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A Benchmark Project On Early Mobility In The Intensive Care Unit, Millicent Odhiambo

MSN Capstone Projects

Introducing early mobility interventions in the Intensive Care Unit (ICU) is a crucial measure to improve patient outcomes and optimize care delivery in the critical care setting. The objective of this project is to tackle the difficulties caused by extended periods of immobility in the Intensive Care Unit (ICU), with the aim of diminishing complications, shortening the duration of ICU stays, and enhancing the functional recovery of patients.

Comparator Groups In Icu-Based Studies Of Physical Rehabilitation: A Scoping Review Of 125 Studies, Heather K O'Grady, Julie C Reid, Christopher Farley, Quincy E B Hanna, Janelle Unger, David J Zorko, Jackie Bosch, Lyn S Turkstra, Michelle E Kho

Physical Therapy Publications

OBJECTIVES: To characterize comparator groups (CGs) in ICU-based studies of physical rehabilitation (PR), including the type, content, and reporting.

DATA SOURCES: We followed a five-stage scoping review methodology, searching five databases from inception to June 30, 2022. Study selection and data extraction were completed independently, in duplicate.

STUDY SELECTION: We screened studies by title and abstract, then full-text. We included prospective studies with greater than or equal to two arms enrolling mechanically ventilated adults (≥ 18 yr), with any planned PR intervention initiated in the ICU.

DATA EXTRACTION: We conducted a quantitative content analysis of authors' description of CG type …

Quantification Of The Negative Impact Of Sedation And Inotropic Support On Achieving Early Mobility In Burn Patients In Icu: A Single Center Observational Study, Lauren Bright, Lisa Van Der Lee, Dana Hince, Fiona M. Wood, Dale W. Edgar

IHR Papers and Journal Articles

Introduction: Early rehabilitation for burns survivors in the intensive care unit (ICU) is arguably more challenging than the general population. Early achievement of functional verticality milestones (FVMs) has the potential to ameliorate the detrimental effects of bed rest and immobility observed in ICU patients and reduce healthcare costs. However, the time to achieving FVMs after burn injury is influenced by factors such as sedation practices, cardiovascular stability, mechanical ventilation, acute skin reconstruction and length of stay (LOS) during the acute intensive care period.

Objectives/Aims: The aims of this study were to identify the association between early achievement of FVMs and …

An International Study Exploring The Experience Of Survivors Of Critical Illness As Volunteers Within Icu Recovery Services, Carly Robinson, Elizabeth Hibbert, Anthony J. Bastin, Joel Meyer, Ashley A. Montgomery-Yates, Tara Quasim, Andrew Slack, Mark E. Mikkelsen, Theodore J. Iwashyna, Kimberly J. Haines, Carla M. Sevin, Joanne Mcpeake, Leanne M. Boehm

Internal Medicine Faculty Publications

Objectives:
Many clinicians have implemented follow-up and aftercare to support patients following ICU. Some of this care is supported and facilitated by peer volunteers. There is limited contemporary work that has explicitly explored volunteer roles within ICU recovery services or the experience of volunteers undertaking these roles. We sought to explore the experience of survivors of critical illness, as volunteers, involved in ICU recovery services and understand their motivation for undertaking these roles.

Design:
Qualitative exploration using in-depth semistructured interviews. The study design used an inductive content analysis process. We also documented the roles that were adopted by volunteers in …

The Effect Of A Nursing Knowledge Practice Improvement Project For Icu Acquired Weakness (Icuaw) And Mobility Protocols To Increase Knowledge And Self-Confidence In Icu Nurses, Renee Rogers

DNP Projects

Objective: The purpose of this project is to conduct a knowledge improvement program about ICU acquired weakness (ICUAW), mobility protocols, and self-confidence for ICU nurses at the University of Kentucky's Trauma & Surgical service.

Aim: The aim of this project is to improve the ICU nurses’ knowledge about ICUAW, mobility protocols/charting, and nursing self-confidence performing the knowledge within clinical practice. As well as assess if there is any correlation between the years of nursing experience and ICU location on knowledge and self-confidence.

Background: A condition that is under recognized in critical care, is ICU acquired weakness (ICUAW), which is muscle …

Multicentre Pilot Randomised Clinical Trial Of Early In-Bed Cycle Ergometry With Ventilated Patients., Michelle E Kho, Alexander J Molloy, France J Clarke, Julie C Reid, Margaret S Herridge, Timothy Karachi, Bram Rochwerg, Alison E Fox-Robichaud, Andrew Je Seely, Sunita Mathur, Vincent Lo, Karen Ea Burns, Ian M Ball, Joseph R Pellizzari, Jean-Eric Tarride, Jill C Rudkowski, Karen Koo, Diane Heels-Ansdell, Deborah J Cook

Articles, Abstracts, and Reports

Introduction: Acute rehabilitation in critically ill patients can improve post-intensive care unit (post-ICU) physical function. In-bed cycling early in a patient's ICU stay is a promising intervention. The objective of this study was to determine the feasibility of recruitment, intervention delivery and retention in a multi centre randomised clinical trial (RCT) of early in-bed cycling with mechanically ventilated (MV) patients.

Methods: We conducted a pilot RCT conducted in seven Canadian medical-surgical ICUs. We enrolled adults who could ambulate independently before ICU admission, within the first 4 days of invasive MV and first 7 days of ICU admission. Following informed consent, …

Understanding The Process Of Recovery From Critical Illness From The Patient Perspective: A Constructivist Grounded Theory, Tania Larsen

Electronic Thesis and Dissertation Repository

Critical illness creates long-term physical, psychological and cognitive deficits that negatively impact quality of life, persisting well beyond hospital discharge. The purpose of this constructivist grounded theory study is to understand and develop theoretical propositions on factors that patient’s perceive influence the process of recovery from critical illness in order to inform more comprehensive patient care management strategies.

