• J Pediatr Nurs · Jan 2018

    Provider Beliefs Regarding Early Mobilization in the Pediatric Intensive Care Unit.

    • Christine L Joyce, Cosme Taipe, Brittany Sobin, Marissa Spadaro, Batsheva Gutwirth, Larissa Elgin, Gabrielle Silver, Bruce M Greenwald, and Chani Traube.
    • Department of Pediatrics, NewYork-Presbyterian Hospital, USA. Electronic address: clj9014@med.cornell.edu.
    • J Pediatr Nurs. 2018 Jan 1; 38: 15-19.

    PurposeCritically ill patients are at risk for short and long term morbidity. Early mobilization (EM) of critically ill adults is safe and feasible, with improvement in outcomes. There are limited studies evaluating EM in pediatric critical care patients. Provider beliefs and concerns must be evaluated prior to EM implementation in the pediatric intensive care unit (PICU).Design And MethodsA survey was distributed to PICU providers assessing beliefs and concerns with regards to EM of PICU patients.ResultsSeventy-one providers responded. Most staff believed EM would be beneficial. The largest perceived benefits were decreased length of both stay and mechanical ventilation. The largest perceived concerns were risk of both endotracheal tube and central venous catheter dislodgement. Surveyed clinicians felt significantly more comfortable mobilizing the oldest as compared to the youngest patients (p<0.0001). Clinicians also felt significantly more comfortable mobilizing patients receiving invasive mechanical ventilation in the oldest as compared to the youngest patients (p<0.0001).ConclusionThere is clear benefit to the EM of adult ICU patients, with evidence supporting its safety and feasibility. As pediatric patients pose different challenges, it is imperative to understand provider concerns prior to the implementation of EM. Our research demonstrates similar concerns between adult and pediatric programs, with the addition of significant concern surrounding EM in very young children.Practice ImplicationsUnderstanding pediatric specific concerns with regards to EM will allow for the proper development and implementation of pediatric EM programs, allowing us to assess safety, feasibility, and ultimately outcomes.Copyright © 2017 Elsevier Inc. All rights reserved.

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