Early mobilization in critically ill patients: patients' mobilization level depends on health care provider's profession.

Journal Article (Journal Article)

OBJECTIVE: To evaluate whether the level of mobilization achieved and the barriers for progressing to the next mobilization level differ between nurses and physical therapists. DESIGN: Prospective, observational study. SETTING: Twenty-bed surgical intensive care unit (SICU) of the Massachusetts General Hospital. PARTICIPANTS: Sixty-three critically ill patients. METHODS: Physical therapists and nurses performed 179 mobilization therapies with 63 patients. OUTCOME MEASUREMENT: Mobilization was defined as the process of enhancing mobility in the SICU, including bed mobility, edge of bed activities, transfers out of bed to a chair, and gait training; the mobilization level was measured on the SICU optimal mobilization scale, a 5-point (0-4) numerical rating scale. RESULTS: Patients' level of mobilization achieved by physical therapists was significantly higher compared with that achieved by nurses (2.3 ± 1.2 mean ± SD versus 1.2 ± 1.2, respectively P < .0001). Different barriers for mobilization were identified by physical therapists and nurses: hemodynamic instability (26% versus 12%, P = .03) and renal replacement therapy (12% versus 1%, P = .03) were barriers rated higher by nurses, whereas neurologic impairment was rated higher by physical therapists providers (18% versus 38%, P = .002). No mobilization-associated adverse events were observed in this study. CONCLUSIONS: This study showed that physical therapists mobilize their critically ill patients to higher levels compared with nurses. Nurse and physical therapists identify different barriers for mobilization. Routine involvement of physical therapists in directing mobilization treatment may promote early mobilization of critically ill patients.

Full Text

Duke Authors

Cited Authors

  • Garzon-Serrano, J; Ryan, C; Waak, K; Hirschberg, R; Tully, S; Bittner, EA; Chipman, DW; Schmidt, U; Kasotakis, G; Benjamin, J; Zafonte, R; Eikermann, M

Published Date

  • April 2011

Published In

Volume / Issue

  • 3 / 4

Start / End Page

  • 307 - 313

PubMed ID

  • 21497316

Electronic International Standard Serial Number (EISSN)

  • 1934-1563

Digital Object Identifier (DOI)

  • 10.1016/j.pmrj.2010.12.022


  • eng

Conference Location

  • United States