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ICU Early Mobilization and Patients’ Recovery

ICU Early Mobilization and Patients’ Recovery

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Recent technological advancement has brought significant changes in the field of medical care. Critical conditions that were considered hopeless at some time in medical care can now be dealt with an almost near certainty. Severely injured or ill patients transferred to a mechanically ventilated care now have between 80 to 90 percent chances of recovery in the United States (Engel, 2013). It should, however, be noted that most these patients never quite recover to full health months or years after recovery and discharge from health facilities. A majority of these survivors have been diagnosed with critical cognitive, physical and psychological disabling including delirium despite their great recovery in the ICU. Some experts in the field of palliative care associate the great improvements in patients in the intensive care units to present technology and care that encourages activity and frequent mobility of patients, unlike the traditional bed rests usually accompanied by heavy sedation (Pandullo, 2015). This paper seeks to determine the relationship between early mobilization of patients in the ICU and their level of recovery.

According to Pandullo et al. (2015), several studies have been performed to establish the consequences immobility in critically ill patients and have determined the harmful effects of bed rest and inactivity. He also moves ahead to prove the reduced activity in patients discharged from mechanically ventilated care to the general in-patient care and how this affects their recovery process after the ICU. To illustrate this theory, Pandullo conducted a retrospective study in a tertiary level hospital with 24 ICU beds. The study involved selected patients of age 18 and above who had stayed in the ICU for over 48 hours and had been discharged directly to in-patient floor. Chart reviews on the patient’s medical records by a team of specialized health practitioners were conducted for data extraction. Different statistical tests were then performed on the data to determine test variables characteristics, association, and volatility using IBM statistical programming language for social sciences.

In a separate but similar study by Engel et al. (2013), to compare the different process used in three different hospitals to facilitate early mobilization in ICUs and their impacts on the clinical outcomes of in critically ill patients. Again, Engel mentions that unlike historical practices whereby critically ill patients were tethered to life-sustaining machinery and were not considered appropriate for early physical mobility since they deemed medically unstable, today’s studies nullifies these baseless assumptions. He suggests that early mobility in ICU patients is as safe as it is beneficial in preventing long-term neurocognitive as well as physical disabilities. To facilitate his studies, Engel et al. reviewed three independent hospital based studies at Wake Forest Hospital, John Hopkins Hospital and University of California San Francisco studies to determine the befits of early mobilization ICU patients. The three hospitals are described to have used almost the same method in collecting data, save for a few disparities such length of ICU admission, criteria for eligibility. A diverse team of professionals have selected emphases of occupational and physical therapists. Critically ill patients were then taken through alternating medical treatments and physiotherapy sessions. Data on patients’ recovery and facilities financial expenditure were collected and analyzed.

I82 patients were found eligible for the study as per Pandullo (2015), and their median age was determined as 65 years out of which 54% were male. Out of the total number of patients involved in the study, 45% were discharged and went home while 13% died or were released to hospice care. The results of this investigation indicated that younger patients were the most mobile during their time in ICU and had the least length of stay in the hospital after being transferred to the inpatients’ floor. Patients whose mobility as only confined to bed level stayed for a much longer stay on chair and ambulation long after discharge to inpatient care. In a similar manner, Engel et al. (2013) found out that the three hospitals recorded significant net savings from early mobility programs despite the increased cost of hiring a new team of mobility specialists. This reduction in cost was attributed to the reduced length of stay in the inpatient care units due to fast recovery brought about by these new programs.

Studies on this subject so far are all in agreement that early mobility and physical therapies for patients in mechanically ventilated units help tremendously in facilitating recovery. Nurses as one of the many practitioners concerned with recuperation of patients and, in fact, spends most of their working hours in patient care, should appreciate the health benefits of maintaining an active lifestyle for their patients. These physical activities should, however, be moderated and closely monitored to avoid burnouts and fatigues that may worsen patients’ health conditions.

Reference

Engel, H. J., Needham, D. M., Morris, P. E., & Gropper, M. A. (2013). ICU early mobilization: from recommendation to implementation at three medical centers. Critical care medicine, 41(9), S69-S80. Pandullo, S. M., Spilman, S. K., Smith, J. A., Kingery, L. K., Pille, S. M., Rondinelli, R. D., &Sahr, S. M. (2015). The time for critically ill patients to regain mobility after early ICU mobilization and transition to a general inpatient floor.Journal of critical care.


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