TY - JOUR
T1 - Early mobilization in critically ill patients
T2 - Patients' mobilization level depends on health care provider's profession
AU - Garzon-Serrano, Jaime
AU - Ryan, Cheryl
AU - Waak, Karen
AU - Hirschberg, Ronald
AU - Tully, Susan
AU - Bittner, Edward A.
AU - Chipman, Daniel W.
AU - Schmidt, Ulrich
AU - Kasotakis, Georgios
AU - Benjamin, John
AU - Zafonte, Ross
AU - Eikermann, Matthias
N1 - Funding Information:
This work was supported by funds from the Massachusetts General Hospital Department of Anesthesia, Critical Care and Pain Medicine , Boston, MA.
PY - 2011/4
Y1 - 2011/4
N2 - Objective: To evaluate whether the level of mobilization achieved and the barriers for progressing to the next mobilization level differ between nurses and physical therapists. Design: Prospective, observational study. Setting: Twenty-bed surgical intensive care unit (SICU) of the Massachusetts General Hospital. Participants: Sixty-three critically ill patients. Methods: Physical therapists and nurses performed 179 mobilization therapies with 63 patients. Outcome Measurement: Mobilization was defined as the process of enhancing mobility in the SICU, including bed mobility, edge of bed activities, transfers out of bed to a chair, and gait training; the mobilization level was measured on the SICU optimal mobilization scale, a 5-point (0-4) numerical rating scale. Results: Patients' level of mobilization achieved by physical therapists was significantly higher compared with that achieved by nurses (2.3 - 1.2 mean - SD versus 1.2 - 1.2, respectively P < .0001). Different barriers for mobilization were identified by physical therapists and nurses: hemodynamic instability (26% versus 12%, P = .03) and renal replacement therapy (12% versus 1%, P = .03) were barriers rated higher by nurses, whereas neurologic impairment was rated higher by physical therapists providers (18% versus 38%, P = .002). No mobilization-associated adverse events were observed in this study. Conclusions: This study showed that physical therapists mobilize their critically ill patients to higher levels compared with nurses. Nurse and physical therapists identify different barriers for mobilization. Routine involvement of physical therapists in directing mobilization treatment may promote early mobilization of critically ill patients.
AB - Objective: To evaluate whether the level of mobilization achieved and the barriers for progressing to the next mobilization level differ between nurses and physical therapists. Design: Prospective, observational study. Setting: Twenty-bed surgical intensive care unit (SICU) of the Massachusetts General Hospital. Participants: Sixty-three critically ill patients. Methods: Physical therapists and nurses performed 179 mobilization therapies with 63 patients. Outcome Measurement: Mobilization was defined as the process of enhancing mobility in the SICU, including bed mobility, edge of bed activities, transfers out of bed to a chair, and gait training; the mobilization level was measured on the SICU optimal mobilization scale, a 5-point (0-4) numerical rating scale. Results: Patients' level of mobilization achieved by physical therapists was significantly higher compared with that achieved by nurses (2.3 - 1.2 mean - SD versus 1.2 - 1.2, respectively P < .0001). Different barriers for mobilization were identified by physical therapists and nurses: hemodynamic instability (26% versus 12%, P = .03) and renal replacement therapy (12% versus 1%, P = .03) were barriers rated higher by nurses, whereas neurologic impairment was rated higher by physical therapists providers (18% versus 38%, P = .002). No mobilization-associated adverse events were observed in this study. Conclusions: This study showed that physical therapists mobilize their critically ill patients to higher levels compared with nurses. Nurse and physical therapists identify different barriers for mobilization. Routine involvement of physical therapists in directing mobilization treatment may promote early mobilization of critically ill patients.
UR - http://www.scopus.com/inward/record.url?scp=79954554976&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79954554976&partnerID=8YFLogxK
U2 - 10.1016/j.pmrj.2010.12.022
DO - 10.1016/j.pmrj.2010.12.022
M3 - Article
C2 - 21497316
AN - SCOPUS:79954554976
SN - 1934-1482
VL - 3
SP - 307
EP - 313
JO - PM and R
JF - PM and R
IS - 4
ER -