Barts Health, West Smithfield, London, EC1A 7BE, UK.
City, University of London, Northampton Square, London, EC1V 0HB, UK.
Aust Crit Care. 2022 Sep;35(5):595-603. doi: 10.1016/j.aucc.2021.09.002. Epub 2021 Oct 30.
There is a need for early mobilisation of patients in intensive care units to prevent acquired weaknesses which can have a long-term impact on health and quality of life. This need is not always fulfilled. We therefore sought to conduct an integrative review of international evidence to answer the question: What are the barriers to nurses mobilising adult patients in intensive care units?
We conducted a systematic search and thematic analysis. We were able to present a descriptive quantitative synthesis of the survey articles included.
We searched CINAHL, MEDLINE, and PsycINFO databases between and including 2010 and 2020 using search terms synonymous with "intensive care unit" and "nurse" and "early mobilisation" and "barrier using Boolean operators" and "truncation". We completed backwards and forwards citation searches on included studies.
We included seven articles which we synthesised into three themes and 13 subthemes as follows: (i) organisational barriers (subthemes were staffing levels, time and workload, resources, and care coordination), (ii) individual barriers (subthemes were self and team safety, knowledge and training, beliefs about the consequences of early mobilisation, stress, and other barriers), and (iii) patient-related barriers (subthemes were medical instability/physical status, patient safety, neurological deficits and sedation, and nonconcordance of patients).
Nurses' barriers were wide ranging, and interventions to improve concordance with early mobilisation need to be tailored to address this group's specific barriers.
需要对重症监护病房的患者进行早期活动，以预防获得性虚弱，这会对健康和生活质量产生长期影响。但这一需求并不总能得到满足。因此，我们旨在对国际证据进行综合回顾，以回答以下问题：护士在重症监护病房中为成人患者进行早期活动的障碍有哪些？
我们进行了系统搜索和主题分析。我们能够对所纳入的调查文章进行描述性定量综合。
我们使用同义词“重症监护病房”和“护士”和“早期活动”和“使用布尔运算符的障碍”以及“截短”在 CINAHL、MEDLINE 和 PsycINFO 数据库中进行了 2010 年至 2020 年之间的搜索。我们对纳入的研究进行了回溯和前向引文搜索。
我们纳入了 7 篇文章，将其综合为 3 个主题和 13 个亚主题，如下所示：（i）组织障碍（亚主题包括人员配备水平、时间和工作量、资源和护理协调），（ii）个体障碍（亚主题包括自我和团队安全、知识和培训、对早期活动后果的信念、压力和其他障碍），（iii）患者相关障碍（亚主题包括医疗不稳定/身体状况、患者安全、神经功能缺损和镇静以及患者不配合）。
护士的障碍范围广泛，需要针对提高与早期活动的一致性的干预措施，以解决这一群体的具体障碍。
