Analysis of adherence to an early mobilization protocol in an intensive care unit: Data collected prospectively over a period of three years by the clinical information system.
Med Intensiva (Engl Ed)
; 47(4): 203-211, 2023 04.
Article
em En
| MEDLINE
| ID: mdl-36344338
ABSTRACT
OBJECTIVE:
To determinate the adherence and barriers of our early mobilization protocol in patients who had received mechanical ventilation >48h in routine daily practice through clinical information system during all Intensive Care Unit (ICU) stay.DESIGN:
Observational and prospective cohort study.SETTING:
Polyvalent ICU over a three-year period (2017-2019). PATIENTS Adult patients on mechanical ventilation >48h who met the inclusion criteria for the early mobilization protocol.INTERVENTIONS:
None. MAIN VARIABLES OF INTEREST Demographics, adherence to the protocol and putative hidden adherence, total number of mobilizations, barriers, artificial airway/ventilatory support at each mobilization level and adverse events.RESULTS:
We analyzed 3269 stay-days from 388 patients with median age of 63 (51-72) years, median APACHE II 23 (18-29) and median ICU stay of 10.1 (6.2-16.5) days. Adherence to the protocol was 56.6% (1850 stay-days), but patients were mobilized in only 32.2% (1472) of all stay-days. The putative hidden adherence was 15.6% (509 stay-days) which would increase adherence to 72.2%. The most common reasons for not mobilizing patients were failure to meeting the criteria for clinical stability in 241 (42%) stay-days and unavailability of physiotherapists in 190 (33%) stay-days. Adverse events occurred in only 6 (0.4%) stay-days.CONCLUSIONS:
Data form Clinical Information System showed although adherence was high, patients were mobilized in only one-third of all stay-days. Knowing the specific reason why patient were not mobilized in each stay-day allow to develop concrete decisions to increase the number of mobilizations.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Deambulação Precoce
/
Unidades de Terapia Intensiva
Tipo de estudo:
Guideline
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Observational_studies
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Prognostic_studies
Limite:
Adult
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Aged
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Humans
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Middle aged
Idioma:
En
Revista:
Med Intensiva (Engl Ed)
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Espanha