Identifying Barriers to Nurse-Facilitated Patient Mobility in the Intensive Care Unit.
Daniel L Young, Jason Seltzer, Mary Glover and 5 others
PMID 29716904WHAT IT FOUND
Nurses and a technician had little free time; 79% of observed minutes were not possible for mobility, mostly documentation and provider communication.
Potential mobility appeared during patient care and downtime.
Key findings
01During 655 minutes, patient care took 47% of time, provider communication 25%, documentation 18%, and down time 10%.
02Most observed events (82%) and minutes (79%) were categorized as not possible for mobility, including all time spent in provider communication and documentation.
03Potential mobility events were identified only during direct patient care or down time, with in-bed (9%) and out-of-bed (7%) events more common than edge-of-bed (1%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 2 nurses and 1 clinical technician were observed in one medical ICU, so other units, staff, and times may differ. Night shift and times with frequent tests and procedures were avoided, so the findings may not apply to those periods. One physical therapist performed all observations, and the observer may not have been completely objective in recording the logbook. Potential mobility events were inferred from post hoc logbook review, not actually observed or tested. The project reported staff time and mobility opportunities, not patient mobility outcomes or intervention effects.
Declared interests
The article is tagged as supported by NIH extramural and non-U.S. government research funding; no author conflict statement or sponsor role is included in the supplied text.
The easy way to misread this
Do not read these mobility opportunities as evidence that nurse-facilitated mobility improves patient outcomes. The events were inferred from logbook review, not tested, and only 2 nurses and 1 clinical technician in one medical ICU were observed.