Mobilizing Ventilated Neurosurgery Patients: An Integrative Literature Review

BACKGROUND: Lack of mobilization in ventilated neurosurgery patients is problematic due to significant consequences. Although early mobility addresses these complications, few studies have been conducted in this population, resulting in infrequent mobilization efforts. Nurses prioritize and implement patient care interventions, including mobilization, with multidisciplinary teams. This integrative literature review examines what is known regarding nursing perceptions on mobilization and their role within a multidisciplinary team for mobilization in ventilated neurosurgery patients. METHODS: A comprehensive literature search was conducted using online databases to identify research articles on early mobility studies in ventilated critically ill and neurosurgical patients from 2010 to 2020. RESULTS: Twenty studies were identified and indicated a paucity of research specific to mobilizing ventilated neurosurgery patients. Nurses understand the purpose and benefits of early mobility in critically ill and mechanically ventilated patients. Mixed perceptions exist regarding the responsibility for prioritizing and initiating mobilization. Main barriers include patient safety concerns, untimeliness due to limited resources, unit culture, lack of nursing knowledge, and need for improved teamwork. Associations between teamwork-based interventions and decreased length of stay, increased rates of mobility, and faster time to early mobilization exist. Nurse-led interventions showed additional benefits including positive perceptions such as empowerment, confidence, increased knowledge, and a progressive shift in unit culture. CONCLUSION: This review demonstrates a continued need for understanding nursing perceptions and role in teamwork to mobilize ventilated neurosurgery patients. Future research should focus on testing nurse-led mobility interventions so higher rates of mobilization and provision of holistic patient care can be achieved.