A recent qualitative study deepened our understanding of the barriers to the practice of early mobilisation in the ICU from the perspective of ICU clinicians: why these barriers exist, what could be done to ameliorate them, and the facilitators that might enhance the practice of early mobilisation.
Three focus group meetings were conducted with 33 nurses, respiratory therapists, physiotherapists and physicians. The key barriers to early mobilisation were: lack of conviction and knowledge regarding the available evidence about early mobilisation; lack of attention to the provision of optimal care; poor communication; the unpredictable nature of the ICU; and limited staffing, equipment, time and clinical knowledge.
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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