Hunter Alex, Johnson Leslie, Coustasse Alberto
Reprinted from Hunter A, Johnson L, Coustasse A. Reduction of intensive care unit length of stay: the case of early mobilization. Health Care Manag. 2014;33(2):128-135. doi:10.1097/HCM.0000000000000006. Author Affiliations: Health Care Administration Program, College of Business, Marshall University Graduate College, South Charleston, West Virginia.
Health Care Manag (Frederick). 2020 Jul/Sep;39(3):109-116. doi: 10.1097/HCM.0000000000000295.
Bed rest or immobilization is frequently part of treatment for patients in the intensive care unit (ICU) with critical illness. The average ICU length of stay (LOS) is 3.3 days, and for every day spent in an ICU bed, the average patient spends an additional 1.5 days in a non-ICU bed. The purpose of this research study was to analyze the effects of early mobilization for patients in the ICU to determine if it has an impact on the LOS, cost of care, and medical complications. The methodology for this study was a literature review. Five electronic databases were used, with a total of 26 articles referenced for this research. Early mobilization suggested a decrease in delirium by 2 days, reduced risk of readmission or death, and reduced ventilator-assisted pneumonia, central line, and catheter infections. Length of stay in the ICU was reduced with statistical significance in several studies examining early mobilization. Limited research on cost of ICU LOS indicated potential savings with early mobilization. When implementing early mobilization in the ICU, total costs were decreased and medical complications were reduced. Early mobilization should become a standard of care for critically ill but stable patients in the ICU.
卧床休息或固定不动常常是重症监护病房(ICU)中重症患者治疗的一部分。ICU的平均住院时长为3.3天,而且患者在ICU病床每多待一天,平均还要在非ICU病床多待1.5天。本研究的目的是分析ICU患者早期活动的效果,以确定其是否会对住院时长、护理成本和医疗并发症产生影响。本研究的方法是文献综述。使用了五个电子数据库,本研究共引用了26篇文章。早期活动表明谵妄减少了2天,再入院或死亡风险降低,呼吸机相关性肺炎、中心静脉导管和导尿管感染减少。在多项研究早期活动的研究中,ICU住院时长有统计学意义的缩短。关于ICU住院时长成本的研究有限,表明早期活动可能节省费用。在ICU实施早期活动时,总成本降低,医疗并发症减少。早期活动应成为ICU中病情严重但稳定的患者的护理标准。