Robot-assisted early mobilization for intensive care unit patients: Feasibility and first-time clinical use.
Int J Nurs Stud
; 152: 104702, 2024 Apr.
Article
in En
| MEDLINE
| ID: mdl-38350342
ABSTRACT
BACKGROUND:
Early mobilization is only carried out to a limited extent in the intensive care unit. To address this issue, the robotic assistance system VEMOTION® was developed to facilitate (early) mobilization measures more easily. This paper describes the first integration of robotic assistance systems in acute clinical intensive care units.OBJECTIVE:
Feasibility test of robotic assistance in early mobilization of intensive care patients in routine clinical practice.SETTING:
Two intensive care units guided by anesthesiology at a German university hospital.PARTICIPANTS:
Patients who underwent elective surgery with postoperative treatment in the intensive care unit and had an estimated ventilation time over 48â¯h.METHODS:
Participants underwent robot-assisted mobilization, scheduled for twenty-minute sessions twice a day, ten times or one week, conducted by nursing staff under actual operational conditions on the units. No randomization or blinding took place. We assessed data regarding feasible cutoff points (in brackets) the possibility of enrollment (xâ¯≥â¯50â¯%), duration (pre- and post-setup (xâ¯≤â¯25â¯min), therapy duration (xâ¯=â¯20â¯min), and intervention-related parameters (number of mobilizing professionals (xâ¯≤â¯2), intensity of training, events that led to adverse events, errors or discontinuation). Mobilizing professionals rated each mobilization regarding their physical stress (xâ¯≤â¯3) and feasibility (xâ¯≥â¯4) on a 7 Point Likert Scale. An estimated sample size of at least twenty patients was calculated. We analyzed the data descriptively.RESULTS:
Within 6â¯months, we screened thirty-two patients for enrollment. 23 patients were included in the study and 16 underwent mobilization using robotic assistance, 7 dropped out (enrollment eligibilityâ¯=â¯69â¯%). On average, 1.9 nurses were involved per therapy unit. Participants received 5.6 robot-assisted mobilizations in mean. Pre- and post-setup had a mean duration of 18â¯min, therapy a mean of 21â¯min. The robot-assisted mobilization was started after a median of 18â¯h after admission to the intensive care unit. We documented two adverse events (pain), twelve errors in handling, and seven unexpected events that led to interruptions or discontinuation. No serious adverse events occurred. The mobilizing nurses rated their physical stress as low (mean 2.0⯱â¯1.3) and the intervention as feasible (mean 5.3⯱â¯1.6).CONCLUSIONS:
Robot-assisted mobilization was feasible, but specific safety measures should be implemented to prevent errors. Robotic-assisted mobilization requires process adjustments and consideration of unit staffing levels, as the intervention does not save staff resources or time. REGISTRATION clinicaltrials.org TRN NCT05071248; Date 2021/10/08; URL https//clinicaltrials.gov/ct2/show/NCT05071248. TWEETABLE ABSTRACT Robot-assisted early mobilization in intensive care patients is feasible and no adverse event occurred.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Robotics
/
Early Ambulation
Type of study:
Clinical_trials
Limits:
Humans
Language:
En
Journal:
Int J Nurs Stud
Year:
2024
Document type:
Article
Country of publication:
Reino Unido