Effectiveness of Nurse-Led Early Mobility Protocols on the Outcomes of Critical Care Patients: A Systematic Review and Meta-Analysis.
Jing Xu, Shengyuan Wang, Qian Zhang and 2 others
PMID 40371936WHAT IT FOUND
Nurse-led early mobility protocols shortened ICU stay by 1.8 days and hospital stay by 2.6 days, but did not improve mobility, body function, muscle strength or mortality.
Key findings
01Across 11 studies and 1127 participants, nurse-led early mobility protocols reduced ICU stay by a pooled weighted mean difference of -1.813 days (95% CI -3.072 to -0.555, p = 0.005).
02Across 10 studies and 1034 participants, nurse-led early mobility protocols reduced hospital stay by a pooled weighted mean difference of -2.622 days (95% CI -5.122 to -0.123, p = 0.040).
03Mobility, body function, muscle strength and mortality did not show a clear benefit over standard care.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The included protocols varied in content, frequency and intensity, and some studies used early rehabilitation packages rather than a uniform nurse-led protocol. Risk of bias was mixed: 3 studies were rated high risk, 5 had some concerns and 7 were low risk. Heterogeneity was high for ICU stay (I2 = 86.3%), hospital stay (I2 = 92.3%), mobility (I2 = 97.2%), body function (I2 = 94.0%) and muscle strength (I2 = 95.6%). Publication bias could not be assessed for mobility, body function and muscle strength because few studies were available. The hospital stay funnel plot was asymmetrical, so publication bias is possible even though Egger's test was not significant (p = 0.22). Many included studies had short follow-up, so longer-term function may not be captured.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the shorter ICU and hospital stays as evidence that nurse-led early mobility improves mobility, strength, body function or survival. Those outcomes were not improved, and the protocols varied widely, so the effect cannot be separated from other components.