Bed rest and immobility in patients on mechanical ventilation and/or in an intensive care unit (ICU) have detrimental effects. Studies in medical ICUs show that early mobilization is safe, does not increase cost, and can be associated with decreased ICU and hospital length of stay (LOS).
Assess the effects of an early mobilization protocol (EMP) on complication rates, ventilator days, and ICU and hospital LOS for patients admitted to a trauma and burn ICU (TBICU).
A retrospective cohort study of a interdisciplinary quality-improvement program.
Pre- and post-EMP patient data from the trauma registry for 2,176 patients admitted to the TBICU between May 2008 and April 2010 were compared.
No adverse events were reported related to the EMP. After adjusting for age and injury severity, there was a decrease in airway, pulmonary, and vascular complications (including pneumonia and DVT) post-EMP. Ventilator days, TBICU and hospital lengths of stay were not significantly decreased.
Using a historical control group, there was no way to account for other changes in patient care that may have occurred between the two periods that could have affected patient outcomes. The dose of physical activity both pre- and post-EMP were not specifically assessed.
Early mobilization of patients in a TBICU was safe and effective. Medical, nursing, and physical therapy staff, as well as hospital administration have embraced the new culture of "early mobilization" in the ICU.
Source: http://ptjournal.apta.org/cgi/content/short/ptj.20110417v1?rss=1
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