ICU early mobilization: From recommendation to implementation at three medical centers

Critical Care Medicine

Volumn 41, Issue 9 SUPPL.1, 2013, Pages

  Engel, Heidi J ^a   Needham, Dale M ^b   Morris, Peter E ^c   Gropper, Michael A ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c WAKE FOREST SCHOOL OF MEDICINE   (United States)

Author keywords

barriers; critical care; early mobility; early mobilization; ICU acquired weakness; interprofessional; outcomes; physical rehabilitation; quality improvement

Indexed keywords

ARTICLE; CLINICAL PRACTICE; COST CONTROL; CRITICALLY ILL PATIENT; DELIRIUM; HEALTH CARE COST; HEALTH CARE PLANNING; HEALTH CARE QUALITY; HEALTH PROGRAM; HUMAN; INTENSIVE CARE UNIT; LENGTH OF STAY; MOBILIZATION; NURSING; OUTCOME ASSESSMENT; PATIENT EDUCATION; PATIENT MOBILITY; PHYSICIAN; PHYSIOTHERAPY; PRIORITY JOURNAL; RESPIRATORY CARE; SEDATION; TOTAL QUALITY MANAGEMENT; UNIVERSITY HOSPITAL;

ACADEMIC MEDICAL CENTERS; BALTIMORE; EARLY AMBULATION; HUMANS; INTENSIVE CARE; INTENSIVE CARE UNITS; NORTH CAROLINA; PROGRAM DEVELOPMENT; QUALITY IMPROVEMENT; RETROSPECTIVE STUDIES; SAN FRANCISCO;

EID: 84883575336     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0b013e3182a240d5     Document Type: Article

References (90)

