Nurse-Initiated Mobilization Practices in 2 Community Intensive Care Units: A Pilot Study

Deonni P Stolldorf; Mary S Dietrich; Tiffani Chidume; Marie McIntosh; Cathy A Maxwell

doi:10.1097/DCC.0000000000000320

Nurse-Initiated Mobilization Practices in 2 Community Intensive Care Units: A Pilot Study

Dimens Crit Care Nurs. 2018 Nov/Dec;37(6):318-323. doi: 10.1097/DCC.0000000000000320.

Authors

Deonni P Stolldorf¹, Mary S Dietrich, Tiffani Chidume, Marie McIntosh, Cathy A Maxwell

Affiliation

¹ Deonni Stolldorf, PhD, RN, is an assistant professor and research faculty member at Vanderbilt University School of Nursing, Nashville, Tennessee, with a clinical background and specialized training in critical care. Dr Stolldorf's research focus is on the implementation and sustainability of healthcare interventions. She is currently funded by the Agency for Healthcare Research and Quality (K01 HS25486-01) to investigate the implementation and sustainment of medication reconciliation interventions. Mary S. Dietrich, PhD, MS, is a professor of statistics and measurement at Vanderbilt University School of Nursing, Nashville, Tennessee, with more than 30 years of experience collaborating with researchers in all areas of study. Dr Dietrich's own interests revolve around the use and development of statistical methods that bridge the psychological, sociological, and biological sciences, in particular systems-level and longitudinal methods. Tiffani Chidume, MSN, RN, CCRN, has 17 years of nursing experience. She is certified as a critical care nurse and has more than 11 years of intensive care unit experience. She has transitioned her clinical expertise to academia, where she is a nursing instructor and the simulation laboratory coordinator. She is currently a doctoral nursing student at the University of Alabama in Huntsville. Marie McIntosh, MSN, FNP-C, is an experienced critical care nurse. She is currently a nurse practitioner in Columbus, Georgia, with more than 5 years of experience. She is affiliated with SFH Electrophysiologist Group in Columbus, as well as St Francis Hospital in Columbus. Cathy Maxwell, PhD, RN, is an assistant professor and research faculty member at Vanderbilt University School of Nursing, Nashville, Tennessee, with a clinical background in critical care and trauma. Dr Maxwell's research is directed at understanding outcomes trajectories of older adults after physical injury.

Abstract

Background: Critical-care nurses play a vital role in promoting safe early mobilization in intensive care unit (ICU) settings to reduce the risks associated with immobility in ICUs, including the risk of delirium, ICU-acquired weakness, and functional decline.

Objective: The purposes of this study were to describe nurse-led mobilization practices in 2 community hospital ICUs and to report differences and similarities between the 2 settings.

Methods: This was a cross-sectional exploratory study of 18 nurses (ICU A: n = 12, ICU B: n = 6) and 124 patients (ICU A: n = 50, ICU B: n = 74). Patient-specific therapeutic intervention needs and nurse-initiated mobilization practices were tracked over a 1-month period.

Results: Differences in patient characteristics and nurse-led mobilization activities were observed between ICUs. After controlling for patient characteristics, we found statistically significant differences in nurse-led mobilization activities between the 2 units, suggesting that factors other than patient characteristics may explain differences in nurse-led mobilization practices.

Publication types

Multicenter Study

MeSH terms

Aged
Critical Care Nursing / methods*
Cross-Sectional Studies
Early Ambulation / nursing*
Female
Hospitals, Community
Humans
Intensive Care Units*
Male
Middle Aged
United States

Grants and funding

K01 HS025486/HS/AHRQ HHS/United States