CCRN, Bonn, Germany.
Nursing Research, Department of Anesthesiology and Intensive Care Medicine, University Hospital of Schleswig-Holstein, Kiel, Germany.
PLoS One. 2020 Oct 15;15(10):e0239853. doi: 10.1371/journal.pone.0239853. eCollection 2020.
Mobilization of intensive care patients is a multi-professional task. Aim of this study was to explore how different professions working at Intensive Care Units (ICU) estimate the mobility capacity using the ICU Mobility Score in 10 different scenarios.
Ten fictitious patient-scenarios and guideline-related knowledge were assessed using an online survey. Critical care team members in German-speaking countries were invited to participate. All datasets including professional data and at least one scenario were analyzed. Kruskal Wallis test was used for the individual scenarios, while a linear mixed-model was used over all responses.
In total, 515 of 788 (65%) participants could be evaluated. Physicians (p = 0.001) and nurses (p = 0.002) selected a lower ICU Mobility Score (-0.7 95% CI -1.1 to -0.3 and -0.4 95% CI -0.7 to -0.2, respectively) than physical therapists, while other specialists did not (p = 0.81). Participants who classified themselves as experts or could define early mobilization in accordance to the "S2e guideline: positioning and early mobilisation in prophylaxis or therapy of pulmonary disorders" correctly selected higher mobilization levels (0.2 95% CI 0.0 to 0.4, p = 0.049 and 0.3 95% CI 0.1 to 0.5, p = 0.002, respectively).
Different professions scored the mobilization capacity of patients differently, with nurses and physicians estimating significantly lower capacity than physical therapists. The exact knowledge of guidelines and recommendations, such as the definition of early mobilization, independently lead to a higher score. Interprofessional education, interprofessional rounds and mobilization activities could further enhance knowledge and practice of mobilization in the critical care team.
对重症监护患者的调动是一项多专业任务。本研究的目的是探讨在 10 种不同情况下,不同专业的重症监护病房(ICU)工作人员如何使用 ICU 活动能力评分来评估患者的活动能力。
通过在线调查评估了 10 种虚构的患者情景和与指南相关的知识。邀请德语国家的重症监护团队成员参与。分析了包括专业数据和至少一个场景的数据。对个体场景使用 Kruskal Wallis 检验,对所有反应使用线性混合模型。
共有 788 名参与者中的 515 名(65%)可以进行评估。与物理治疗师相比,医生(p=0.001)和护士(p=0.002)选择的 ICU 活动能力评分较低(-0.7,95%CI-1.1 至-0.3 和-0.4,95%CI-0.7 至-0.2),而其他专家则没有(p=0.81)。将自己归类为专家或能够根据“S2e 指南:肺部疾病预防或治疗中的定位和早期活动”正确定义早期活动的参与者选择了更高的活动水平(0.2,95%CI0.0 至 0.4,p=0.049 和 0.3,95%CI0.1 至 0.5,p=0.002)。
不同专业的人员对患者的活动能力评估不同,护士和医生评估的活动能力明显低于物理治疗师。对指南和建议的准确了解,如早期活动的定义,独立导致评分更高。跨专业教育、跨专业查房和活动可以进一步提高重症监护团队对活动的认识和实践。