Using electronic health records to classify risk for adverse safety events with ICU patient Mobility: A Cross-Sectional study.
Anna Krupp, Kelly Potter, Linder Wendt and 2 others
PMID 39378525WHAT IT FOUND
Many ICU patients classified as low-risk for out-of-bed mobility were not mobilized, while some high-risk patients were.
Activity orders, sedation, and vasoactive dose changes tracked with documented mobility.
Key findings
01In a final sample of 4,088 ICU patients, documented out-of-bed mobility was more likely among patients who met all low-risk criteria than among those who stayed in bed.
02On day one, 26.8% of the 1,111 low-risk patients had documented out-of-bed mobility, rising to 38.6% on day two and 46.8% on day three.
03Some high-risk patients were mobilized: 6.5% of 2,878 high-risk patients on day one, 11.7% on day two, and 14.8% on day three.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
The study was retrospective and single-site, so the findings may not apply to other ICUs. It used routine documentation, and missing data led to varying daily samples. The risk algorithm was not tested against expert bedside decisions or patient outcomes. It did not examine delirium or staffing, which may affect mobility. The authors noted some differences were significant but not clinically meaningful.
The easy way to misread this
Do not use this risk classification as a bedside clearance tool. It was retrospective electronic health record analysis, not prospective validation, and it showed mismatch between algorithm risk and documented mobility.