Investigating Education and Organizational Support for Early Mobility

Abstract

Background: Early mobilization (EM) of patients on mechanical ventilation has been shown to enhance recovery following critical illness, leading to decreased ventilator-associated days, improved lung functional capacity, and shorter hospital stays. Despite its recognized safety and benefits, there remains limited information regarding multidisciplinary clinicians’ understanding of EM and the organizational support they receive.

Methods: This was a cross-sectional, exploratory survey targeting healthcare professionals who are ≥18 years of age and have at least one year of experience working in an ICU. The survey, consisting of 53 MCQs used branching logic, was developed through a review of relevant literature on EM and was geared towards ICU professionals.

Results: A total of 52 respondents participated in the survey, with 22 completed responses included in the final analysis. The participants included physicians (4.5%), RTs (68.1%), RNs (4.5%), PTs (9%), and occupational therapists (OTs) (13.6%). A significant portion of participants held a bachelor’s degree or higher (77.2%), and the majority had a minimum of 10 years of experience in healthcare (72.7%), with most having less than 10 years of experience in ICU settings (72.7%). Of the surveyed healthcare professionals, 55% reported not receiving formal training for EM, and 60% indicated no formal training on patient mobilization. OTs and PTs reported higher levels of training and education in the mobility of critical care patients. Regarding familiarity with EM, 32% of participants reported not being trained or familiar with Passive Range of Motion (PROM), while 68% were familiar with the term and process of EM. Only 26% of those familiar with EM received training to perform the task. The study identified significant knowledge gaps and perceived barriers to implementing EM in the ICU. Lack of training and education (36.4%) and insufficient staffing (36.4%) were the most significant barriers, followed by patient condition (18.2%) and lack of support (4.5%).

Conclusions: This study underscores the importance of implementing programs and initiatives to provide healthcare professionals with the necessary education and organizational support for early mobilization (EM) in ICU settings. While there is substantial evidence supporting EM for ventilated ICU patients and a positive attitude among healthcare disciplines towards learning and performing it, our findings reveal a critical need for enhanced education and training to ensure safety and efficacy.