A Proposed Instrument to Determine Mobility Eligibility Criteria and Levels for Mechanically Ventilated Patients in the Intensive Care Unit

Immobility is a problem among mechanically ventilated patients in the intensive care unit. Early mobility has been shown to benefit mechanically ventilated patient outcomes by minimizing hospital stays and costs, decreasing the risk of infection, and improving muscle strength to lead to a better quality of life. No inclusive checklists exist to evaluate patients progressing to varying levels of mobility based on specific criteria such as hemodynamics, neurological function, and disease acuity. This gap was identified after a current and comprehensive literature review on early mobilization among mechanically ventilated patients. The purpose of this project was to combine a comprehensive literature review and an assessment of practicing nurses’ knowledge, attitudes, and beliefs to develop recommendations for a draft instrument that critical care registered nurses could utilize to assess, coordinate, and increase early mobility among mechanically ventilated patients in the intensive care unit setting at the University of Pittsburgh Medical Center Susquehanna Williamsport. This project aimed to answer the following research question Q1 How can a comprehensive review of the literature combined with feedback from clinical experts be used to create a standardized draft instrument designed for use by Registered Nurses to assess and initiate early mobility among mechanically ventilated patients in the intensive care unit setting? This project used a descriptive, quality improvement design and the Iowa model as a theoretical framework. The Patient Mobilization Attitudes and Beliefs Survey for the Intensive Care Unit helped obtain provider feedback. This feedback was analyzed and a lack of resources, time, and education were found to be notable barriers to mobility. An instrument was drafted using the information from the literature review and survey responses for an all-inclusive list of criteria, levels of mobility, and a tolerance assessment. The instrument is intended to be tested in a pilot study after this project phase.