Background Patient immobility and a lack of physical activity in the intensive care unit results in a myriad of negative patient and hospital outcomes. Objective To report research findings related to the use of exercise physiologists in promoting and providing aggressive and progressive early mobilization within the intensive care unit. Methods This observational cohort study used the researcher-generated 12-point Activity Mobilization Evaluation Scale and delirium prevention bundle in 3 medical-surgical intensive care units to track patients’ progress with mobilization. Results On average, most of the 216 patients in the study population realized a 1.6-point change ( P < .001) in activity level with intervention by an exercise physiologist. Almost all of the study population (97%) maintained or increased the level of activity after receiving a minimum of 1 session with an exercise physiologist (mean, 3.5 sessions per day) during the 3-month study period. Conclusion The introduction of exercise physiologists in the intensive care units proved to be a novel, safe, and effective strategy that maintained or increased the activity level of 97% of study patients.

Background Strategies for preventing delirium include early identification and avoiding or modifying patient, environmental, and iatrogenic factors. Minimal research exists on a prescriptive delirium prevention bundle that details elements or strategies for each bundle component. Even less research has been focused on nurse-driven interventions or components. Objective To evaluate the effectiveness of a delirium prevention bundle in decreasing delirium incidence in 2 medical-surgical intensive care units in a large Texas medical center. Methods Researchers used the Confusion Assessment Method for the Intensive Care Unit to assess delirium incidence by using a controlled interventional cohort design with 447 delirium-negative critically ill patients. Bundle components consist of sedation cessation, pain management, sensory stimulation, early mobilization, and sleep promotion. Results The intervention, analyzed by using a logistic regression model, reduced the odds of delirium by 78% (odds ratio, 0.22; P = .001). Conclusions The delirium prevention bundle was effective in reducing the incidence of delirium in critically ill medical-surgical patients. Further validation studies are under way.