School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
Research Center, Sacré-Coeur Hospital, Montreal, Quebec, Canada.
J Intensive Care Med. 2019 Mar;34(3):218-226. doi: 10.1177/0885066617696846. Epub 2017 Mar 7.
Early mobilization is safe, feasible, and associated with better outcomes in patients with critical illness. However, barriers to mobilization in clinical practice still exist. The objective of this study was to assess the knowledge and practice patterns of intensive care unit (ICU) clinicians, as well as the barriers and facilitators to early mobilization.
Cross-sectional survey.
Intensive care units of 3 university-affiliated hospitals in Montreal, Canada.
One hundred and thirty-eight ICU clinicians, including nurses, physicians, respiratory therapists, and physiotherapists.
None.
Perceived barriers, facilitators, knowledge, and practice patterns of early mobilization were assessed using a previously validated mobility survey tool.
The overall response rate was 50.0% (138 of 274). Early mobilization was not perceived as a top priority in 49% of respondents. Results showed that clinicians were not fully aware of the benefits of early mobilization as per the current literature. About 58% of clinicians did not feel well trained and informed to mobilize mechanically ventilated patients. Perceptions on patient-level barriers varied with clinicians' professional training, but there was a high degree of interprofessional and intraprofessional disagreement on the permissible maximal level activity in different scenarios of critically ill patients.
Our survey shows limited awareness, among our respondents, of the clinical benefits of early mobilization and high level of disagreement on the permissible maximal level of activity in the critically ill patients. Future studies should evaluate the role of knowledge translation in modifying these barriers and improving early mobilization.
早期活动在危重症患者中是安全、可行的，并与更好的结果相关。然而，在临床实践中仍然存在活动障碍。本研究的目的是评估重症监护病房（ICU）临床医生的知识和实践模式，以及早期活动的障碍和促进因素。
横断面调查。
加拿大蒙特利尔的 3 所大学附属医院的 ICU。
138 名 ICU 临床医生，包括护士、医生、呼吸治疗师和物理治疗师。
无。
使用先前验证的活动能力调查工具评估对早期活动的感知障碍、促进因素、知识和实践模式。
总体应答率为 50.0%（274 名中的 138 名）。49%的受访者认为早期活动不是优先事项。结果表明，临床医生对早期活动的益处没有充分认识，与当前文献不符。约 58%的临床医生觉得自己没有得到充分的培训和信息，无法对机械通气患者进行活动。对患者层面障碍的看法因临床医生的专业培训而异，但在不同危重症患者场景下允许的最大活动水平方面，存在高度的跨专业和专业内的分歧。
我们的调查显示，我们的受访者对早期活动的临床益处认识有限，并且对危重症患者允许的最大活动水平存在高度分歧。未来的研究应评估知识转化在改变这些障碍和促进早期活动方面的作用。
