SCCM Resource Library-How to Implement an Early ICU Mobility Program

Pdf Summary

The document focuses on the implementation and benefits of early mobility in critical care patients, particularly those mechanically ventilated. The Institute for Healthcare Improvement’s Rethinking Critical Care (IHI-RCC) program advocates for evidence-based critical care bundles aimed at reducing patient harm by promoting early mobility. Implementation challenges include unit-specific barriers such as lack of leadership, perceived resource scarcity, and insufficient knowledge about the bundles.<br /><br />A Shared Mental Model (SMM) through the ICU Liberation Bundle aids in defining team roles and responsibilities, facilitating clear communication. Staff education is crucial, as evidenced by the success of multidisciplinary, evidence-based educational plans which enhance early mobility programs. This includes the Safe Patient Handling and Mobility (SPHM) education, fostering staff familiarity with ergonomics and equipment use.<br /><br />The ICU Liberation Bundle consists of several evidence-based interventions, including pain management, sedation choices, delirium assessment, and early mobility, aiming to improve outcomes for critically ill patients. Overcoming barriers involves addressing patient, clinician, and protocol-related challenges and fostering a culture embracing early mobility.<br /><br />Critical to successful implementation are multidisciplinary teamwork, optimizing team communication through electronic health records, and supportive leadership. Daily multidisciplinary rounds are encouraged, involving key healthcare roles such as intensivists, nurses, therapists, and pharmacists.<br /><br />COVID-19 introduces additional challenges, including infection control measures and restricted family interactions. Teams need to adapt, ensuring the continuity of patient-centered care despite PPE barriers. Tools like ICU Mobility Scale and patient activity tracking in electronic health records are recommended for standardizing communications and ensuring effective early mobility programs.<br /><br />Ultimately, incorporating these strategies promises reduced ICU and hospital lengths of stay, fewer ventilator days, and improved staff and patient satisfaction. Regular assessments and leadership support are critical for sustainable implementation.

Asset Subtitle

Quality and Patient Safety, Patient and Family Support, 2020, 00:07:29

Asset Caption

This article was first published in the Fall 2020 issue of Critical Connections. Early mobility has been a proposed treatment for mechanically ventilated patients since the 1970s. Its benefits are reduced intensive care unit (ICU) and hospital lengths of stay (LOS) and fewer ventilator days and ICU readmissions. Early mobility is an essential element in the Society of Critical Care Medicine’s (SCCM) ICU Liberation Bundle (formerly known as the A-F Bundle) of evidence-based interventions to improve quality outcomes for mechanically ventilated, critically ill patients. The ICU Liberation Bundle is a model of effective interdependent interventions:

Assess, prevent, and manage pain
Both spontaneous awakening and spontaneous breathing trials
Choice of analgesia and sedation
Delirium: assess, prevent, and manage
Early mobility and exercise
Family engagement and empowerment

Critical Connections is the critical care industry’s only newsmagazine, provides information on cutting-edge topics in critical care useful to the entire multiprofessional team. Author: Laura S. Maples MSN, RN, CCRN-KLaura S. Maples MSN, RN, CCRN-K

Meta Tag

Content Type Article

Knowledge Area Quality and Patient Safety

Knowledge Area Patient and Family Support

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Membership Level Professional

Membership Level Associate

Tag Guidelines

Tag Evidence Based Medicine

Tag Rehabilitation Medicine

Year 2020

Keywords

early mobility

critical care

mechanically ventilated

IHI-RCC program

ICU Liberation Bundle

multidisciplinary teamwork

Safe Patient Handling and Mobility

COVID-19 challenges

electronic health records

patient outcomes

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.