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Early mobilisation in critically ill children: does routine patient screening reduce time to commencing mobilisation?

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dc.contributor.authorSimpson, C.E.M.
dc.contributor.authorEsterman, A.J.
dc.contributor.authorGanu, S.S.
dc.contributor.authorMaki, K.
dc.contributor.authorKeeley, S.R.
dc.contributor.authorWard, E.J.
dc.contributor.authorTsiros, M.D.
dc.date.issued2023
dc.descriptionData source: Supplementary data, https://doi.org/10.1016/j.aucc.2021.12.007
dc.description.abstractObjective: The objective of this study was to investigate the impact of daily screening for medical readiness to participate in early mobilisation in the paediatric intensive care unit (PICU), on reducing time to mobilisation and to explore the safety-, feasibility-, and patient-level barriers to the practice. Methods: An interventional study with a historical control group was conducted in a PICU in a tertiary teaching hospital in Australia. The Early Mobilisation Screening Checklist was applied at 24e48 h of PICU stay with the aim to reduce time to commencing mobilisation. All patients aged term to 18 years admitted to the PICU for >48 h were included in this study. Data on time to mobilisation and patient characteristics were collected by an unblinded case note audit of children admitted to the PICU over 5months in 2018 for the baseline group and over a corresponding period in 2019 for the intervention group. Measurements and main results: A total of 71 children were enrolled. Survival analysis was used to compare time to mobilisation between groups, and a cox regression model found that children in the intervention group were 1.26 times more likely to participate in mobility, but this was not statistically significant (P ¼ 0.391, log rank test for equality of survival functions). Early mobilisation was safe, with no adverse events reported in 177 participant mobilisation days. Feasibility was demonstrated by 62% of participants mobilising within 72 h of admission. Mechanical ventilation during stay (P ¼ 0.043) and days receiving sedation infusion (% of days) (P ¼ 0.042) were associated with a decreased likelihood of participating in mobility. Conclusions: Implementation of routine screening alone does not significantly reduce time to commencing mobility in the PICU. Early mobilisation in the PICU is safe and feasible and resulted in no adverse events during mobilisation. Patient characteristics influencing participation in mobility warrant further exploration.
dc.identifier.citationAustralian Critical Care, 2023; 36(2):208-214
dc.identifier.doi10.1016/j.aucc.2021.12.007
dc.identifier.issn1036-7314
dc.identifier.issn1878-1721
dc.identifier.orcidEsterman, A.J. [0000-0001-7324-9171]
dc.identifier.urihttps://hdl.handle.net/11541.2/27469
dc.language.isoen
dc.publisherElsevier
dc.relation.fundingUniversity of South Australia
dc.relation.fundingHospital Research Foundation
dc.relation.fundingSA Health
dc.rightsCopyright 2022 Australian College of Critical Care Nurses. Published by Elsevier Access Condition Notes: Accepted manuscript available after 1 July 2024
dc.source.urihttps://doi.org/10.1016/j.aucc.2021.12.007
dc.subjectrehabilitation
dc.subjectchildren
dc.subjectearly mobilisation
dc.subjectintensive care units
dc.subjectphysiotherapy
dc.subjectcritical care
dc.titleEarly mobilisation in critically ill children: does routine patient screening reduce time to commencing mobilisation?
dc.typeJournal article
pubs.publication-statusPublished
ror.fileinfo12240712090001831 13240712080001831 d80a75ee-6688-49e0-a8ca-bde5fc6fefdd
ror.mmsid9916609041501831

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