An Environmental Scan for Early Mobilization Practices in U.S. ICUs

Area of Science:

• Critical Care Medicine
• Implementation Science
• Quality Improvement

Background:

• Early mobilization is a proven intervention to enhance patient outcomes in intensive care units (ICUs).
• The extent to which early mobilization has been adopted into routine ICU practice remains unclear.
• Understanding current practices and barriers is crucial for effective dissemination and implementation strategies.

Purpose of the Study:

• To conduct an environmental scan of U.S. ICUs to assess readiness for early mobilization.
• To identify current early mobilization practices and associated barriers.
• To inform dissemination and implementation efforts for early mobilization.

Main Methods:

• A telephone survey was administered to 500 randomly selected U.S. ICUs.
• The selection was stratified by regional hospital density and hospital size.
• Respondents were primarily nursing leadership, with a 73% response rate.

Main Results:

• Only 45% of surveyed ICUs reported implementing early mobilization, with two-thirds of those using a written protocol.
• Factors associated with early mobilization protocols included dedicated physical/occupational therapy, written sedation protocols, and daily multidisciplinary rounds.
• Common barriers cited were equipment, staffing, patient safety, and competing priorities.

Conclusions:

• While awareness of early mobilization benefits is widespread, practical adoption in ICUs is limited.
• Implementing multidisciplinary rounds and formal sedation protocols may enhance early mobilization adoption.
• Further research is needed on methods to audit and compare institutional early mobilization practices.