Intensivists oversee ICU patient care. From this vantage, they can prioritize early mobility treatments through practices including:
Awareness of the benefits of early mobility in the ICU continues to grow, but actual implementation of early mobility protocols lags behind.([FOOTNOTE=Bakhru RN, Wiebe DJ, McWilliams DJ, Spuhler VJ, Schweickert, WO. An environmental scan for early mobilization practices in U.S. ICUs. Crit Care Med. 2015;43(11):2360–2369. doi: 10.1097/CCM.0000000000001262],[ANCHOR=],[LINK=])
Intensivists can champion early mobility by:
Intensivists have options for getting their patients moving.
Dr. Wischmeyer of Duke University gives an overview of the challenges associated with early mobility, and the importance of implementing protocols.
There is growing evidence that the benefits of early mobility outweigh the risks.1 Intensivists are well-situated to serve as early mobility champions, advocating for it in their ICUs. Adequate training, teamwork, and coordination of patient goals for all members of the early mobility team can reduce adverse events.([FOOTNOTE=Bailey P, Thomsen GE, Spuhler VJ, et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med. 2007 Jan;35(1):139–145. doi: 10.1097/0l.CCM.0000251130.69568.87],[ANCHOR=],[LINK=])
When planning a patient’s care regimen, intensivists can use interventions designed to work in concert. The ABCDEF bundle offers one such management strategy. It includes:
Caregivers using this bundle have reported improved patient outcomes, including less time on mechanical ventilation, less delirium, and greater mobility.4