title: Implementing a Mobility Program to Minimize Post-Intensive Care Syndrome.
abstract: Immobility in the intensive care unit (ICU) is associated with neuromuscular weakness, post-intensive care syndrome, functional limitations, and high costs. Early mobility-based rehabilitation in the ICU is feasible and safe. Mobility-based rehabilitation varied widely across 5 ICUs in 1 health care system, suggesting a need for continuous training and evaluation to maintain a strong mobility-based rehabilitation program. Early mobility-based rehabilitation shortens ICU and hospital stays, reduces delirium, and increases muscle strength and the ability to ambulate. Long-term effects include increased ability for self-care, faster return to independent functioning, improved physical function, and reduced hospital readmission and death. Factors that influence early mobility-based rehabilitation include having an interdisciplinary team; strong unit leadership; access to physical, occupational, and respiratory therapists; a culture focused on patient safety and quality improvement; a champion of early mobility; and a focus on measuring performance and outcomes.
authors.affiliation: Ramona O. Hopkins is Professor, Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, and Clinical Research Investigator, Center for Humanizing Critical Care, and Department of Medicine, Pulmonary and Critical Care Division, Intermountain Healthcare, 5121 South Cottonwood St, Murray, UT 84107 (mona.hopkins@imail.org). Lorie Mitchell is Nurse Manager, Shock Trauma Intensive Care Unit, Department of Medicine, Intermountain Medical Center. George E. Thomsen is Medical Director, Coronary Intensive Care Unit, Department of Medicine, Intermountain Medical Center. Michele Schafer is Member, Intensive Care Unit Patient-Family Advisory Council, Intermountain Medical Center. Maggie Link is Physical Therapist, Shock Trauma Intensive Care Unit, Intermountain Medical Center. Samuel M. Brown is Director, Center for Humanizing Critical Care, Assistant Professor of Pulmonary and Critical Care Medicine, Department of Medicine, Intermountain Healthcare, and University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Ramona O
authors.initials: RO
authors.lastname: Hopkins
authors.forename: Lorie
authors.initials: L
authors.lastname: Mitchell
authors.forename: George E
authors.initials: GE
authors.lastname: Thomsen
authors.forename: Michele
authors.initials: M
authors.lastname: Schafer
authors.forename: Maggie
authors.initials: M
authors.lastname: Link
authors.forename: Samuel M
authors.initials: SM
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000523:psychology*; D016638:Critical Illness / Q000523:psychology* / Q000534:rehabilitation*; D004496:Education, Continuing; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010351:Patient Discharge; D010361:Patients / Q000523:psychology*; D013315:Stress, Psychological / Q000628:therapy*; D017741:Survivors / Q000523:psychology*; D013577:Syndrome