1. Joint Commission: Improving Care in the ICU. Oakbrook Terrace Illinois: Joint Commission Resources; 2004
2. van der Schaaf M, Beelen A, Dongelmans DA, et al: Poor functional recovery after a critical illness: A longitudinal study. J Rehabil Med 2009; 41:1041-1048
3. Timmers TK, Verhofstad MH, Moons KG, et al: Long-term quality of life after surgical intensive care admission. Arch Surg 2011; 146:412-418
4. Livingston DH, Tripp T, Biggs C, et al: A fate worse than death? Longterm outcome of trauma patients admitted to the surgical intensive care unit. J Trauma 2009; 67:341-348
5. Herridge MS, Tansey CM, Matté A, et al; Canadian Critical Care Trials Group: Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 2011; 364:1293-1304
6. Morandi A, Jackson JC, Ely EW: Delirium in the intensive care unit. Int Rev Psychiatry 2009; 21:43-58
7. Hopkins RO, Suchyta MR, Farrer TJ, et al: Improving post-intensive care unit neuropsychiatric outcomes: Understanding cognitive effects of physical activity. Am J Respir Crit Care Med 2012; 186:1220-1228
8. Hopkins RO, Jackson JC: Short-and long-term cognitive outcomes in intensive care unit survivors. Clin Chest Med 2009; 30: 143-153
9. Hopkins RO, Jackson JC: Long-term neurocognitive function after critical illness. Chest 2006; 130:869-878
10. Hopkins RO, Jackson JC: Neuroimaging after critical illness: Implications for neurorehabilitation outcome. NeuroRehabilitation 2012; 31:311-318
11. Girard TD, Jackson JC, Pandharipande PP, et al: Delirium as a predictor of long-term cognitive impairment in survivors of critical illness. Crit Care Med 2010; 38:1513-1520
12. Davydow DS, Desai SV, Needham DM, et al: Psychiatric morbidity in survivors of the acute respiratory distress syndrome: A systematic review. Psychosom Med 2008; 70:512-519
13. Ali NA, O'Brien JM Jr, Hoffmann SP, et al; Midwest Critical Care Consortium: Acquired weakness, handgrip strength, and mortality in critically ill patients. Am J Respir Crit Care Med 2008; 178:261-268
14. Stevens RD, Marshall SA, Cornblath DR, et al: A framework for diagnosing and classifying intensive care unit-acquired weakness. Crit Care Med 2009; 37:S299-S308
15. de Jonghe B, Lacherade JC, Sharshar T, et al: Intensive care unitacquired weakness: Risk factors and prevention. Crit Care Med 2009; 37:S309-S315
16. Stevens RD, Dowdy DW, Michaels RK, et al: Neuromuscular dysfunction acquired in critical illness: A systematic review. Intensive Care Med 2007; 33:1876-1891
17. Herridge MS, Cheung AM, Tansey CM, et al; Canadian Critical Care Trials Group: One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 2003; 348:683-693
18. Needham DM, Dinglas VD, Bienvenu OJ, et al; NIH NHLBI ARDS Network: One year outcomes in patients with acute lung injury randomised to initial trophic or full enteral feeding: Prospective follow-up of EDEN randomised trial. BMJ 2013; 346:f1532
19. Allen C, Glasziou P, Del Mar C: Bed rest: A potentially harmful treatment needing more careful evaluation. Lancet 1999; 354:1229-1233
20. Batt J, dos Santos CC, Cameron JI, et al: Intensive care unit-acquired weakness: Clinical phenotypes and molecular mechanisms. Am J Respir Crit Care Med 2013; 187:238-246
21. Puthucheary Z, Rawal J, Ratnayake G, et al: Neuromuscular blockade and skeletal muscle weakness in critically ill patients: Time to rethink the evidence? Am J Respir Crit Care Med 2012; 185:911-917
22. Winkelman C: Bed rest in health and critical illness: A body systems approach. AACN Adv Crit Care 2009; 20:254-266
23. Dowdy DW, Eid MP, Dennison CR, et al: Quality of life after acute respiratory distress syndrome: A meta-analysis. Intensive Care Med 2006; 32:1115-1124
24. Jackson JC, Mitchell N, Hopkins RO: Cognitive functioning, mental health, and quality of life in ICU survivors: An overview. Anesthesiol Clin 2011; 29:751-764
25. Bienvenu OJ, Colantuoni E, Mendez-Tellez PA, et al: Depressive symptoms and impaired physical function after acute lung injury: A 2-year longitudinal study. Am J Respir Crit Care Med 2012; 185:517-524
26. Iwashyna TJ, Ely EW, Smith DM, et al: Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA 2010; 304:1787-1794
27. Needham DM, Davidson J, Cohen H, et al: Improving long-term outcomes after discharge from intensive care unit: Report from a stakeholders' conference. Crit Care Med 2012; 40:502-509
28. Bemis-Dougherty AR, Smith JM: What follows survival of critical illness? Physical therapists' management of patients with post-intensive care syndrome. Phys Ther 2013; 93:179-185
29. Banerjee A, Girard TD, Pandharipande P: The complex interplay between delirium, sedation, and early mobility during critical illness: Applications in the trauma unit. Curr Opin Anaesthesiol 2011; 24:195-201
30. Morandi A, Brummel NE, Ely EW: Sedation, delirium and mechanical ventilation: The 'ABCDE' approach. Curr Opin Crit Care 2011; 17:43-49
