Defining new barriers to mobilisation in a highly active intensive care unit - have we found the ceiling? An observational study

Heart & Lung : the Journal of Critical Care
Christopher BrockBernie Bissett

Abstract

Mobilisation of intensive care (ICU) patients attenuates ICU-acquired weakness, but the prevalence is low (12-54%). Better understanding of barriers and enablers may inform practice. To identify barriers to mobilisation and factors associated with successful mobilisation in our medical /surgical /trauma ICU where mobilisation is well-established. 4-week prospective study of frequency and intensity of mobilisation, clinical factors and barriers (extracted from electronic database). Generalized linear mixed models were used to describe associations between demographics, clinical factors and successful mobilisation. 202 patients accounted for 742 patient days. Patients mobilised on 51% of patient days. Most frequent barriers were drowsiness (18%), haemodynamic/respiratory contraindications (17%), and medical orders (14%). Predictors of successful mobilisation included high Glasgow Coma Score (OR = 1.44, 95%CI=[1.29-1.60]), and male sex (OR = 2.29, 95%CI=[1.40-3.75]) but not age (OR = 1.05, 95%CI=[1.01-1.08]). Our major barriers (drowsiness, haemodynamic/respiratory contraindications) may be unavoidable, indicating an upper limit of feasible mobilisation therapy in ICU.

Citations

Feb 23, 2019·Journal of Clinical Nursing·Eva LaerknerHelle Ploug Hansen
Mar 7, 2020·Journal of Evaluation in Clinical Practice·Cathrine TadyanemhanduVeronica Ntsiea
Mar 3, 2019·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Elisa MattioliMarjorie Funk
Nov 18, 2020·Intensive & Critical Care Nursing : the Official Journal of the British Association of Critical Care Nurses·Sarina A FazioHeather M Young
May 20, 2021·Nursing in Critical Care·Marta Raurell-TorredàUNKNOWN MOviPre group
Jun 29, 2021·Journal of Multidisciplinary Healthcare·Wendie ZhouLingling Ji
Jul 2, 2021·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Dawn CooperJanet A Parkosewich
Dec 20, 2020·Burns : Journal of the International Society for Burn Injuries·Brads SchmittJohn Greenwood

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