Original Research: Implementation of an Early Mobility Program in an ICU

Area of Science:

• Critical Care Medicine
• Physical Therapy
• Hospital Quality Improvement

Background:

• Implementing dedicated intensive care unit (ICU) mobility teams in community hospitals requires feasibility assessment.
• Nurse-sensitive quality-of-care outcomes are critical metrics for evaluating ICU interventions.

Purpose of the Study:

• To assess the feasibility and impact of a dedicated ICU mobility team in a community hospital setting.
• To compare nurse-sensitive quality-of-care outcomes, costs, sedation, delirium, and functional status between ICU patients receiving mobility team intervention and routine care.

Main Methods:

• A retrospective longitudinal study was conducted at a community acute care hospital.
• Patients were randomly assigned to either a dedicated mobility team intervention group or a routine care group.
• Eligibility for early mobility sessions was determined by a mobility algorithm, with patients progressing through four phases based on stability and ability.

Main Results:

• The mobility intervention group (66 patients) experienced significantly fewer falls, ventilator-associated events, pressure ulcers, and catheter-associated urinary tract infections (CAUTIs) compared to the routine care group (66 patients).
• The mobility group demonstrated lower hospital costs, reduced delirium days, decreased sedation levels, and improved functional independence.
• Patients in the mobility group were mobilized out of bed 2.5 more days, with no adverse events reported.

Conclusions:

• A dedicated ICU mobility team is feasible to implement in community hospitals.
• Early mobilization of ICU patients by a dedicated team leads to improved patient outcomes, including fewer delirium days and enhanced functional status.
• The intervention positively impacts sedation levels and overall patient recovery.