Nursing and Physiotherapy Roles in Early Mobilization of Hospitalized Patients

Authors

  • Alhazmaı, Rabıah Makhtab W
  • Mariam Sheaf Ashwe Alrowily
  • Ahod Obeed Alanazi
  • Alaa Mudhhi S Alshammari
  • Alruwaili, Reham Muwafiq S
  • Hammad Alhomidy Raggad Alrawily
  • Alruwaili, Naifah Jazzaa J
  • Ali Yahya Alqahtani
  • Haneen Abdalmatti Ibrahim Alfalih
  • Alruwaili, Manal Turki D
  • Lubna Salem Alatawi

DOI:

https://doi.org/10.22399/ijcesen.4563

Keywords:

Early Mobilization, Nursing Role, Physiotherapy Role, Hospitalized Patients, Recovery Outcomes, Patient Independence

Abstract

Early mobilization of hospitalized patients is a crucial component of modern healthcare, significantly contributing to enhanced recovery outcomes, reduced length of hospital stays, and diminishing the risks of complications such as deep vein thrombosis and pulmonary issues. Nurses play a pivotal role in this initiative, acting as frontline caregivers who assess patient mobility levels, provide emotional support, and encourage patients to participate in their recovery. They are responsible for developing individualized mobilization plans in collaboration with multidisciplinary teams, ensuring safety and comfort during the process. By educating patients about the benefits of movement, nursing professionals not only foster patient independence but also promote adherence to mobility protocols. Physiotherapists complement the efforts of nursing staff through their specialized knowledge in movement and rehabilitation techniques. They conduct thorough assessments of patients' physical capabilities, identify any limitations, and tailor exercise programs that are safe and effective. Physiotherapists implement evidence-based strategies to facilitate early mobilization, utilizing tools such as gait training, balance exercises, and strength training. Their expertise is particularly vital in managing patients with complex conditions, ensuring the transition from bed to walking is as smooth as possible. Through collaborative efforts, nursing and physiotherapy teams create a seamless approach to mobilization, greatly enhancing patient outcomes and overall satisfaction with their healthcare experience.

References

[1] Corcoran JR, Herbsman JM, Bushnik T, et al. Early rehabilitation in the medical and surgical intensive care units for patients with and without mechanical ventilation: an interprofessional performance improvement project. PM R. 2017;9(2):113‐119. doi: 10.1016/j.pmrj.2016.06.015.

[2] Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71.

[3] Hopkins RO, Spuhler VJ, Thomsen GE. Transforming ICU culture to facilitate early mobility. Crit Care Clin. 2007;23(1):81‐96. doi: 10.1016/j.ccc.2006.11.004.

[4] Pashikanti L, Von Ah D. Impact of early mobilization protocol on the medical‐surgical inpatient population: an integrated review of literature. Clin Nurse Specialist. 2012;26(2):87‐94. doi: 10.1097/NUR.0b013e31824590e6.

[5] Park J, Jeon K, Chung CR, et al. A nationwide analysis of intensive care unit admissions, 2009–2014–the Korean ICU National Data (KIND) study. J Crit Care. 2018;44:24‐30. doi: 10.1016/j.jcrc.2017.09.017.

[6] Koyuncu F, Iyigun E. The effect of mobilization protocol on mobilization start time and patient care outcomes in patients undergoing abdominal surgery. J Clin Nurs. 2022;31(9–10):1298‐1308. doi: 10.1111/jocn.15986.

[7] Cheung AM, Tansey CM, Tomlinson G, et al. Two‐year outcomes, health care use, and costs of survivors of acute respiratory distress syndrome. Am J Respir Crit Care Med. 2006;174(5):538‐544. doi: 10.1164/rccm.200505-693OC.

[8] Gurses AP, Carayon P. Performance obstacles of intensive care nurses. Nurs Res. 2007;56(3):185‐194. doi: 10.1097/01.NNR.0000270028.75112.00.

[9] Herridge MS, Cheung AM, Tansey CM, et al. One‐year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med. 2003;348(8):683‐693. doi: 10.1056/NEJMoa022450.

[10] Higgins SD, Erdogan M, Coles SJ, Green RS. Early mobilization of trauma patients admitted to intensive care units: a systematic review and meta‐analyses. Injury. 2019;50(11):1809‐1815. doi: 10.1016/j.injury.2019.09.007.

