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Progressive Mobility Protocol Reduces Venous Thromboembolism Rate in Trauma Intensive Care Patients: A Quality
Kathryn Booth1, Josh Rivet, Richelle Flici
1Carilion Roanoke Memorial Hospital, Roanoke, Virginia (Mss Booth, Flici, Holland, and Hubbard; Drs Rivet, Harvey, Hamill, Collier, and Trivedi; and Mr Hundley); and Virginia Tech Carilion School of Medicine, Carilion Roanoke Memorial Hospital, Roanoke, Virginia (Dr Collier).
Summary
Implementing a structured progressive mobility protocol in the intensive care unit (ICU) for trauma patients is safe. This approach may decrease venous thromboembolism (VTE) complications and patient deconditioning.
Area of Science:
- Critical Care Medicine
- Trauma Surgery
- Rehabilitation Medicine
Background:
- Intensive care unit (ICU) trauma patients face significant risks from immobility.
- Early mobilization is crucial for mitigating complications in critically ill patients.
Purpose of the Study:
- To evaluate the impact of a structured progressive mobility (PM) protocol on ICU trauma patient outcomes.
- To compare outcomes before and after PM protocol implementation.
Main Methods:
- A pre- and post-intervention study design was used.
- Key outcomes included hospital/ICU length of stay, ventilator days, falls, respiratory failure, pneumonia, and venous thromboembolism (VTE).
- Physical therapy (PT) consult rates and timeliness were tracked.
Main Results:
- Physical therapy (PT) consults increased from 53% to over 90% post-intervention, with 24-hour consult completion rising from 23% to 74%-94%.
- No adverse events occurred during PM sessions.
- While most clinical outcomes showed no significant difference, VTE incidence decreased significantly from 21% pre-intervention to 7.5% post-intervention (p = .0004).
Conclusions:
- A structured progressive mobility (PM) protocol is safe for ICU trauma patients.
- The PM protocol may reduce VTE complications and patient deconditioning.
- Multidisciplinary commitment and patient/family engagement are vital for successful PM program implementation.
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