MAKING IT WORK IN YOUR ICU

Clinicians and ICU administrators can manage the demands of early mobility. Tools for patient assessment, data collection and analysis, and team communications can help.

The First Steps. Reduce Immobility.

24% more patients regained independent status with early mobility([FOOTNOTE=*With early mobility therapy vs. standard care, where 35% of patients regained independent status. Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373:1874 – 1882.],[ANCHOR=],[LINK=])*

ICU nurses are often the first to see immobility-related changes in a patient’s condition such as:

  • Muscle loss
  • Ventilator-acquired illnesses
  • Pressure sores

Nurses can also improve patient outcomes by initiating early mobility, which can reduce patient time on a ventilator and length of ICU stay.1,([FOOTNOTE=Morris PE, Goad A, Thompson C, et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med. 2008;36(8):2238–2243. doi: 10.1097/CCM.Ob013e318180b90e.],[ANCHOR=],[LINK=])

MOBILIZING PATIENTS SAFELY

ICU nurses have several tools at their fingertips to help ensure patient safety. Using standard neurological and physical assessments, they can:

  • Assess sedation and pain levels
  • Implement sedation “vacations” to prepare patients for mobility
  • Determine a patient’s readiness for movement

RELIEVE THE STAFFING BURDEN

45% of studies report limited staff as an early mobility barrier2

A lack of human resources represents a major barrier to early mobility programs.2 Certified nursing assistants can fill that gap by:

  • Helping with patient surveillance
  • Moving/lifting patients
  • Managing line and drain integrity during mobility sessions

EMBRACING NEW STANDARDS OF CARE

More than 70 strategies are available to overcome barriers to early mobility([FOOTNOTE=*As identified in survey. Dubb R, Nydahl P, Hermes C, et al. Barriers and strategies for early mobilization of patients in intensive care units. Ann Am Thorac Soc. 2016;13(5):724 – 730.],[ANCHOR=],[LINK=])

In addition to speaking up for their patients, nurses play a vital role in changing ICU practice and culture. Through their advocacy, they can help overcome many of the barriers that prevent early mobility, including lack of time, resources, and education.