Early mobility is an element of the ABCDEF bundle designed to improve outcomes such as ventilator-free days and decreased length of stay. Evidence indicates that adherence to an early mobility protocol can prevent delirium and reduce length of stay in the intensive care unit and the hospital and may decrease length of stay in a rehabilitation facility. Yet many barriers exist to implementing early mobility effectively, including patient acuity, uncertainty about when to start mobilizing the patient, staffing and equipment needs, increased costs, and limited nursing time. Implementation of early mobility requires interdisciplinary collaboration, commitment, and tools that facilitate mobility and prevent injury to nurses. This article focuses on aspects of care that can affect patient outcomes, such as preventing delirium, reducing sedation, monitoring the patient’s ability to wean from the ventilator, and encouraging early mobility. It also addresses the effects of immobility as well as challenges in achieving mobility and how to overcome them.
Feature| June 01 2019
Early Mobility in the Intensive Care Unit: Evidence, Barriers, and Future Directions
Susan M. Dirkes, MS, RN, CCRN;
Susan M. Dirkes and Charles Kozlowski are staff nurses at the University of Michigan hospital, Ann Arbor, Michigan.
Corresponding author: Susan M. Dirkes, ms, rn, ccrn, 3443 Tallywood Circle, Sarasota, FL 34237 (email: firstname.lastname@example.org).
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Crit Care Nurse (2019) 39 (3): 33-42.
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Susan M. Dirkes, Charles Kozlowski; Early Mobility in the Intensive Care Unit: Evidence, Barriers, and Future Directions. Crit Care Nurse 1 June 2019; 39 (3): 33–42. doi: https://doi.org/10.4037/ccn2019654
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