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Related Experiment Video

Updated: Jan 24, 2026

A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
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PROtocol-based MObilizaTION on intensive care units: stepped-wedge, cluster-randomized pilot study (Pro-Motion).

Peter Nydahl1, Ulf Günther2, Anja Diers2

  • 1Department of Anesthesiology and Intensive Care Medicine, University Hospital of Schleswig-Holstein, Kiel, Kiel, Germany.

Nursing in Critical Care
|May 25, 2019
PubMed
Summary

Implementing early mobilization protocols in intensive care units (ICUs) showed a trend toward increased patient mobilization. However, significant increases in ICU mobilizations require further investigation into staffing levels and their impact on patient outcomes.

Keywords:
Clinical protocolsEarly ambulationImplementation scienceIntensive care unitsRehabilitation

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Area of Science:

  • Critical Care Medicine
  • Rehabilitation
  • Healthcare Implementation Science

Background:

  • Early mobilization in intensive care units (ICUs) is crucial for patient recovery but faces implementation challenges.
  • Standardized protocols can potentially improve the rate of out-of-bed mobilizations for ICU patients.

Purpose of the Study:

  • To assess the impact of an early mobilization protocol on the rate of out-of-bed mobilizations in ICU patients.
  • To evaluate secondary outcomes including mechanical ventilation duration, delirium incidence, and length of stay.

Main Methods:

  • A multicenter, stepped-wedge, cluster-randomized pilot study was conducted.
  • Five ICUs implemented an inter-professional early mobilization protocol in a randomized, monthly sequence.
  • Patient mobilization was assessed using the ICU Mobility Scale in monthly point prevalence surveys.

Main Results:

  • Out-of-bed mobilizations increased non-significantly from 36.2% to 45.8% during the intervention period.
  • The frequency of once-daily mobilizations increased, while multiple daily mobilizations decreased.
  • No significant differences were observed in mechanical ventilation, delirium, or ICU/hospital length of stay. Protocol adherence was high (>90%), and safety events were rare.

Conclusions:

  • Implementing an early mobilization protocol is feasible and safe, showing a trend toward increased patient mobilization.
  • Significant increases in mobilization rates may necessitate additional staffing, warranting further research.
  • The study highlights the potential of inter-professional protocols to enhance early mobilization in ICUs.