The proposed solution for this evidence-based project is the development of a nurse-driven mobility protocol for patients in the intensive care unit (ICU). This solution has evolved through further research and assignments, considering the risks associated with bedrest in the ICU and the benefits of mobilization for patients.
Bedrest in the ICU can lead to complications such as deep vein thrombosis (DVT), decreased cardiac output, and pressure ulcers. Numerous studies have shown that mobilization of ICU patients is safe and results in multiple benefits. Therefore, implementing a mobility protocol that includes an assessment of mobility criteria, utilizing the existing Bed Mobility Assessment Tool (BMAT), and allowing nurses to order physical therapy can increase the number of patients participating in mobilization.
The assessment of mobility criteria would occur immediately after a patient is admitted to the ICU, with the goal of initiating mobilization within 72 hours. This is important because deconditioning often occurs after 72 hours of bedrest. The assessment would include factors such as vitals and medications that may prevent the patient from participating in therapy. By utilizing the BMAT, nurses can also assess the patient’s current mobility level. Based on these assessments, the nurse may initiate mobilization activities with the patient or order physical therapy for further evaluation.
Initially, the implementation of early mobility may have seemed uncertain. However, advanced research has revealed protocols that have been successful in other ICUs. Many of these protocols rely solely on physical therapists, but this is not necessary for all patients. If a nurse assesses a patient and determines that they are safe to participate in mobility exercises, the nurse should be able to assist in the process. For more critical patients, such as those who are intubated, involving a physical therapist in the mobility plan is crucial.
Through evaluating the patient population in Banner Estrella’s ICU and conducting extensive research, the current ideas on early mobility of ICU patients have been developed. By implementing a nurse-driven mobility protocol and utilizing the BMAT for assessment, more patients can be mobilized, potentially reducing the risks associated with bedrest and improving patient outcomes.
In summary, the proposed solution for this evidence-based project is the implementation of a nurse-driven mobility protocol for ICU patients. This protocol includes an assessment of mobility criteria, utilizing the BMAT, and allowing nurses to order physical therapy. Through advanced research and consideration of the risks and benefits of bedrest and mobilization, this solution aims to increase the number of patients participating in mobilization and ultimately improve patient outcomes in the ICU.