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Nurse-Led Algorithm-Based Early Mobilization Protocol for Reducing Post-Intensive Care Syndrome in Intensive Care
1Yunhee Jeong, RN, MSN, Staff Nurse, Graduate Student, Cardiovascular Intensive Care Unit, Gil Medical Center, Gachon University, Incheon, South Korea. Hyeongsuk Lee, RN, PhD, Associate Professor, College of Nursing, Research Institute of AI and Nursing Science, Gachon University, Incheon, South Korea.
Background:
Post-intensive care syndrome (PICS) is a significant challenge for cardiac surgery survivors. While early mobilization (EM) is recommended, there is a lack of evidence regarding the effectiveness and safety of nurse-led, algorithm-based protocols in cardiovascular intensive care units (ICUs).
Objective:
To evaluate the effects of a nurse-led algorithm-based EM protocol on PICS scores, psychological distress (anxiety and depression), sleep quality, and nursing satisfaction in patients following cardiac surgery.
Methods:
A randomized controlled pretest-posttest study was conducted with 38 adult patients at a Korean tertiary hospital. Participants were randomly assigned to a control (n = 19) or experimental (n = 19) group. The experimental group received the protocol from 12 hours post-intensive care admission until transfer. Outcomes were measured using the PICS Questionnaire, Hospital Anxiety and Depression Scale, Korean Modified Leeds Sleep Evaluation Questionnaire, and Nursing Service Satisfaction Tool. Data were analyzed using nonparametric tests.
Results:
Significant improvements were observed in the experimental group compared with the control group in PICS scores (Z = -3.83, P < .001), anxiety and depression (Z = -3.52, P < .001), sleep quality (Z = -3.83, P < .001), and all subdomains of nursing satisfaction (Z = -3.58 to -3.83, P < .001). No mobilization-related adverse events occurred, indicating the safety of the protocol.
Conclusions:
The application of a nurse-led algorithm-based EM protocol is a safe and effective strategy to reduce PICS, alleviate psychological distress, and enhance sleep and nursing satisfaction after cardiac surgery. This standardized nurse-driven approach should be integrated into routine cardiovascular ICU clinical practice.
Trial Registration:
This study was registered with the Korean Clinical Research Information Service (CRIS) (identifier: KCT0010880, https://cris.nih.go.kr).
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