Abstract

The effects of immobility in the intensive care unit (ICU) lead to significant short and long-term complications among patients. Early mobility practices positively impact patients’ cognitive and physical outcomes while in the ICU and post ICU discharge; however, patient safety barriers exist with implementing early mobility interventions. An integrative literature review was completed to summarize early mobility practices among individuals in the ICU, adverse safety events that occurred during mobilizing, and best practices to prevent adverse safety events from occurring. Using CINAHL, PubMed, OVID, and ProQuest, eleven articles were analyzed for level and quality of evidence, including two randomized controlled trials (RCTs) and one clinical practice guideline based on systematic reviews of RCTs. The literature review provided two best-practice themes for successful early mobility interventions, including (a) the criteria to determine early mobility readiness, and (b) the criteria to progress mobility. Literature utilized best-practice screening algorithms and protocols to outline criteria to safely initiate and progress mobility interventions. Implementation of an early mobility practice utilizing the ABCDE bundle in conjunction with the Agency for Healthcare Research and Quality (AHRQ) ICU Early Mobility Screening Algorithm and ICU Early Mobility Protocol is recommended. To assist with translating best-practice evidence into clinical practice, the American Association of Critical Care Nurses Synergy Model was utilized to demonstrate patient characteristics and nurse competencies and their connection to optimize patient outcomes. Additional factors for a successful implementation of an early mobility practice includes leadership cooperation, the commitment of a multidisciplinary team, staff education and engagement, and a sustainability plan for continued adherence.

Date of Completion of Thesis/SIP

Spring 4-22-2021

Document Type

Scholarly Inquiry Paper (SIP)

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

First Advisor

Julie Ponto

Second Advisor

Ann Loth

Included in

Nursing Commons

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