PICU Move! Improving Early Mobilization in a Large Pediatric Intensive Care Unit

Area of Science:

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

Background:

• Early mobilization is recommended in pediatric intensive care units (PICUs).
• Standardized protocols are needed to guide mobilization based on patient acuity.
• Implementing such protocols requires both systems and individual-level interventions.

Purpose of the Study:

• To implement and evaluate a standardized early mobilization protocol in a large PICU.
• To assess the impact of systems-based and person-based interventions on mobilization practices.
• To measure changes in therapy utilization and patient activity timing.

Main Methods:

• A standardized early mobilization protocol, "PICU Move!," using Critical Care Illness Levels (CCILs) was implemented.
• Interventions included electronic health record integration, opt-out therapy consultations, and staff education.
• Process measures (compliance, consultations) and outcome measures (time to activity, therapy contacts) were tracked.

Main Results:

• High compliance with CCIL ordering (95.9%) and increased PT/OT consultations (from 38.8% to 82.6% and 34.3% to 81.2%).
• Significant increase in multiple PT/OT contacts and a reduction in time to first registered nurse activity.
• No safety events related to early mobilization were reported.

Conclusions:

• Systems-based interventions, supported by person-based strategies, effectively enhanced early mobilization in a large PICU.
• The "PICU Move!" protocol safely reduced patient activity delays and increased therapy engagement.
• This approach demonstrates a successful model for improving pediatric critical care patient mobility.