31. Barr J, Fraser GL, Puntillo K, et al; American College of Critical Care Medicine: Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med 2013; 41:263-306
32. Iwashyna TJ, Netzer G: The burdens of survivorship: An approach to thinking about long-term outcomes after critical illness. Semin Respir Crit Care Med 2012; 33:327-338
33. Gosselink R, Bott J, Johnson M, et al: Physiotherapy for adult patients with critical illness: Recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients. Intensive Care Med 2008; 34:1188-1199
34. Bailey P, Thomsen GE, Spuhler VJ, et al: Early activity is feasible and safe in respiratory failure patients. Crit Care Med 2007; 35:139-145
35. Morris PE, Goad A, Thompson C, et al: Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med 2008; 36:2238-2243
36. Warburton DE, Nicol CW, Bredin SS: Health benefits of physical activity: The evidence. CMAJ 2006; 174:801-809
37. Courneya KS: Exercise in cancer survivors: An overview of research. Med Sci Sports Exerc 2003; 35:1846-1852
38. Holtermann A, Marott JL, Gyntelberg F, et al: Does the benefit on survival from leisure time physical activity depend on physical activity at work? A prospective cohort study. PLoS One 2013; 8:e54548
39. Mathieu RAt, Powell-Wiley TM, Ayers CR, et al: Physical activity participation, health perceptions, and cardiovascular disease mortality in a multiethnic population: The Dallas Heart Study. Am Heart J 2012; 163:1037-1040
40. Kayambu G, Boots R, Paratz J: Physical therapy for the critically ill in the ICU: A systematic review and meta-analysis. Crit Care Med 2013; 41:1543-1554
41. Adler J, Malone D: Early mobilization in the intensive care unit: A systematic review. Cardiopulm Phys Ther J 2012; 23:5-13
42. Mendez-Tellez PA, Needham DM: Early physical rehabilitation in the ICU and ventilator liberation. Respir Care 2012; 57:1663-1669
43. Titsworth WL, Hester J, Correia T, et al: The effect of increased mobility on morbidity in the neurointensive care unit. J Neurosurg 2012; 116:1379-1388
44. Zomorodi M, Topley D, McAnaw M: Developing a mobility protocol for early mobilization of patients in a surgical/trauma ICU. Crit Care Res Pract 2012; 2012:964547
45. Choi J, Tasota FJ, Hoffman LA: Mobility interventions to improve outcomes in patients undergoing prolonged mechanical ventilation: A review of the literature. Biol Res Nurs 2008; 10:21-33
46. Lipshutz AK, Gropper MA: Acquired neuromuscular weakness and early mobilization in the intensive care unit. Anesthesiology 2013; 118:202-215
47. 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; 28:307-318
48. Schweickert WD, Pohlman MC, Pohlman AS, et al: Early physical and occupational therapy in mechanically ventilated, critically ill patients: A randomised controlled trial. Lancet 2009; 373:1874-1882
49. Hopkins RO, Spuhler VJ, Thomsen GE: Transforming ICU culture to facilitate early mobility. Crit Care Clin 2007; 23:81-96
50. Pawlik AJ, Kress JP: Issues affecting the delivery of physical therapy services for individuals with critical illness. Phys Ther 2013; 93:256-265
51. Fan E: What is stopping us from early mobility in the intensive care unit? Crit Care Med 2010; 38:2254-2255
52. Burtin C, Clerckx B, Robbeets C, et al: Early exercise in critically ill patients enhances short-term functional recovery. Crit Care Med 2009; 37:2499-2505
53. Clark DE, Lowman JD, Griffin RL, et al: Effectiveness of an early mobilization protocol in a trauma and burns intensive care unit: A retrospective cohort study. Phys Ther 2013; 93:186-196
54. Engel HJ, Tatebe S, Alonzo PB, et al: A Physical Therapist-Established Intensive Care Unit Early Mobilization Program: A quality improvement project for critical care at the University of California San Francisco Medical Center. Phys Ther 2013; 93:975-985
55. Needham DM, Korupolu R, Zanni JM, et al: Early physical medicine and rehabilitation for patients with acute respiratory failure: A quality improvement project. Arch Phys Med Rehabil 2010; 91:536-542
56. Lipshutz AK, Fee C, Schell H, et al: Strategies for success: A PDSA analysis of three QI initiatives in critical care. Jt Comm J Qual Patient Saf 2008; 34:435-444
57. Nembhard IM: Learning and improving in quality improvement collaboratives: Which collaborative features do participants value most? Health Serv Res 2009; 44:359-378
58. Institute for Healthcare Improvement: Plan-do-study-act worksheet. Available at: http://www.ihi.org/knowledge/Pages/Tools/PlanDoStudyActWorksheet. aspx. Accessed July 18, 2013
59. Norrenberg M, Vincent JL: A profile of European intensive care unit physiotherapists. European Society of Intensive Care Medicine. Intensive Care Med 2000; 26:988-994
60. Ely EW, Baker AM, Dunagan DP, et al: Effect on the duration of mechanical ventilation of identifying patients capable of breathing spontaneously. N Engl J Med 1996; 335:1864-1869
61. Kress JP, Pohlman AS, O'Connor MF, et al: Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 2000; 342:1471-1477
