, or transferred from bed to a stretcher for a test. The implementation of an early mobility protocol that can be used by critical care nurses is important for positive patient outcomes minimizing the functional decline due to an ICU stay. This paper describes a pilot study to evaluate an early mobilization protocol to test the safety and feasibility for mechanically ventilated patients in a surgical trauma ICU in conjunction with the current unit standards.

No MeSH data available.


Related in: MedlinePlus

Daily awakening protocol.
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fig1: Daily awakening protocol.

Mentions: Although current research has established the importance of daily awakenings, spontaneous breathing trials, and delirium/sedation management along with mobility protocols, very little research discusses the use of early mobility protocols to improve patient outcomes, and there are many remaining gaps in the literature. The protocols that are available in the literature do not provide enough details for replication. This is especially concerning since the importance of mobility has been established in the literature. Mobility protocols are so important that Critical Care Clinics (2007) devoted an entire issue addressing the barriers and facilitators of protocol intervention. In 2010, Critical Care Nurse provided a supplement addressing progressive mobility in the critically ill [24]. Despite this importance, current mobility research is limited with no published protocols of how these programs should be implemented in the critical care setting. In fact, while all patients in the surgical intensive care unit for this study were placed on a daily awakening protocol as well as a protocol for sedation, delirium, and analgesic management, a formal early mobility protocol had not been designed (Figure 1). Therefore, the purpose of this study was to pilot an early mobility protocol to test the safety and feasibility for mechanically ventilated patients in the surgical-trauma intensive care unit in conjunction with our current standards of assessment.


Developing a mobility protocol for early mobilization of patients in a surgical/trauma ICU.

Zomorodi M, Topley D, McAnaw M - Crit Care Res Pract (2012)

Daily awakening protocol.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539434&req=5

fig1: Daily awakening protocol.
Mentions: Although current research has established the importance of daily awakenings, spontaneous breathing trials, and delirium/sedation management along with mobility protocols, very little research discusses the use of early mobility protocols to improve patient outcomes, and there are many remaining gaps in the literature. The protocols that are available in the literature do not provide enough details for replication. This is especially concerning since the importance of mobility has been established in the literature. Mobility protocols are so important that Critical Care Clinics (2007) devoted an entire issue addressing the barriers and facilitators of protocol intervention. In 2010, Critical Care Nurse provided a supplement addressing progressive mobility in the critically ill [24]. Despite this importance, current mobility research is limited with no published protocols of how these programs should be implemented in the critical care setting. In fact, while all patients in the surgical intensive care unit for this study were placed on a daily awakening protocol as well as a protocol for sedation, delirium, and analgesic management, a formal early mobility protocol had not been designed (Figure 1). Therefore, the purpose of this study was to pilot an early mobility protocol to test the safety and feasibility for mechanically ventilated patients in the surgical-trauma intensive care unit in conjunction with our current standards of assessment.

Bottom Line: As technology and medications have improved and increased, survival rates are also increasing in intensive care units (ICUs), so it is now important to focus on improving the patient outcomes and recovery.Frequently, a critically ill patient only receives movement from nurses; such as, being turned side to side, pulled up in bed, or transferred from bed to a stretcher for a test.The implementation of an early mobility protocol that can be used by critical care nurses is important for positive patient outcomes minimizing the functional decline due to an ICU stay.

View Article: PubMed Central - PubMed

Affiliation: Chapel Hill School of Nursing, University of North Carolina, Chapel Hill, NC 27599-7460, USA.

ABSTRACT
As technology and medications have improved and increased, survival rates are also increasing in intensive care units (ICUs), so it is now important to focus on improving the patient outcomes and recovery. To do this, ICU patients need to be assessed and started on an early mobility program, if stable. While the early mobilization of the ICU patients is not without risk, the current literature has demonstrated that patients can be safely and feasibly mobilized, even while requiring mechanical ventilation. These patients are at a high risk for muscle deconditioning due to limited mobility from numerous monitoring equipment and multiple medical conditions. Frequently, a critically ill patient only receives movement from nurses; such as, being turned side to side, pulled up in bed, or transferred from bed to a stretcher for a test. The implementation of an early mobility protocol that can be used by critical care nurses is important for positive patient outcomes minimizing the functional decline due to an ICU stay. This paper describes a pilot study to evaluate an early mobilization protocol to test the safety and feasibility for mechanically ventilated patients in a surgical trauma ICU in conjunction with the current unit standards.

No MeSH data available.


Related in: MedlinePlus