[PROtocol-based MObilizaTION on intensive care units : Design of a cluster randomized pilot study]

Area of Science:

• Critical Care Medicine
• Rehabilitation
• Healthcare Implementation Science

Background:

• Early mobilization in intensive care units (ICUs) is evidence-based but underutilized in practice.
• Standardized protocols can facilitate the implementation of early mobilization strategies.
• Limited data exists on the effectiveness of structured protocols in increasing patient mobilization.

Purpose of the Study:

• To assess the feasibility and estimate effect sizes of implementing an early mobilization protocol in ICUs.
• To compare mobilization rates between ICUs with and without a standardized early mobilization protocol.
• To identify barriers and facilitators to early mobilization in the ICU setting.

Main Methods:

• A multicenter, stepped-wedge, cluster-randomized pilot study involving five ICUs.
• Randomized implementation of an interprofessional early mobilization protocol across ICUs.
• Monthly one-day point prevalence surveys to evaluate patient mobilization using the ICU Mobility Scale (IMS).

Main Results:

• The study aims to evaluate the feasibility of protocol implementation and estimate effect sizes for future research.
• Primary outcome: percentage of patients mobilized out of bed (IMS score ≥3).
• Secondary outcomes: mechanical ventilation, delirium, ICU/hospital length of stay, and adverse events.

Conclusions:

• This pilot study provides a foundation for a larger explanatory trial on early mobilization protocols.
• The findings will inform strategies to improve the implementation and effectiveness of early mobilization in ICUs.
• Optimizing early mobilization can potentially improve patient outcomes and reduce healthcare costs.