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Four Misconceptions About Early Mobility Programs — And How Nurses Can Help Overcome Them

Overcoming Misconceptions About Early Mobility Programs

As an ICU nurse, you are often the first to notice changes in your patient’s condition. You’ve seen how immobilized patients can weaken — and you’re probably familiar with the research on the importance of early mobility in patient recovery.

Although early mobility may benefit the patient, its implementation isn’t always intuitive. Patients may be tired or unwilling. You may worry about their safety or comfort, that they are too sick or not ready. Or you may have concerns about the logistics of getting patients up and moving with all their equipment.

Common misconceptions about early mobility programs abound. Fortunately, the ICU community has overcome many of these through experience and research. Here’s how you too can overcome these limiting ideas.

1. My patient is too sick

Even a sick patient may benefit from movement instead of bedrest. This may seem counterintuitive in an ICU. Mechanically ventilated patients in particular seem unlikely candidates for movement, as mobilization might cause them additional respiratory stress. But research indicates it may actually help with patient recovery.

What you can do in your ICU:

  • Understand the positives. Early mobility may yield a variety of patient benefits, such as reducing rates of ventilator-associated pneumonia and helping patients wean off the ventilator earlier.1 Learn more about the potentially adverse effects of immobility and how to present the evidence to advocate for early mobility in your ICU.
  • Help patients breathe easy. Patients may experience respiratory stress or agitation triggered by a variety of sources, including technology ill suited to their needs.2 Learn about the sources of agitation and explore ventilation technologies that might help patients breathe more naturally.

2. My patient isn’t ready

When patients are tired, in pain, or simply unwilling, you may want to wait until they are further healed before mobilizing. However, when it comes to mobility, sooner may be better. It takes only four to seven days for ICU-acquired weakness to appear. And its effects can persist months to years after hospitalization. No medical therapy exists to treat it,3 but early mobility exercises may help ward off some of the effects.4*

What you can do in your ICU:

3. My patient is too sedated

You may worry that sedated patients lack the cognizance and coordination to undertake mobility exercises. And when patients are uncomfortable or agitated, sedation may seem like the easiest solution. But a growing body of research shows it may not be the best one.

What you can do in your ICU:

4. Mobilizing patients is logistically prohibitive

Moving a patient, especially out of bed, poses several challenges. Tubes and equipment must travel as a seamless extension of the patient. Equipment must function dependably — perhaps in a suboptimized state.

What you can do in your ICU:

  • Plan together. The right planning and communication can help team, patient, and technology move in lockstep for a smooth and safe mobilization event. Use communication guides to help get everyone on the same page and brush up on common equipment challenges to help you anticipate problems before they arise.
  • Let technology be your eyes. The last thing you need to worry about is whether your technology is giving you the data you need. Learn how advanced synchrony ventilation tools can adapt to different patients and activities.

Related: Can a ventilator filter choice help protect clinicians from contagious respiratory pathogens? See the lessons learned from two Canadian hospitals managing viral outbreaks.

You can help overcome the misconceptions surrounding early mobility programs. Explore the tools and technologies that can help your patients get mobile today.

1. Klompas M, Branson R, Eichenwald EC, et al. Strategies to prevent ventilator-associated pneumonia in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(8):915–936. doi:10.1086/677144.
2. Cohen IL. Current issues in agitation management. Advanced Studies Med. 2002;2(9):332-337.
3. Nordon-Craft A, Moss M, Quan D, Schenkman M. Intensive care unit–acquired weakness: implications for physical therapist management. Phys Ther. 2012;92(12):1494–1506. doi:10.2522/ptj.20110117.
*As part of the ABCDEF bundle. Vasilevskis EE, Ely EW, Speroff T, Pun BT, Boehm L, Dittus RS. Reducing iatrogenic risks: ICU-acquired delirium and weakness—crossing the quality chasm. Chest. 2010;138(5):1224–1233. doi:10.1378/chest.10-0466.

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About the Author

Jessica Carideo is a Commercial Marketing Strategist at Medtronic focused on intensive care (ICU/NICU/PICU) and post-acute (skilled nursing/long-term care/homecare) settings. Jessica develops content marketing strategies in these areas of care for Medtronic’s Respiratory and Monitoring Solutions portfolio.

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