Starting an ICU Early Mobility Program
Are you looking to start an ICU early mobility program? If so, there are many factors that you’ll need to consider. One thing you need to think about is the current culture in your ICU. Is the culture to sedate all ICU patients, for patients to stay in bed? Is the staff ready for and supportive of a change? How well do the different departments work together? Are P.T.’s and O.T’s actively involved in the treatment of your ICU patients?
The next thing that I would advise would be to create a multi-disciplinary early mobility team, decide on a time frame, a start date, and start planning. You’ll need to create protocols, exclusion criteria and, add an early mobility line item to your pre-printed order sets.
It is important to have super-users or champions from each department who can then start training their coworkers and prepare them for your start date.
It is helpful to agree on the way that you will define mobility. I recommend using a system of 5 mobility stages. Stage1- bed in chair position, Stage 2- sitting edge of bed/dangling, Stage 3- Sitting in a chair, Stage 4- Standing/marching at bedside, Stage 5- Ambulation >10′. When documenting or discussing mobility in rounds, be sure that all team members are using the same grading system and language.
There are many resources out there and the evidence is strong in support of early mobility. The mobility will lead to better outcomes, improved cognitive status and improved patient satisfaction. Take the first step and get those patients moving!!