[11] Hassan A, Rajamani A, Fitzsimons F. The MOVIN'project (mobilisation of ventilated intensive care patients at Nepean): a quality improvement project based on the principles of knowledge translation to promote nurse‐led mobilisation of critically ill ventilated patients. Intensive Crit Care Nurs. 2017;42:36‐43. doi: 10.1016/j.iccn.2017.04.011.

[12] Chung CR. Current status of intensive care rehabilitation. Korean Soc Internal Med Fall Conf Proc. 2019;2:680‐683.

[13] Zhang H, Liu H, Li Z, et al. Early mobilization implementation for critical ill patients: a cross‐sectional multi‐center survey about knowledge, attitudes, and perceptions of critical care nurses. Int J Nurs Stud. 2022;9(1):49‐55. doi: 10.1016/j.ijnss.2021.10.001.

[14] Winkelman C, Johnson KD, Hejal R, et al. Examining the positive effects of exercise in intubated adults in ICU: a prospective repeated measures clinical study. Intensive Crit Care Nurs. 2012;28(6):307‐318. doi: 10.1016/j.iccn.2012.02.007.

[15] Weijing S, Gong X, Zhuang Y. Impact of knowledge, attitudes and self‐reported practices of nurses on early mobilization of mechanically ventilated patients in the ICU. Nurs Crit Care. 2024;29(3):573‐583. doi: 10.1111/nicc.13041.

[16] Schardt C, Adams MB, Owens T, Keitz S, Fontelo P. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decision Making. 2007;7:1‐6. doi: 10.1186/1472-6947-7-16.

[17] Bassett RD, Vollman KM, Brandwene L, Murray T. Integrating a multidisciplinary mobility programme into intensive care practice (IMMPTP): a multicentre collaborative. Intensive Crit Care Nurs. 2012;28(2):88‐97. doi: 10.1016/j.iccn.2011.12.001.

[18] Nydahl P, Günther U, Diers A, et al. PROtocol‐based MObilizaTION on intensive care units: stepped‐wedge, cluster‐randomized pilot study (pro‐motion). Nurs Crit Care. 2020;25(6):368‐375. doi: 10.1111/nicc.12438.

[19] Wang J, Shi C, Xiao Q, Jia Y, et al. ICU nurses' practice and intention to implement early mobilization: a multi‐centre cross‐sectional survey. Nurs Crit Care. 2024;29(5):1067‐1077. doi: 10.1111/nicc.13100.

[20] Morris PE, Berry MJ, Files DC, et al. Standardized rehabilitation and hospital length of stay among patients with acute respiratory failure: a randomized clinical trial. JAMA. 2016;315(24):2694‐2702. doi: 10.1001/jama.2016.7201.

[21] Dong ZH, Yu BX, Sun YB, Fang W, Li L. Effects of early rehabilitation therapy on patients with mechanical ventilation. World J Emerg Med. 2014;5(1):48‐52. doi: 10.5847/wjem.j.issn.1920-8642.2014.01.008.

[22] Lee CM, Fan E. ICU‐acquired weakness: what is preventing its rehabilitation in critically ill patients? BMC Med. 2012;10:1‐4. doi: 10.1186/1741-7015-10-115.

[23] Burtin C, Clerckx B, Robbeets C, et al. Early exercise in critically ill patients enhances short‐term functional recovery. Crit Care Med. 2009;37(9):2499‐2505. doi: 10.1097/CCM.0b013e3181a38937.

[24] Herridge MS, Tansey CM, Matté A, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364(14):1293‐1304. doi: 10.1056/NEJMoa1011802.

[25] Babazadeh M, Jahani S, Poursangbor T, et al. Perceived barriers to early mobilization of intensive care unit patients by nurses in hospitals affiliated to Jundishapur University of Medical Sciences of Ahvaz in 2019. J Med Life. 2021;14(1):100‐104. doi: 10.25122/jml-2019-0135.

[26] Balas MC, Vasilevskis EE, Burke WJ, et al. Critical care nurses' role in implementing the “ABCDE bundle” into practice. Crit Care Nurs. 2012;32(2):35‐47. doi: 10.4037/ccn2012229.