62. Needham DM, Wang W, Desai SV, et al: Intensive care unit exposures for long-term outcomes research: Development and description of exposures for 150 patients with acute lung injury. J Crit Care 2007; 22:275-284
63. Zanni JM, Korupolu R, Fan E, et al: Rehabilitation therapy and outcomes in acute respiratory failure: An observational pilot project. J Crit Care 2010; 25:254-262
64. Pronovost PJ, Berenholtz SM, Needham DM: Translating evidence into practice: A model for large scale knowledge translation. BMJ 2008; 337:a1714
65. Lord RK, Mayhew CR, Korupolu R, et al: ICU early physical rehabilitation programs: Financial modeling of cost savings. Crit Care Med 2013; 41:717-724
66. Needham DM, Korupolu R: Rehabilitation quality improvement in an intensive care unit setting: Implementation of a quality improvement model. Top Stroke Rehabil 2010; 17:271-281
67. Institute for Healthcare Improvement: Science of improvement: Establishing measures. Available at: http://www.ihi.org/knowleged/Pages/ HowtoImprove/ScienceofImprovementEstablishingMeasures. aspx. Accessed July 18, 2013
68. Goldhill DR, Badacsonyi A, Goldhill AA, et al: A prospective observational study of ICU patient position and frequency of turning. Anaesthesia 2008; 63:509-515
69. Weinert CR, Calvin AD: Epidemiology of sedation and sedation adequacy for mechanically ventilated patients in a medical and surgical intensive care unit. Crit Care Med 2007; 35:393-401
70. Stiller K: Safety issues that should be considered when mobilizing critically ill patients. Crit Care Clin 2007; 23:35-53
71. Brook AD, Ahrens TS, Schaiff R, et al: Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation. Crit Care Med 1999; 27:2609-2615
72. Treggiari MM, Romand JA, Yanez ND, et al: Randomized trial of light versus deep sedation on mental health after critical illness. Crit Care Med 2009; 37:2527-2534
73. Needham DM, Chandolu S, Zanni J: Interruption of sedation for early rehabilitation improves outcomes in ventilated, critically ill adults. Aust J Physiother 2009; 55:210
74. Needham DM: Mobilizing patients in the intensive care unit: Improving neuromuscular weakness and physical function. JAMA 2008; 300:1685-1690
75. Morris PE, Griffin L, Berry M, et al: Receiving early mobility during an intensive care unit admission is a predictor of improved outcomes in acute respiratory failure. Am J Med Sci 2011; 341:373-377
76. Needham DM, Feldman DR, Kho ME: The functional costs of ICU survivorship. Collaborating to improve post-ICU disability. Am J Respir Crit Care Med 2011; 183:962-964
77. Needham DM, Kamdar BB, Stevenson JE: Rehabilitation of mind and body after intensive care unit discharge: A step closer to recovery. Crit Care Med 2012; 40:1340-1341
78. Johns Hopkins Critical Care Rehabilitation Conference: Understanding and Improving ICU Patient Outcomes. Available at: http://www. hopkinscme.edu/ CourseDetail.aspx/80032299. Accessed July 18, 2013
79. Kho ME, Damluji A, Zanni JM, et al: Feasibility and observed safety of interactive video games for physical rehabilitation in the intensive care unit: A case series. J Crit Care 2012; 27:219.e1-219.e6
80. Needham DM, Truong AD, Fan E: Technology to enhance physical rehabilitation of critically ill patients. Crit Care Med 2009; 37:S436-S441
81. Hager DN, Dinglas VD, Subhas S, et al: Reducing deep sedation and delirium in acute lung injury patients: A quality improvement project. Crit Care Med 2013; 41:1435-1442
82. Kamdar BB, King LM, Collop NA, et al: The effect of a quality improvement intervention on perceived sleep quality and cognition in a medical ICU. Crit Care Med 2013; 41:800-809
83. Jones C: Surviving the intensive care: Residual physical, cognitive, and emotional dysfunction. Thorac Surg Clin 2012; 22:509-516
84. Nordon-Craft A, Moss M, Quan D, et al: Intensive care unit-acquired weakness: Implications for physical therapist management. Phys Ther 2012; 92:1494-1506
85. Bienvenu OJ, Gellar J, Althouse BM, et al: Post-traumatic stress disorder symptoms after acute lung injury: A 2-year prospective longitudinal study. Psychol Med 2013:1-15
86. Müller M, Strobl R, Grill E: Goals of patients with rehabilitation needs in acute hospitals: Goal achivement is an indicator for improved functioning. J Rehabil Med 2011; 43:145-150
87. Misak CJ: ICU-acquired weakness: Obstacles and interventions for rehabilitation. Am J Respir Crit Care Med 2011; 183:845-846
88. Iwashyna TJ: Trajectories of recovery and dysfunction after acute illness, with implications for clinical trial design. Am J Respir Crit Care Med 2012; 186:302-304
89. Hopkins RO, Spuhler VJ: Strategies for promoting early activity in critically ill mechanically ventilated patients. AACN Adv Crit Care 2009; 20:277-289
90. Ohtake PJ, Strasser DC, Needham DM: Translating research into clinical practice: The role of quality improvement in providing rehabilitation for people with critical illness. Phys Ther 2013; 93:128-133