ICU clinicians’ perspectives on early mobilisation

...what are the barriers to and facilitators of implementing early mobilisation?

Patients discharged from an intensive care unit (ICU) typically have residual physical impairments and limitations in functional activities, which restrict their participation in daily activities and lifestyle. This may be true even if the primary pathology that led to ICU admission has resolved.

These impairments, limitations and restrictions may be the result of a number of complex interrelated factors involving reduced mobility, which commonly occur in patients hospitalised in an ICU.

Early mobilisation — defined as initiating walking or other activities within 24 to 48 hours after ICU admission — has increasing evidence for its safety, feasibility, and ability to ameliorate the impairments, limitations and restrictions. However, as in all areas of clinical practice, translating this evidence into practice is problematic.

The key individual-level facilitators were intrinsic motivation, positive outcome expectations, conscious effort to mobilise early, good planning/ coordination, the presence of ICU champions, and expert support by a physiotherapist.

The key organisational-level facilitators were reminder system, pro-early mobilisation culture, implementation of an early mobilisation protocol, and improved ICU organisation.

> From: Anekwe et al., J Physiother 66 (2020) 120-127 . All rights reserved to Australian Physiotherapy Association. Click here for the online summary.


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