Much work has been done in recent years to support early mobility in mechanically ventilated patients to decrease the muscle weakness that rapidly occurs in patients on bed rest. However, patients with any potential or actual cardiovascular, pulmonary, or neurologic instability are routinely excluded from study protocols. Amidei and Sole studied patients with respiratory failure and at least one comorbidity to evaluate how early passive activity could be initiated. Passive exercise early and prior to initiating active mobility protocols may contribute to better patient outcomes and decreased intensive care unit (ICU) length of stay.
Increasing either passive or active patient mobility is definitely a team effort. Consider the following:
Evaluate current knowledge and practice on your unit. This could be done through an on-line survey using e-mail.
Include your physician staff in the knowledge and practice evaluation.
Collaborate with your clinical nurse specialist,...