Team: A Prospective Multi-Centre Cohort Study Of Early Activity And Mobilisation In Icu

Carol Lynette Hodgson, Sue Berney, Rinaldo Bellomo, Linda Denehy, Megan Harrold, Alisa Higgins, Jeffrey J Presneill, Manoj K Saxena, Elizabeth Skinner, Heidi Buhr, P Young, Stephen Webb

Research output: Contribution to journalLetterOther

Abstract

The extent to which patients are mobilised by physiotherapists in ANZ (Australia and New Zealand) ICU?s is not yet known. Aims: The overall purpose of the study is to gather data to inform the design of a pilot RCT of early mobility in ventilated ICU patients. Specifically we aim to: 1. Describe current mobility practice, including the incidence, duration and intensity of mobilisation in mechanically ventilated patients 2. Identify patient, site, and treatment related factors that are associated with successful mobilisation in mechanically ventilated patients. Methods: This was a prospective, observational, inception cohort study. The study was conducted in 13 ICUs in Australia and New Zealand and is currently recruiting 200 patients, with a maximum of 25 patients being recruited from any one site. Participants were eligible for inclusion if they are admitted to an ICU, invasively ventilated, and are expected to still require treatment in an ICU in two days? time. Patients were studied daily from time of enrolment until day 14 and at the time of ICU discharge. Mobilisation was measured using a purpose designed scale and scored from 1 (in bed) to 12 (walking). Barriers to mobility were recorded. Results: 40 patients on mechanical ventilation were enrolled into the study. On day one the highest level of activity according to the TEAM mobility scale was lying in bed (score 1, 100 ). Most patients (95 ) were not mobilised within the first 72 hours of mechanical ventilation. Patients receiving mechanical ventilation were rarely mobilised out of bed (95 ). In 95 of participant?s the main barrier to early mobilisation was sedation. Other barriers included cardiac instability and written rest in bed orders. Patients who were mobilised out of bed after 72 hours (20 ) were mobilised by both a physiotherapist and a nurse, although mobilization practice (time, equipment and staff) varied between sites. Conclusion: Although physiotherapists are commonly employed to work in intensive care units in Australia and New Zealand, early mobilisation practice differs between intensive care units. Most patients are not mobilised out of bed while receiving mechanical ventilation. The main barrier to mobilisation was sedation.
Original languageEnglish
Pages (from-to)3625 - 3625
Number of pages1
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume187
Publication statusPublished - 2013

Cite this

@article{200feb0fc7854375bbe90b29bb118e53,
title = "Team: A Prospective Multi-Centre Cohort Study Of Early Activity And Mobilisation In Icu",
abstract = "The extent to which patients are mobilised by physiotherapists in ANZ (Australia and New Zealand) ICU?s is not yet known. Aims: The overall purpose of the study is to gather data to inform the design of a pilot RCT of early mobility in ventilated ICU patients. Specifically we aim to: 1. Describe current mobility practice, including the incidence, duration and intensity of mobilisation in mechanically ventilated patients 2. Identify patient, site, and treatment related factors that are associated with successful mobilisation in mechanically ventilated patients. Methods: This was a prospective, observational, inception cohort study. The study was conducted in 13 ICUs in Australia and New Zealand and is currently recruiting 200 patients, with a maximum of 25 patients being recruited from any one site. Participants were eligible for inclusion if they are admitted to an ICU, invasively ventilated, and are expected to still require treatment in an ICU in two days? time. Patients were studied daily from time of enrolment until day 14 and at the time of ICU discharge. Mobilisation was measured using a purpose designed scale and scored from 1 (in bed) to 12 (walking). Barriers to mobility were recorded. Results: 40 patients on mechanical ventilation were enrolled into the study. On day one the highest level of activity according to the TEAM mobility scale was lying in bed (score 1, 100 ). Most patients (95 ) were not mobilised within the first 72 hours of mechanical ventilation. Patients receiving mechanical ventilation were rarely mobilised out of bed (95 ). In 95 of participant?s the main barrier to early mobilisation was sedation. Other barriers included cardiac instability and written rest in bed orders. Patients who were mobilised out of bed after 72 hours (20 ) were mobilised by both a physiotherapist and a nurse, although mobilization practice (time, equipment and staff) varied between sites. Conclusion: Although physiotherapists are commonly employed to work in intensive care units in Australia and New Zealand, early mobilisation practice differs between intensive care units. Most patients are not mobilised out of bed while receiving mechanical ventilation. The main barrier to mobilisation was sedation.",
author = "Hodgson, {Carol Lynette} and Sue Berney and Rinaldo Bellomo and Linda Denehy and Megan Harrold and Alisa Higgins and Presneill, {Jeffrey J} and Saxena, {Manoj K} and Elizabeth Skinner and Heidi Buhr and P Young and Stephen Webb",
year = "2013",
language = "English",
volume = "187",
pages = "3625 -- 3625",
journal = "American Journal of Respiratory and Critical Care Medicine",
issn = "1073-449X",
publisher = "American Thoracic Society",

}

Team: A Prospective Multi-Centre Cohort Study Of Early Activity And Mobilisation In Icu. / Hodgson, Carol Lynette; Berney, Sue; Bellomo, Rinaldo; Denehy, Linda; Harrold, Megan; Higgins, Alisa; Presneill, Jeffrey J; Saxena, Manoj K; Skinner, Elizabeth; Buhr, Heidi; Young, P; Webb, Stephen.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 187, 2013, p. 3625 - 3625.

