TY - JOUR
T1 - Development, implementation, and evaluation of an early mobility protocol in a regional level II trauma center
AU - McCarty, Catherine A.
AU - Renier, Colleen M.
AU - Conway, Pat G.
AU - Vogel, Linda
AU - Woehrle, Theo A.
AU - Anderson, Leslie A.
AU - Hanson, Eric J.
AU - Benrud, Lisa M.
AU - Gerchman-Smith, Mary
N1 - Funding Information:
The project was supported in part by a grant from the Essentia Health Duluth Clinic Foundation.
Publisher Copyright:
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - The purpose of this project was to develop and evaluate a collaborative nursing/therapist protocol for early mobility in a medical-surgical intensive care unit (MICU) in a regional level II trauma center. Data for patients in the MICU were compared for the periods August 3, 2015-August 2, 2016, and August 3, 2014-August 2, 2015. Semistructured interviews were conducted with 10 nurses and 1 therapist. Average MICU length of stay decreased from 3.81 to 3.50 days (P =.057). Mean time in mobility chairs did not change (0.12 days vs 0.11 days, P =.389). Mean number of days to first documented level 2-5 activity decreased significantly, from 1.81 to 1.51 days (P =.036). The percentage of hospitalizations with any documented level 3 or 4 activity increased significantly (from 3.8% to 7.4% and from 61.5% to 66.7%, P =.003 and P =.031, respectively). Barriers/challenges to implementation included having enough people to assist, space, documentation, having to coax the physician to place order for upright mobility, availability of therapists for later stages of protocol, patient variability, fear of patient falls, availability of therapy chairs, staff changes, time, and patient refusal. A multidisciplinary approach to protocol development for early mobility in an intensive care unit was successfully implemented at a regional level II trauma center.
AB - The purpose of this project was to develop and evaluate a collaborative nursing/therapist protocol for early mobility in a medical-surgical intensive care unit (MICU) in a regional level II trauma center. Data for patients in the MICU were compared for the periods August 3, 2015-August 2, 2016, and August 3, 2014-August 2, 2015. Semistructured interviews were conducted with 10 nurses and 1 therapist. Average MICU length of stay decreased from 3.81 to 3.50 days (P =.057). Mean time in mobility chairs did not change (0.12 days vs 0.11 days, P =.389). Mean number of days to first documented level 2-5 activity decreased significantly, from 1.81 to 1.51 days (P =.036). The percentage of hospitalizations with any documented level 3 or 4 activity increased significantly (from 3.8% to 7.4% and from 61.5% to 66.7%, P =.003 and P =.031, respectively). Barriers/challenges to implementation included having enough people to assist, space, documentation, having to coax the physician to place order for upright mobility, availability of therapists for later stages of protocol, patient variability, fear of patient falls, availability of therapy chairs, staff changes, time, and patient refusal. A multidisciplinary approach to protocol development for early mobility in an intensive care unit was successfully implemented at a regional level II trauma center.
KW - APACHE
KW - Early mobility
KW - ICU
KW - Multidisciplinary
KW - Protocol
KW - Trauma center
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U2 - 10.1097/CNQ.0000000000000391
DO - 10.1097/CNQ.0000000000000391
M3 - Article
C2 - 34818301
AN - SCOPUS:85120690573
SN - 0887-9303
VL - 45
SP - 83
EP - 87
JO - Critical Care Nursing Quarterly
JF - Critical Care Nursing Quarterly
IS - 1
ER -