Semi-structured interviews were conducted with 17 participants admitted to an ICU. All interviews were audio-recorded and transcribed verbatim. Data collection and analysis occurred concurrently using the constant comparative method. Data were analysed initially with line-by-line coding, then focused coding. Initial codes were …

Mobile Critical Care Recovery Program (M-Ccrp) For Acute Respiratory Failure Survivors: Study Protocol For A Randomized Controlled Trial, Sikandar Khan, Ashok Biju, Sophia Wang, Sujuan Gao, Omar Irfan, Amanda Harrawood, Stephanie Martinez, Anthony Perkins, Frederick W. Unverzagt, Sue Lasiter

Medical College Documents

Background: Patients admitted to intensive care units (ICU) with acute respiratory failure (ARF) face chronic complications that can impede return to normal daily function. A mobile, collaborative critical care model may enhance the recovery of ARF survivors.
Methods: The Mobile Critical Care Recovery Program (m-CCRP) study is a two arm, randomized clinical trial. We will randomize 620 patients admitted to the ICU with acute respiratory failure requiring mechanical ventilation in a 1:1 ratio to one of two arms (310 patients per arm) – m-CCRP intervention versus attention control. Those in the intervention group will meet with a care coordinator after …

Expert Consensus For Respiratory Physiotherapy Management Of Mechanically Ventilated Adults With Community-Acquired Pneumonia: A Delphi Study, Lisa Van Der Lee, Anne-Marie Hill, Shane Patman

Physiotherapy Papers and Journal Articles

Rationale and aims: Patients with community‐acquired pneumonia (CAP) are frequently admitted to an intensive care unit. Physiotherapy may be provided to optimize respiratory function; however, there is significant variability in clinical practice and limited research directing best practice for this cohort. This study aimed to determine expert consensus for best physiotherapy practice for invasively ventilated adults with CAP.

Method: A modified Delphi technique involved an international expert panel completing three rounds of an online questionnaire. The initial 35‐statement questionnaire, based on a systematic literature review and survey of current clinical practice, covered physiotherapy assessment and treatment of intubated patients with …

Safety And Effectiveness Of Propranolol In Severely Burned Patients: Systematic Review And Meta-Analysis, Ramiro Manzano-Nunez, Herney Andrés García-Perdomo, Paula Ferrada, Carlos Alberto Ordoñez Delgado, Diego Andrés Gomez, Jorge Esteban Foianini

Surgery Publications

Background

The objective of this systematic review was to determine the effectiveness and safety of propranolol compared to placebo or usual care for improving clinical relevant outcomes in severely burned patients (TBSA >20%).

Methods

Relevant articles from randomized controlled trials were identified by a literature search in MEDLINE, EMBASE, and CENTRAL. We included trials involving patients with a severe burn (>20% of total body surface area affected). Trials were eligible if they evaluated propranolol and compared to usual care or placebo. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for the final analysis. We …

Development, Implementation, And Outcomes Of An Acute Care Clinician Scientist Clinical Placement: Case Report., Sarah Wojkowski, Janelle Unger, Magda Mccaughan, Beverley Cole, Michelle E Kho

Physical Therapy Publications

Purpose: This article presents the development, implementation, and outcomes of an innovative clinician scientist (CS) placement for a 2nd-year, entry-level MSc(PT) student at McMaster University. Client Description: All physiotherapy students participating in the third 6-week clinical placement at McMaster University were eligible to apply for one CS placement. A placement description and expectations were developed collaboratively by the clinical site and the MSc(PT) programme before placement matching. Intervention: A shared supervisory model between one acute care physiotherapist and a critical care CS was developed to provide supervision in both clinical and research-related activities during the placement. Measures and Outcomes: The …

After-Hours Respiratory Physiotherapy For Intubated And Mechanically Ventilated Patients With Community-Acquired Pneumonia: An Australian Perspective, Lisa Van Der Lee, Anne-Marie Hill, Shane Patman

Physiotherapy Papers and Journal Articles

Introduction: Community acquired pneumonia (CAP) is a common reason for admission to an intensive care unit for intubation and mechanical ventilation, and results in high morbidity and mortality. The primary aim of the study was to investigate availability and provision of respiratory physiotherapy, outside of normal business hours, for intubated and mechanically ventilated adults with CAP in Australian hospitals.

Materials and methods: A cross-sectional, mixed methods online survey was conducted. Participants were senior intensive care unit physiotherapists from 88 public and private hospitals. Main outcome measures included presence and nature of an after-hours physiotherapy service and factors perceived to influence …

Profiling Physiotherapy In Australian And New Zealand Intensive Care, Kristin Leslie, Shane Patman

Health Sciences Conference Papers

Physiotherapy for ICU patients is considered essential by many health professionals and professional bodies, yet the evidence base for this service is insufficient. No published research outlining optimal management of this service exist. Effective evaluation and implementation of best practice ‘critical-care physiotherapy’ requires knowledge of the current profile of ICU physiotherapists’.

Leslie, K., & Patman, S. (2008). Profiling physiotherapy in Australian and New Zealand intensive care. Anaesthesia and Intensive Care, 36(6), 897.

ISSN: 0310-057X