Mobilisation OverViEw in a Quaternary intensive care unit: A cross-sectional descriptive survey

Despite abundant high-quality international literature demonstrating potential benefits of early mobilisation (EM) for patients in intensive care units (ICUs), point prevalence studies have shown low EM rates in Australian ICUs. Recent clinical guidelines exist, but awareness rates of these and current attitudes to EM in Australia are unknown.

The objective of this study was to determine awareness of recent guidelines and operationalise barriers and enablers to EM in an Australian ICU using the Theoretical Domains Framework.

A cross-sectional descriptive survey was designed and distributed to all nursing, medical, and physiotherapy clinicians in an Australian quaternary ICU specialising in burns, trauma, and neurosurgery. Data were collected in the Research Electronic Data Capture platform and analysed using IBM SPSS Statitics for Windows (IBM Corp: Armonk, NY). Quantitative data were summarised with descriptive statistics. Qualitative data underwent thematic and content analysis.

The response rate was 46%; a representative sample was achieved. Guideline awareness was low (23%). Dichotomised variable analysis revealed knowledge and evidence (45%, M = 2.68, standard deviation [SD] = 1.69) and staffing (45%, M = 3.14, SD = 1.65) as perceived barriers to EM. Decision-making (52%, M = 2.93, SD = 1.67) and time (39%, M = 3.28, SD = 1.58) were moderate barriers; however, nondichotomised groups were comparable. Perceived enablers were intention (65%, M = 3.42, SD = 1.59), social influences (78%, M = 3.45, SD = 1.60), resources (83%, M = 3.81, SD = 1.36), skills (83 %, M = 4.06, SD = 1.45), and beliefs (94%, M = 4.43, SD = 1.09). Qualitative responses largely reinforced these findings, particularly barriers of limited staffing and equipment.

This study highlights low awareness of EM guidelines and the presence of persistent system-level barriers to EM despite clinicians' positive attitudes and intentions. Findings suggest that stronger guideline dissemination, education, and practical supports are needed to embed EM into routine ICU practice. Future research should focus on implementation strategies and evaluation of safe, context-specific approaches to support consistent delivery of EM.