Early Mobilization: Changing the Mindset
Emily Castro1, Michael Turcinovic2, John Platz2
1Emily Castro is a critical care nurse educator at North Shore University Hospital, Manhasset, New York.Michael Turcinovic is a critical care physical therapist and wound care certified provider at North Shore University Hospital.John Platz is an attending physician in the surgical intensive care unit and trauma service at North Shore University Hospital, Long Island Jewish Medical Center in New Hyde Park, New York, and SouthSide Hospital in Bay Shore, New York.Isabel Law was the nurse manager during the inception of the early mobilization quality improvement project at North Shore University Hospital. She is now director of patient care services at Franklin General Hospital, Valley Stream, New York. ecastro@nshs.edu.
Background:
Staff in the surgical intensive care unit (SICU) had several concerns about mobilizing patients receiving mechanical ventilation.
Objective:
To assess and improve the mindset of SICU staff toward early mobilization of patients receiving mechanical ventilation before, 6 months after, and 1 year after implementation of early mobilization.
Methods:
The Plan-Do-Study-Act model was used to guide the planning, implementation, evaluation, and interventions to change the mindset and practice of SICU staff in mobilizing patients receiving mechanical ventilation. Interventions to overcome barriers to early mobilization included interdisciplinary collaboration, multimodal education, and operational changes. The mindset of the SICU staff toward early mobilization of patients receiving mechanical ventilation was assessed by using a survey questionnaire distributed 2 weeks before, 6 months after, and 1 year after implementation of early mobilization.
Results:
The median score on 6 of 7 survey questions changed significantly from before, to 6 months after, to 1 year after implementation, indicating a change in the mindset of SICU staff toward early mobilization of patients receiving mechanical ventilation. The SICU staff agreed that most patients receiving mechanical ventilation are able to get out of bed safely with coordination among personnel and that early mobilization of intubated patients decreases length of stay and decreases occurrence of ventilator-associated pneumonia, deep vein thrombosis, and skin breakdown.
Conclusions:
SICU interdisciplinary team collaboration, multimodal education, and operational support contribute to removing staff bias against mobilizing patients receiving mechanical ventilation.
More Related Videos
Related Concept Videos
01:20Motivational Cycle
The cycle begins with a need. This need can arise from various conditions, such as hunger, thirst, or temperature changes. For instance, when an individual feels cold, their body...
01:38Cognitive Dissonance
01:24Growth versus Fixed Mindset
01:25Motivational Bias
01:42Schemas
01:29Impression Management Techniques III: Aligning Actions