• Anwar Hassan, Arvind Rajamani, and Fiona Fitzsimons.
• Intensive Care Unit, Nepean Hospital, Penrith, NSW, 2747, Australia. Electronic address: anwarpt77@yahoo.com.au.
• Intensive Crit Care Nurs. 2017 Oct 1; 42: 36-43.

ObjectiveProspective quality improvement project to evaluate the impact of a training programme to promote nurse-led mobilisation of intubated critically ill patients.MethodsThis project involved an educational programme to upskill nurses and overcome the barriers/challenges to nurse-led mobilisation. Initial strategies focused on educating and upskilling nurses to attain competency in active mobilisation. Subsequent strategies focused on positive reinforcement to achieve a culture shift. A pre- and post-intervention audit was used to evaluate its effectiveness.ResultsA baseline audit showed that ∼9% of ventilated patients were mobilised. Several barriers were identified. Twenty-three nurses underwent training in actively mobilising ventilated patients. This increased their confidence levels and there was reduction in reported barriers. However, the rate of active mobilisation remained low (9.7%). Subsequently, a programme of positive reinforcement with rewards and visual reminders was introduced, which saw an increase in the number of nurse-led mobilisations of both ventilated patients (from 9.7% to 34.8%; p=0.0003), and non-ventilated patients (29.5% versus 62.9%; p=<0.0001).ConclusionIt is safe and feasible to train nurses to perform active mobilisation of ventilated patients. However, to promote a culture change, training and competency must be combined with a multi-pronged approach including reminders, positive reinforcement and rewards.Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

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