HOW EARLY IS TOO EARLY
BARRIERS, ENABLERS AND OUTCOMES
Abstract
Background
Advances in critical care have led to increased survival but there is growing evidence of significant and long-lasting physical and psychological dysfunction in survivors. Preventing the physical consequences of critical illness and supporting recovery through rehabilitation strategies has therefore been identified as a high priority area. Research within the adult Intensive Care Unit (ICU) setting indicates early mobilisation (EM) is safe, feasible and can result in reduced length of ICU and hospital stay and a reduction in long-term neuromuscular dysfunction.
Objectives
To determine barriers, facilitators and outcomes of EM within the PICU setting.
Methods
Review of published paediatric literature surrounding EM.
Results
A number of studies report barriers to implementing and conducting EM. These reflect issues at the patient, provider and institutional level. Facilitators consequently reflect strategies to implement local EM guidelines, promote training and education for the entire multi-disciplinary workforce, the development of a mobility culture as well as ensuring adequacy of staff and equipment resources to ensure EM delivery. Currently there is a lack of evidence concerning EM outcomes in PICU.
Conclusion
Further research is required to determine the optimum timing of ‘early’ mobilisation and intervention dose, the timing of therapy cessation and measurement of enduring effects. Restoration and the promotion of recovery go beyond purely physical and functional outcomes. Studies must also consider outcomes related to cognitive, social and emotional capabilities and participation in daily life if the true value of EM is to be determined.
EUROPE WIDE NURSING PRACTICES
Presentation files
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Early rehab - nursing roles 19.06.2019 14:53
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Early rehab - nursing roles_def 20.06.2019 10:01
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Early rehab - nursing roles_def1 20.06.2019 16:24
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Early rehab - nursing roles_def2 20.06.2019 19:27