[27] Kim C, Kim S, Yang J, Choi M. Nurses' perceived barriers and educational needs for early mobilisation of critical ill patients. Aust Crit Care. 2019;32(6):451‐457. doi: 10.1016/j.aucc.2018.11.065.

[28] Chen B, Xie G, Lin Y, et al. A systematic review and meta‐analysis of the effects of early mobilization therapy in patients after cardiac surgery. Medicine. 2021;100(15):e25314. doi: 10.1097/MD.0000000000025314.

[29] Zang K, Chen B, Wang M, et al. The effect of early mobilization in critically ill patients: a meta‐analysis. Nurs Crit Care. 2020;25(6):360‐367. doi: 10.1111/nicc.12455.

[30] Azevedo P, Gomes B, Macedo J, Ferreira S, Pereira J, Pires A. Muscle weakness in critically ill patients: effects of a systematized rehabilitation nursing program. Enfermería Clínica (English Edition). 2023;33(3):216‐222. doi: 10.1016/j.enfcle.2022.11.001.

[31] Adler J, Malone D. Early mobilization in the intensive care unit: a systematic review. Cardiopulm Phys Ther J. 2012;23(1):5‐13. doi: 10.1097/01823246-201223010-00002.

[32] Othman SY, Elbiaa MA, Mansour ER, el‐Menshawy AM, Elsayed SM. Effect of neuromuscular electrical stimulation and early physical activity on ICU‐acquired weakness in mechanically ventilated patients: a randomized controlled trial. Nurs Crit Care. 2024;29(3):584‐596. doi: 10.1111/nicc.13010.

[33] Lai CC, Chou W, Chan KS, et al. Early mobilization reduces duration of mechanical ventilation and intensive care unit stay in patients with acute respiratory failure. Arch Phys Med Rehabil. 2017;98(5):931‐939. doi: 10.1016/j.apmr.2016.11.007.

[34] Sterne JA, Hernán MA, Reeves BC, et al. ROBINS‐I: a tool for assessing risk of bias in non‐randomised studies of interventions. BMJ. 2016;355:i4919. doi: 10.1136/bmj.i4919.

[35] Sterne JA, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. doi: 10.1136/bmj.l4898.

[36] Hodgson CL, Bailey M, Bellomo R, et al. A binational multicenter pilot feasibility randomized controlled trial of early goal‐directed mobilization in the ICU. Crit Care Med. 2016;44(6):1145‐1152. doi: 10.1097/CCM.0000000000001643.

[37] Schaller SJ, Anstey M, Blobner M, et al. Early, goal‐directed mobilisation in the surgical intensive care unit: a randomised controlled trial. Lancet. 2016;388(10052):1377‐1388. doi: 10.1016/S0140-6736(16)31637-3.

[38] McGuinness LA, Higgins JP. Risk‐of‐bias VISualization (robvis): an R package and shiny web app for visualizing risk‐of‐bias assessments. Res Synth Methods. 2021;12(1):55‐61. doi: 10.1002/jrsm.1411.

[39] Bergman L, Chaboyer W. Early mobilization of intensive care unit patients: It's not that simple but can be done. Nurs Crit Care. 2020;25(6):337‐338. doi: 10.1111/nicc.12556.

[40] Bilodeau C, Gallagher F, Tanguay A. Early mobilization of mechanically ventilated patients: nursing practice in Quebec intensive care units. Can J Crit Care Nurs. 2018;29(4):21‐28.

[41] Hoyer EH, Brotman DJ, Chan K, et al. Barriers to early mobility of hospitalized general medicine patients: survey development and results. Am J Phys Med Rehabil. 2015;94(4):304‐312. doi: 10.1097/PHM.0000000000000185.

Downloads

Published

2024-11-30

How to Cite

Alhazmaı, Rabıah Makhtab W, Mariam Sheaf Ashwe Alrowily, Ahod Obeed Alanazi, Alaa Mudhhi S Alshammari, Alruwaili, Reham Muwafiq S, Hammad Alhomidy Raggad Alrawily, … Lubna Salem Alatawi. (2024). Nursing and Physiotherapy Roles in Early Mobilization of Hospitalized Patients. International Journal of Computational and Experimental Science and Engineering, 10(4). https://doi.org/10.22399/ijcesen.4563

Issue

Section

Research Article