Defining new barriers to mobilisation in a highly active intensive care unit – have we found the ceiling? An observational study.

Christopher Brock, Vince Marzano, Margot GREEN, Jiali Wang, Teresa Neeman, Imogen Mitchell, Bernie BISSETT

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Mobilisation of intensive care (ICU) patients attenuates ICU-acquired weakness, but the prevalence
is low (12–54%). Better understanding of barriers and enablers may inform practice.
Objectives: To identify barriers to mobilisation and factors associated with successful mobilisation in our
medical /surgical /trauma ICU where mobilisation is well-established.
Methods: 4-week prospective study of frequency and intensity of mobilisation, clinical factors and barriers
(extracted from electronic database). Generalized linear mixed models were used to describe
associations between demographics, clinical factors and successful mobilisation.
Results: 202 patients accounted for 742 patient days. Patients mobilised on 51% of patient days. Most
frequent barriers were drowsiness (18%), haemodynamic/respiratory contraindications (17%), and medical
orders (14%). Predictors of successful mobilisation included high Glasgow Coma Score (OR = 1.44,
95%CI=[1.29–1.60]), and male sex (OR = 2.29, 95%CI=[1.40–3.75]) but not age (OR = 1.05, 95%CI=[1.01–1.08]).
Conclusions: Our major barriers (drowsiness, haemodynamic/respiratory contraindications) may be unavoidable,
indicating an upper limit of feasible mobilisation therapy in ICU.
Original languageEnglish
Pages (from-to)380-385
Number of pages6
JournalHeart and Lung: Journal of Acute and Critical Care
Volume47
Issue number4
DOIs
Publication statusPublished - 1 Jul 2018

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Observational Studies
Intensive Care Units
Sleep Stages
Hemodynamics
Critical Care
Coma
Linear Models
Demography
Databases
Prospective Studies
Wounds and Injuries
Therapeutics

Cite this

Brock, Christopher ; Marzano, Vince ; GREEN, Margot ; Wang, Jiali ; Neeman, Teresa ; Mitchell, Imogen ; BISSETT, Bernie. / Defining new barriers to mobilisation in a highly active intensive care unit – have we found the ceiling? An observational study. In: Heart and Lung: Journal of Acute and Critical Care. 2018 ; Vol. 47, No. 4. pp. 380-385.
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title = "Defining new barriers to mobilisation in a highly active intensive care unit – have we found the ceiling? An observational study.",
abstract = "Background: Mobilisation of intensive care (ICU) patients attenuates ICU-acquired weakness, but the prevalenceis low (12–54{\%}). Better understanding of barriers and enablers may inform practice.Objectives: To identify barriers to mobilisation and factors associated with successful mobilisation in ourmedical /surgical /trauma ICU where mobilisation is well-established.Methods: 4-week prospective study of frequency and intensity of mobilisation, clinical factors and barriers(extracted from electronic database). Generalized linear mixed models were used to describeassociations between demographics, clinical factors and successful mobilisation.Results: 202 patients accounted for 742 patient days. Patients mobilised on 51{\%} of patient days. Mostfrequent barriers were drowsiness (18{\%}), haemodynamic/respiratory contraindications (17{\%}), and medicalorders (14{\%}). Predictors of successful mobilisation included high Glasgow Coma Score (OR = 1.44,95{\%}CI=[1.29–1.60]), and male sex (OR = 2.29, 95{\%}CI=[1.40–3.75]) but not age (OR = 1.05, 95{\%}CI=[1.01–1.08]).Conclusions: Our major barriers (drowsiness, haemodynamic/respiratory contraindications) may be unavoidable,indicating an upper limit of feasible mobilisation therapy in ICU.",
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Defining new barriers to mobilisation in a highly active intensive care unit – have we found the ceiling? An observational study. / Brock, Christopher; Marzano, Vince; GREEN, Margot; Wang, Jiali; Neeman, Teresa; Mitchell, Imogen; BISSETT, Bernie.

In: Heart and Lung: Journal of Acute and Critical Care, Vol. 47, No. 4, 01.07.2018, p. 380-385.

Research output: Contribution to journalArticle

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T1 - Defining new barriers to mobilisation in a highly active intensive care unit – have we found the ceiling? An observational study.

AU - Brock, Christopher

AU - Marzano, Vince

AU - GREEN, Margot

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AU - Mitchell, Imogen

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N2 - Background: Mobilisation of intensive care (ICU) patients attenuates ICU-acquired weakness, but the prevalenceis low (12–54%). Better understanding of barriers and enablers may inform practice.Objectives: To identify barriers to mobilisation and factors associated with successful mobilisation in ourmedical /surgical /trauma ICU where mobilisation is well-established.Methods: 4-week prospective study of frequency and intensity of mobilisation, clinical factors and barriers(extracted from electronic database). Generalized linear mixed models were used to describeassociations between demographics, clinical factors and successful mobilisation.Results: 202 patients accounted for 742 patient days. Patients mobilised on 51% of patient days. Mostfrequent barriers were drowsiness (18%), haemodynamic/respiratory contraindications (17%), and medicalorders (14%). Predictors of successful mobilisation included high Glasgow Coma Score (OR = 1.44,95%CI=[1.29–1.60]), and male sex (OR = 2.29, 95%CI=[1.40–3.75]) but not age (OR = 1.05, 95%CI=[1.01–1.08]).Conclusions: Our major barriers (drowsiness, haemodynamic/respiratory contraindications) may be unavoidable,indicating an upper limit of feasible mobilisation therapy in ICU.

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