Perceived barriers to early progressive mobilization in the ICU: Multidisciplinary perspectives in an underserved population

Abstract

Early progressive mobilization is the initiation of movement when a patient is hemodynamically stable, adequately oxygenated, and minimally able to participate. Early progressive mobilization has been linked to decreased morbidity and mortality as inactivity has a profound adverse effect on the brain, skin, skeletal muscle, pulmonary and cardiovascular systems. Literature supports early progressive mobilization and physical therapy as a safe and effective intervention that can have a positive impact on functional outcomes. While the benefits of early progressive mobilization in the intensive care unit have been well documented in recent years, many intensive care units are unable to effectively integrate early progressive mobilization into their daily practice. Therefore, the purpose of this project was to determine whether an educational intervention on the Early Progressive Mobilization Protocol at an urban intensive care unit in Las Vegas, Nevada affected knowledge of, skill in, and attitudes toward implementation of the protocol in practice, as well as to determine whether there was a difference in reported compliance scores among various disciplines. A pre-test survey designed to examine these variables and the reported compliance with the Early Progressive Mobilization protocol was administered. Educational sessions were provided to participants on the Early Progressive Mobilization Protocol after the pre-test. A post-test was administered after the educational session to determine the educational impact on the identified variables. Data analysis was completed using frequency distributions. Valuable insight was gained on the potential impact of targeted educational intervention. Further study is warranted to assess the effects of routine training in intensive care units with similar protocols.