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Hospitals Struggling To Implement Recommended Movement Protocols For ICU Patients

SAN DIEGO, May 20, 2014 /PRNewswire/ -- Data presented today at the American Thoracic Society (ATS) annual meeting in San Diego, Calif., highlights a major gap in patient care in intensive care units (ICU) around the country. Research has demonstrated that patients in the ICU achieve significantly better outcomes when the process of "early mobility" – having patients sit, stand and move their bodies early in critical illness – is a systematic part of their care. Yet, a review of practices at hospitals throughout the U.S. and Europe shows that more than half of hospital teams do not regularly employ early mobility with patients and only about a quarter have a formal early mobility protocol.
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Major professional organizations, including the Society for Critical Care Medicine (SCCM), the American Association of Critical-Care Nurses (AACN), and the American Nurses Association (ANA) all recommend adoption of early mobility practices. The study presented at ATS is the first international survey of how closely these recommendations are being followed. The data also will be presented this week at the AACN National Teaching Institute (NTI) meeting in Denver.

"Advances in medicine mean that many patients now survive critical illnesses treated in the ICU. However, a stay in the ICU bears its own risks," says William Schweickert, MD, Assistant Professor of Medicine, Hospital of the University of Pennsylvania. "A growing body of research shows that having patients become mobile early on in their recovery helps mitigate these risks and makes a significant difference in a patient's outcome."

Few Hospitals Have Protocols But Those That Do Achieve Better Outcomes

The research team surveyed nurse managers and directors of 951 medical and mixed-medical ICUs in the U.S., France, the U.K. and Germany. Respondents were asked about the existence of an established early mobility protocol in their facility and were interviewed about the use of early mobility practices in the absence of a formal protocol. In the interim analysis presented at ATS, 27 percent of those surveyed reported having an early mobility protocol in place, with an additional 21 percent reporting they have implemented early mobility practices in the absence of a standardized protocol. The majority (52 percent) reported having neither.

The most common practices reported by those surveyed included use of early mobility sessions twice daily, every day. In hospitals without a protocol but which employed early mobility practices, the sessions were most often initiated by physician order. In the minority of hospitals with an established mobility protocol in place, sites reported shorter patient stays in the ICU, a shorter overall length of stay in the hospital, and greater patient satisfaction.

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