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Implementing early mobility protocols in pediatric intensive care units (PICUs) reduced many perceived barriers. However, challenges like staff shortages and patient instability persist, impacting early mobility for critically ill children.

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Area of Science:

  • Pediatric Critical Care Medicine
  • Rehabilitation Therapy
  • Healthcare Quality Improvement

Background:

  • Early mobility is recognized as safe and feasible in pediatric intensive care units (PICUs).
  • Despite benefits, PICUs face persistent barriers to implementing early mobility programs.
  • Understanding provider perceptions is crucial for successful protocol integration.

Purpose of the Study:

  • To assess perceived barriers to early mobility in a PICU before and after protocol implementation.
  • To identify specific challenges that continue to hinder early mobility practices.

Main Methods:

  • A single-center prospective study surveyed PICU providers using a five-point Likert scale on 26 potential barriers.
  • Surveys were administered one month prior to and six months after initiating a PICU-wide early mobility protocol.
  • Paired pre- and post-implementation survey data from 97 providers were analyzed.

Main Results:

  • System-based barriers significantly decreased post-implementation (e.g., lack of guidelines, training, orders).
  • Barriers related to staff availability, equipment, and coordination remained significant concerns.
  • Perceived barriers were lower among day shift providers with more early mobility exposure.

Conclusions:

  • Early mobility protocol implementation significantly altered provider perceptions of barriers.
  • Persistent challenges include resource limitations (staff, equipment) and patient-specific factors.
  • Despite ongoing challenges, 90% of providers believed early mobility positively impacted patients.