Research output: Contribution to journalLetterOther

TY - JOUR

T1 - Team: A Prospective Multi-Centre Cohort Study Of Early Activity And Mobilisation In Icu

AU - Hodgson, Carol Lynette

AU - Berney, Sue

AU - Bellomo, Rinaldo

AU - Denehy, Linda

AU - Harrold, Megan

AU - Higgins, Alisa

AU - Presneill, Jeffrey J

AU - Saxena, Manoj K

AU - Skinner, Elizabeth

AU - Buhr, Heidi

AU - Young, P

AU - Webb, Stephen

PY - 2013

Y1 - 2013

N2 - The extent to which patients are mobilised by physiotherapists in ANZ (Australia and New Zealand) ICU?s is not yet known. Aims: The overall purpose of the study is to gather data to inform the design of a pilot RCT of early mobility in ventilated ICU patients. Specifically we aim to: 1. Describe current mobility practice, including the incidence, duration and intensity of mobilisation in mechanically ventilated patients 2. Identify patient, site, and treatment related factors that are associated with successful mobilisation in mechanically ventilated patients. Methods: This was a prospective, observational, inception cohort study. The study was conducted in 13 ICUs in Australia and New Zealand and is currently recruiting 200 patients, with a maximum of 25 patients being recruited from any one site. Participants were eligible for inclusion if they are admitted to an ICU, invasively ventilated, and are expected to still require treatment in an ICU in two days? time. Patients were studied daily from time of enrolment until day 14 and at the time of ICU discharge. Mobilisation was measured using a purpose designed scale and scored from 1 (in bed) to 12 (walking). Barriers to mobility were recorded. Results: 40 patients on mechanical ventilation were enrolled into the study. On day one the highest level of activity according to the TEAM mobility scale was lying in bed (score 1, 100 ). Most patients (95 ) were not mobilised within the first 72 hours of mechanical ventilation. Patients receiving mechanical ventilation were rarely mobilised out of bed (95 ). In 95 of participant?s the main barrier to early mobilisation was sedation. Other barriers included cardiac instability and written rest in bed orders. Patients who were mobilised out of bed after 72 hours (20 ) were mobilised by both a physiotherapist and a nurse, although mobilization practice (time, equipment and staff) varied between sites. Conclusion: Although physiotherapists are commonly employed to work in intensive care units in Australia and New Zealand, early mobilisation practice differs between intensive care units. Most patients are not mobilised out of bed while receiving mechanical ventilation. The main barrier to mobilisation was sedation.

AB - The extent to which patients are mobilised by physiotherapists in ANZ (Australia and New Zealand) ICU?s is not yet known. Aims: The overall purpose of the study is to gather data to inform the design of a pilot RCT of early mobility in ventilated ICU patients. Specifically we aim to: 1. Describe current mobility practice, including the incidence, duration and intensity of mobilisation in mechanically ventilated patients 2. Identify patient, site, and treatment related factors that are associated with successful mobilisation in mechanically ventilated patients. Methods: This was a prospective, observational, inception cohort study. The study was conducted in 13 ICUs in Australia and New Zealand and is currently recruiting 200 patients, with a maximum of 25 patients being recruited from any one site. Participants were eligible for inclusion if they are admitted to an ICU, invasively ventilated, and are expected to still require treatment in an ICU in two days? time. Patients were studied daily from time of enrolment until day 14 and at the time of ICU discharge. Mobilisation was measured using a purpose designed scale and scored from 1 (in bed) to 12 (walking). Barriers to mobility were recorded. Results: 40 patients on mechanical ventilation were enrolled into the study. On day one the highest level of activity according to the TEAM mobility scale was lying in bed (score 1, 100 ). Most patients (95 ) were not mobilised within the first 72 hours of mechanical ventilation. Patients receiving mechanical ventilation were rarely mobilised out of bed (95 ). In 95 of participant?s the main barrier to early mobilisation was sedation. Other barriers included cardiac instability and written rest in bed orders. Patients who were mobilised out of bed after 72 hours (20 ) were mobilised by both a physiotherapist and a nurse, although mobilization practice (time, equipment and staff) varied between sites. Conclusion: Although physiotherapists are commonly employed to work in intensive care units in Australia and New Zealand, early mobilisation practice differs between intensive care units. Most patients are not mobilised out of bed while receiving mechanical ventilation. The main barrier to mobilisation was sedation.

UR - http://www.atsjournals.org/doi/pdf/10.1164/ajrccm-conference.2013.187.1_MeetingAbstracts.A3625

M3 - Letter

VL - 187

SP - 3625

EP - 3625

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

SN - 1073-449X

ER -