A SYSTEMATIC REVIEW EVALUATING THE ROLE OF NURSES AND PROCESSES FOR DELIVERING EARLY MOBILITY INTERVENTIONS IN THE INTENSIVE CARE UNIT
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Abstract
Objectives: To investigate processes for delivering early mobility interventions in adult intensive care unit patients used in research and quality improvement studies and the role of nurses in early mobility interventions.
Methods: A systematic review was conducted. Electronic databases PubMED, CINAHL, PEDro, and Cochrane were searched for studies published from 2000 to June 2017 that implemented an early mobil- ity intervention in adult intensive care units. Included studies involved progression to ambulation as a component of the intervention, included the role of the nurse in preparing for or delivering the interven- tion, and reported at least one patient or organisational outcome measure. The System Engineering Initiative for Patient Safety (SEIPS) model, a framework for understanding structure, processes, and healthcare outcomes, was used to evaluate studies.
Results: 25 studies were included in the final review. Studies consisted of randomised control trials, prospective, retrospective, or mixed designs. A range of processes to support the delivery of early mobil- ity were found. These processes include forming interdisciplinary teams, increasing mobility staff, mobil- ity protocols, interdisciplinary education, champions, communication, and feedback.
Conclusion: Variation exists in the process of delivering early mobility in the intensive care unit. In par- ticular, further rigorous studies are needed to better understand the role of nurses in implementing early mobility to maintain a patient’s functional status.
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