A multisite study of multidisciplinary ICU team member beliefs toward early mobility
Leanne M Boehm1, Jana Lauderdale2, Amy N Garrett3
1Vanderbilt University School of Nursing; 461 21st Ave South, Nashville, TN 37240, USA; Critical Illness, Brain dysfunction, and Survivorship (CIBS) Center at Vanderbilt, Nashville, TN, USA; Vanderbilt Center for Clinical Quality and Implementation Research (CCQIR), Nashville, TN, USA.
Background:
Early mobility is underutilized in critical care.
Objective:
Describe multidisciplinary intensive care unit (ICU) providers beliefs about the conduct of early mobility during critical illness.
Methods:
A 7-item elicitation survey was administered to a multidisciplinary sample of ICU team members. We conducted independent thematic analysis of n = 95 surveys.
Results:
Analysis resulted in three themes: immediate risk vs. long-term reward conflict, nurse is the initiator and coordinator of early mobilization, and situational factors. Staffing was the primary facilitator and barrier to early mobility. Enablers included protection from complications of hospitalization, reduced hospital length of stay, and improved patient morale. Barriers strongly revolved around team member risk aversion (e.g., falls, hemodynamic instability, line dislodgment). Nurses were equally identified as positive and negative referents for early mobility.
Conclusions:
Strong positive and negative attitudinal beliefs were elicited. Early mobility is a protective behavior that requires sufficient numbers of trained staff and equipment.
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