Multiprofessional perceptions and barriers to early mobilization in intensive care: a study at a university hospital

Abstract

INTRODUCTION: Hospitalization often causes mobility difficulties and hinders daily activities. Progressive mobilization of patients in intensive care units (ICUs) is safe and linked to better clinical and functional outcomes. OBJECTIVE: To assess the perception of a multidisciplinary team in the ICUs of a university hospital regarding early mobilization (EM). METHODS: A prospective observational study was conducted using data collected from professionals and students in the ICU of Clementino Fraga Filho University Hospital at the Federal University of Rio de Janeiro between June and December 2019. Data on EM perception were collected using a questionnaire. Descriptive statistics and Fisher's exact tests were used to analyze the differences between the professional categories. RESULTS: In comparison to physiotherapists (88%), a smaller percentage of physicians (37.5%) and nurses (50%) reported that patients on mechanical ventilation (MV) are mobilized within 48 hours (P<0.05). Additionally, a smaller percentage of physicians and nurses reported that their workload was sufficient to mobilize patients at least once a day (62.5% vs. 62.5% vs. 96%; P<0.05). Physiotherapists reported more frequently than physicians that “patients undergoing procedures” were a barrier (57.7% vs. 18.7%; P<0.05). Conversely, regarding mechanical ventilation (MV), physicians identified this barrier more frequently (43.7% vs. 7.7%; P<0.05). There was overall agreement on the benefits of EM (>80%), with the main perceived barriers being the availability of professionals (58%), the clinical condition of patients (55%) and patients undergoing procedures (45%). CONCLUSION: In a university hospital without an established EM protocol, the multidisciplinary team showed satisfactory knowledge and perceptions of EM. However, creating institutional protocols and guidelines is essential to engage multidisciplinary teams in implementing EM and overcoming barriers.