Discordant Perceptions of the Risk Versus Benefit of Early Mobility Across ICU Professionals

Purpose: Early mobility and rehabilitation in the intensive care unit (ICU) setting is a well-established component of physical therapist (PT) practice. Despite this, there is variability between institutions and disciplines regarding perceived barriers to early mobility. The purpose of this study was to examine perceptions of the interprofessional team regarding the safety of early mobility in the ICU across disciplines with regard to specific devices and insertion sites. Methods: This survey study used a convenience sample of professionals who staff the ICUs at a level 1 trauma academic medical center. The survey included questions regarding profession, primary ICU of practice, years of experience, level of agreement with statements related to early mobility, and perceived risk-to-benefit ratio of early mobility for specific clinical scenarios. Results: Across items related to ICU interventions and perceived risk-to-benefit ratio, internal consistency was excellent with α = .94. Statistically significant differences were noted between professions for each device and insertion site. Concern for femoral insertion across all devices was apparent in the lower percentage of non-PT respondents perceiving a favorable risk-to-benefit ratio across professions for femoral compared to nonfemoral insertion sites. Conclusions: Despite existing research regarding the safety and benefits of early mobilization and rehabilitation of patients in the ICU, members of the interprofessional team have concerns regarding the risk-to-benefit ratio for various monitoring and interventional devices. This overall unfavorable perceived risk-to-benefit ratio contrasts with team members' reported general support for and participation in early mobilization, and with the routine, daily practice at our institution.