Intensive Care Unit Liberation: A Quality Improvement Project on the Role of Early Mobilization in Mechanically Ventilated Patients

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Stanton, Amanda
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2024-03-06
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Background: This project addressed the issues surrounding the lack of early mobilization in mechanically ventilated patients in an adult, medical intensive care unit (ICU). The aim was to improve patient outcomes, reduce ventilator time, and minimize ICU length of stay (LOS) through an early mobilization protocol. The objectives included development, implementation, and evaluation of an evidence-based early mobilization protocol. A literature review indicated that early mobilization mitigates muscle atrophy, reduces ventilator time, and ICU LOS. Based on findings, a protocol for early mobilization was developed. Kurt Lewin's Change Theory helped guide this project, offering a systematic approach to change and transitioning to new, evidence-based interventions. Methods: Over 10 weeks in a 24-bed ICU with mechanically ventilated patients, seventy staff members completed a 2-week education period on early mobility. Eligible patients underwent early mobility with daily data collection on demographics, ventilator time, and ICU LOS. Evaluation was based on the ability to participate, time on the ventilator, and ICU LOS compared to current practice. Feedback from providers was also collected to assess feasibility of the protocol. Outcomes: Seventy-one patients (N=71) were included, with 55 receiving early mobility. The average days on ventilator decreased from 6 +/- 1 days to 4.85 days (p = .007), with the ICU LOS decreasing from 12 +/- 5 days to 9 days (p = .099). Recommendations: This project recommends integrating early mobility interventions into critical care by adopting tailored protocols, fostering multidisciplinary collaboration, and implementing ongoing education initiatives.
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University.
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