title: Making of a Successful Early Mobilization Program for a Medical Intensive Care Unit.
abstract: To provide a guideline for intensive care unit (ICU) early mobilization program development and implementation and to describe the patient characteristics and endpoints for those who participated in our hospital's early mobilization program.
  
  
  
  An ICU early mobilization program was developed with five guiding principles: analgesia/sedation optimization, sedation minimization, protocol of progressive mobility, physical therapy and occupational therapy recruitment, and nursing education. This program began in April 2014, and the initial 32 patients who ambulated while receiving mechanical ventilation were retrospectively assessed and their characteristics described.
  
  
  
  After program implementation, more than 50 mechanically ventilated patients ambulated in the first year following early mobilization initiation. Patients with an FiO2 as high as 1.0 and on nonconventional modes of mechanical ventilation successfully ambulated without adverse events. The mean ambulation distance was 102 ± 152 f. and usually required three ICU staff members with 5 to 10 minutes of preparation before ambulation. After implementation, a retrospective analysis revealed a decrease in the average length of ICU stay, from 4.8 to 4.1 days.
  
  
  
  Addressing analgesia and sedation practices, along with instituting a progressive mobility protocol and recruiting physical and occupational therapy, may serve as a guide to the creation of a successful early mobilization program. This study provides additional supportive evidence that early mobilization in the ICU is safe and effective.
authors.affiliation: From Texas Tech University Health Sciences Center, and University Medical Center, Lubbock, Texas.
authors.forename: Mark
authors.initials: M
authors.lastname: Sigler
authors.affiliation: From Texas Tech University Health Sciences Center, and University Medical Center, Lubbock, Texas.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Nugent
authors.affiliation: From Texas Tech University Health Sciences Center, and University Medical Center, Lubbock, Texas.
authors.forename: Raed
authors.initials: R
authors.lastname: Alalawi
authors.affiliation: From Texas Tech University Health Sciences Center, and University Medical Center, Lubbock, Texas.
authors.forename: Kavitha
authors.initials: K
authors.lastname: Selvan
authors.affiliation: From Texas Tech University Health Sciences Center, and University Medical Center, Lubbock, Texas.
authors.forename: Jim
authors.initials: J
authors.lastname: Tseng
authors.affiliation: From Texas Tech University Health Sciences Center, and University Medical Center, Lubbock, Texas.
authors.forename: Hawa
authors.initials: H
authors.lastname: Edriss
authors.affiliation: From Texas Tech University Health Sciences Center, and University Medical Center, Lubbock, Texas.
authors.forename: Alisha
authors.initials: A
authors.lastname: Turner
authors.affiliation: From Texas Tech University Health Sciences Center, and University Medical Center, Lubbock, Texas.
authors.forename: Kristi
authors.initials: K
authors.lastname: Valdez
authors.affiliation: From Texas Tech University Health Sciences Center, and University Medical Center, Lubbock, Texas.
authors.forename: David
authors.initials: D
authors.lastname: Krause
mesh_terms: D000698:Analgesia / Q000379:methods; D002985:Clinical Protocols; D016292:Procedural Sedation / Q000379:methods; D016638:Critical Illness / Q000534:rehabilitation / Q000628:therapy; D004434:Early Ambulation / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D016730:Program Development