In this episode, Kali Dayton, a critical care nurse practitioner with a passion for ICU mobility, dives into the transformative power of movement for critically ill patients. She discusses the detrimental effects of sedation compared to the benefits of early mobility, emphasizing its role in recovery and preventing complications. Kali advocates for a culture shift among healthcare teams, promoting collaboration and innovative practices like verticalization beds. Her insights reveal how prioritizing patient mobility not only enhances care but also reduces hospital costs.
Mobility in critical care significantly mitigates muscle atrophy and improves recovery outcomes, including reduced delirium and shorter hospital stays.
Empowering nurses through education and collaboration with rehabilitation specialists is essential for improving patient mobility and overall care in the ICU.
Transforming ICU culture to embrace early mobility practices requires addressing staff skepticism and emphasizing the financial benefits and safety of such initiatives.
Deep dives
The Role of Mobility in Critical Care
Mobility plays a crucial role in the recovery of critically ill patients. Engaging in physical movement can help mitigate muscle atrophy, which can occur as quickly as 2% per day in the ICU, leading to long-term disability. Studies have shown that patients who mobilize early have significantly better outcomes, including decreased rates of delirium and shorter hospital stays. Despite common misconceptions, patients on mechanical ventilation can and should be mobilized to preserve their strength and function.
The Importance of Nurse Empowerment
Creating an environment where nurses feel empowered and knowledgeable about mobility practices is vital for enhancing patient care in the ICU. Nurses often find themselves as gatekeepers, managing sedation and patient movements, which can lead to feelings of burden when patients become agitated or immobile. Providing nurses with the necessary education and support, as well as training in collaboration with rehabilitation colleagues, allows them to better manage delirium and mobilize patients. This holistic approach results in improved care for critically ill patients and fosters a supportive healthcare environment.
Cultural Shifts and Resistance to Change
Changing the culture within an ICU presents challenges, particularly with physicains and staff who may be hesitant to adopt new mobility practices. The initial resistance often stems from fear and uncertainty regarding the safety of mobilizing patients. Engaging skeptics through education, training, and exposure to successful practices encourages acceptance of new techniques. Transforming such skeptics into advocates for early mobility ultimately contributes to a more progressive and effective critical care environment.
Evaluating Patient Risks
Concerns about patient safety during mobility initiatives often overshadow the potential benefits, leading to a more conservative approach that may exacerbate issues like ICU-acquired weakness and delirium. Evidence suggests that the risks associated with early mobility, such as falls or adverse events, are minimal compared to the complications resulting from immobility. It is crucial to view mobility as a preventive measure against deleterious outcomes rather than solely focusing on eliminating falls or self-extubation. By creating a culture that prioritizes both patient safety and mobility, healthcare teams can enhance recovery outcomes.
Training and Collaboration among Team Members
Implementing a successful mobility program requires collaboration among various healthcare team members, including nurses, respiratory therapists, and rehabilitation specialists. Teams should receive education not only on the protocols for mobilization but also on how to effectively work together to provide ongoing support for patients. Training sessions can focus on using tools like verticalization beds and ensuring all team members are comfortable with mobility practices. A monthly review of patient mobility data, along with case studies, can reinforce the importance of teamwork in optimizing patient outcomes.
Financial Implications of Mobility Practices
Investing in mobility programs has demonstrated substantial financial benefits for healthcare institutions, contrary to the belief that such initiatives are too costly. By reducing hospital stays, readmission rates, and the incidence of complications, hospitals can save significant amounts of money that can be directed toward staffing and resources necessary for effective mobility practices. Additionally, patients who engage in early mobility are less likely to require extensive rehabilitation after discharge, further decreasing costs. Hence, improving mobility practices should be positioned as a cost-effective strategy rather than an expensive undertaking.
The idea that movement is medicine doesn’t stop with the critically ill. On this week’s episode of Critical Care Time we sit down with Kali Dayton, a critical care NP with a passion for ICU mobility. We talk all things mobility in the critically ill: The roles of bedside nurses and clinicians, how we can implement best mobility practices with our patients, the financial and patient-care benefits of fostering a culture of movement in your ICU and what it means to be an “ICU Revolutionist” - along with so much more! If you truly care for the critically ill you cannot miss this episode!
