TY - JOUR
T1 - Perceived Barriers to Mobility in a Medical ICU
T2 - The Patient Mobilization Attitudes & Beliefs Survey for the ICU
AU - Goodson, Carrie M.
AU - Friedman, Lisa Aronson
AU - Mantheiy, Earl
AU - Heckle, Kevin
AU - Lavezza, Annette
AU - Toonstra, Amy
AU - Parker, Ann M.
AU - Seltzer, Jason
AU - Velaetis, Michael
AU - Glover, Mary
AU - Outten, Caroline
AU - Schwartz, Kit
AU - Jones, Antionette
AU - Coggins, Sarah
AU - Hoyer, Erik H.
AU - Chan, Kitty S.
AU - Needham, Dale M.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Financial support was provided by the National Heart Lung Blood Institute for Dr Goodson [T32HL007534] and Dr Parker [K23HL138206]. The funding bodies had no role in the design, implementation, or output of this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
The authors would like to thank all of the survey respondents and the entire Johns Hopkins MICU staff for their participation in this ongoing quality improvement project. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Financial support was provided by the National Heart Lung Blood Institute for Dr Goodson [T32HL007534] and Dr Parker [K23HL138206]. The funding bodies had no role in the design, implementation, or output of this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© The Author(s) 2018.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Purpose: Early mobilization in the intensive care unit (ICU) can improve patient outcomes but has perceived barriers to implementation. As part of an ongoing structured quality improvement project to increase mobilization of medical ICU patients by nurses and clinical technicians, we adapted the existing, validated Patient Mobilization Attitudes & Beliefs Survey (PMABS) for the ICU setting and evaluated its performance characteristics and results. Materials and Methods: The 26-item PMABS adapted for the ICU (PMABS-ICU) was administered as an online survey to 163 nurses, clinical technicians, respiratory therapists, attending and fellow physicians, nurse practitioners, and physician assistants in one medical ICU. We evaluated the overall and subscale (knowledge, attitude, and behavior) scores and compared these scores by respondent characteristics (clinical role and years of work experience). Results: The survey response rate was 96% (155/163). The survey demonstrated acceptable discriminant validity and acceptable internal consistency for the overall scale (Cronbach α: 0.82, 95% confidence interval: 0.76-0.85), with weaker internal consistency for all subscales (Cronbach α: 0.62-0.69). Across all respondent groups, the overall barrier score (range: 1-100) was relatively low, with attending physicians perceiving the lowest barriers (median [interquartile range]: 30 [28-34]) and nurses perceiving the highest (37 [31-40]). Within the first 10 years of work experience, greater experience was associated with a lower overall barrier score (−0.8 for each additional year; P = 0.02). Conclusions: In our medical ICU, across 6 different clinical roles, there were relatively low perceived barriers to patient mobility, with greater work experience over the first 10 years being associated with lower perceived barriers. As part of a structured quality improvement project, the PMABS-ICU may be valuable in assisting to identify specific perceived barriers for consideration in designing mobility interventions for the ICU setting.
AB - Purpose: Early mobilization in the intensive care unit (ICU) can improve patient outcomes but has perceived barriers to implementation. As part of an ongoing structured quality improvement project to increase mobilization of medical ICU patients by nurses and clinical technicians, we adapted the existing, validated Patient Mobilization Attitudes & Beliefs Survey (PMABS) for the ICU setting and evaluated its performance characteristics and results. Materials and Methods: The 26-item PMABS adapted for the ICU (PMABS-ICU) was administered as an online survey to 163 nurses, clinical technicians, respiratory therapists, attending and fellow physicians, nurse practitioners, and physician assistants in one medical ICU. We evaluated the overall and subscale (knowledge, attitude, and behavior) scores and compared these scores by respondent characteristics (clinical role and years of work experience). Results: The survey response rate was 96% (155/163). The survey demonstrated acceptable discriminant validity and acceptable internal consistency for the overall scale (Cronbach α: 0.82, 95% confidence interval: 0.76-0.85), with weaker internal consistency for all subscales (Cronbach α: 0.62-0.69). Across all respondent groups, the overall barrier score (range: 1-100) was relatively low, with attending physicians perceiving the lowest barriers (median [interquartile range]: 30 [28-34]) and nurses perceiving the highest (37 [31-40]). Within the first 10 years of work experience, greater experience was associated with a lower overall barrier score (−0.8 for each additional year; P = 0.02). Conclusions: In our medical ICU, across 6 different clinical roles, there were relatively low perceived barriers to patient mobility, with greater work experience over the first 10 years being associated with lower perceived barriers. As part of a structured quality improvement project, the PMABS-ICU may be valuable in assisting to identify specific perceived barriers for consideration in designing mobility interventions for the ICU setting.
KW - barriers
KW - early mobility
KW - multiprofessional
KW - quality improvement
KW - rehabilitation
KW - survey
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U2 - 10.1177/0885066618807120
DO - 10.1177/0885066618807120
M3 - Article
C2 - 30336716
AN - SCOPUS:85059344219
SN - 0885-0666
VL - 35
SP - 1026
EP - 1031
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
IS - 10
ER -