Nursing & Healthcare

Biography

Biography: Julia C.Stecker

Abstract

Immobility in critically ill patients can lead to devastating health consequences. In a scenario where patients do not qualify for the standardized early mobility algorithms, patients might be at risk of receiving limited, suboptimal or even no interventions for early mobility at all. This quality improvement study aims to identify the current literature to support patients-centered interventions. The goal is to promote early mobility in critically ill patients unable to tolerate interventions from standardized progressive mobility algorithms. A gap analysis in the Coronary Care Unit (CCU) of an academic hospital in the Seattle area reviewed a need to tailor interventions for patients with limited mobility. A systematic investigation included retrospective literature review.The literature suggests there are two main groups of identified barriers for the delay in early mobility in chronically ill patients. The first barrier is patients-related and the second is institutional-related. An intervention to minimize patients-related barriers include correctly identifying and managing underlying causes that lead to mobility intolerance. It includes addressing and correcting the respiratory and cardiovascular imbalance, pain, physical limitation or temporary physical restriction, and patient preferences when it comes to mobility. The evidence from the literature indicates promoting staff education, use optimization of current resources, use of an interdisciplinary team and use of technology may minimize institution-related barriers. Adopting patients-centered interventions can eliminate the barriers standing between patients and the actions from staff for the promotion of early mobility.