NURSE EARLY MOBILIZATION INTERVENTIONS IN CRITICALLY ILL ADULTS: IMPACT ON ICU-ACQUIRED WEAKNESS, MECHANICAL VENTILATION DURATION, AND PATIENT FUNCTIONAL RECOVERY

Abstract Background: Intensive care unit (ICU)-acquired weakness is a frequent complication among critically ill patients, contributing to prolonged mechanical ventilation, extended ICU stay, and poor functional outcomes. Early mobilization, supported by nursing care, is proposed as an effective strategy to prevent muscle atrophy and improve recovery. We aimed to evaluate the effects of nurse-related early mobilization interventions on ICU-acquired weakness, mechanical ventilation duration, length of ICU stays, and patient functional recovery. Methods: A systematic review was conducted using randomized controlled trials, cohort studies, and systematic reviews published between 2016 and 2024. Eligible studies included adult ICU patients (≥18 years) receiving early mobilization interventions with documented nursing involvement. Databases searched included PubMed, CINAHL, Embase, Web of Science, and Cochrane Library. Methodological quality was assessed using appropriate appraisal tools. Results: Twenty studies met the inclusion criteria, encompassing a total of 7,652 patients. Interventions varied from progressive mobility protocols and neuromuscular electrical stimulation to interdisciplinary early mobility programs. Across studies, early mobilization was associated with significant reductions in ICU-acquired weakness incidence (0–40% vs. up to 100% in controls), shorter mechanical ventilation duration (mean difference range: −2.5 to −9 days), and decreased ICU length of stay (mean difference range: −2 to −5 days). Functional recovery, diaphragm function, and mobility scores improved significantly in intervention groups. Complication rates were low (<1%), and interventions were deemed feasible and safe across diverse ICU settings. Conclusions: Nurse-related early mobilization interventions are effective and safe in reducing ICU-acquired weakness, shortening mechanical ventilation duration, and improving patient functional outcomes. Implementation of standardized protocols with strong nursing involvement is recommended to enhance recovery in critically ill adults.