Identifying barriers to nurse-facilitated patient mobility in the intensive care unit

Daniel L. Young, Jason Seltzer, Mary Glover, Caroline Outten, Annette Lavezza, Earl Mantheiy, Ann Parker, Dale Needham

Research output: Contribution to journalArticle

Abstract

Background Nurse-facilitated mobility of patients in the intensive care unit can improve outcomes. However, a gap exists between research findings and their implementation as part of routine clinical practice. Such a gap is often attributed, in part, to the barrier of lack of time. The Translating Evidence Into Practice model provides a framework for research implementation, including recommendations for identifying barriers to implementation via direct observation of clinical care. Objectives To report on design, implementation, and outcomes of an approach to identify and understand lack of time as a barrier to nurse-facilitated mobility in the intensive care unit. Methods An interprofessional team designed the observational process and evaluated the resulting data by using qualitative content analysis. Results During three 4-hour observations of 2 nurses and 1 nursing technician, 194 distinct tasks were performed (ie, events). A total of 4 categories of nurses' work were identified: patient care (47% of observation time), provider communication (25%), documentation (18%), and down time (10%). In addition, 3 types of potential mobility events were identified: in bed, edge of bed, and out of bed. The 194 observed events included 34 instances (18%) of potential mobility events that could be implemented: in bed (53%), edge of bed (6%), and out of bed (41%). Conclusions Nurses have limited time for additional clinical activities but may miss potentially important opportunities for facilitating patient mobility during existing patient care. The proposed method is feasible and helpful in empirically investigating barriers to nurse-facilitated patient mobility in the intensive care unit. (American Journal of Critical Care. 2018; 27:186-193).

Original languageEnglish (US)
Pages (from-to)186-193
Number of pages8
JournalAmerican Journal of Critical Care
Volume27
Issue number3
DOIs
StatePublished - May 1 2018

ASJC Scopus subject areas

  • Critical Care

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