title: Interprofessional Survey of Perceived Barriers and Facilitators to Early Mobilization of Critically Ill Patients in Montreal, Canada.
abstract: OBJECTIVE
  Early mobilization is safe, feasible, and associated with better outcomes in patients with critical illness. However, barriers to mobilization in clinical practice still exist. The objective of this study was to assess the knowledge and practice patterns of intensive care unit (ICU) clinicians, as well as the barriers and facilitators to early mobilization.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Intensive care units of 3 university-affiliated hospitals in Montreal, Canada.
  
  
  METHODS
  One hundred and thirty-eight ICU clinicians, including nurses, physicians, respiratory therapists, and physiotherapists.
  
  
  METHODS
  None.
  
  
  METHODS
  Perceived barriers, facilitators, knowledge, and practice patterns of early mobilization were assessed using a previously validated mobility survey tool.
  
  
  RESULTS
  The overall response rate was 50.0% (138 of 274). Early mobilization was not perceived as a top priority in 49% of respondents. Results showed that clinicians were not fully aware of the benefits of early mobilization as per the current literature. About 58% of clinicians did not feel well trained and informed to mobilize mechanically ventilated patients. Perceptions on patient-level barriers varied with clinicians' professional training, but there was a high degree of interprofessional and intraprofessional disagreement on the permissible maximal level activity in different scenarios of critically ill patients.
  
  
  CONCLUSIONS
  Our survey shows limited awareness, among our respondents, of the clinical benefits of early mobilization and high level of disagreement on the permissible maximal level of activity in the critically ill patients. Future studies should evaluate the role of knowledge translation in modifying these barriers and improving early mobilization.
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.|Research Center, Sacré-Coeur Hospital, Montreal, Quebec, Canada.|Center for Interdisciplinary Research in Rehabilitation in Montreal, Jewish Rehabilitation Hospital, Laval, Quebec, Canada.
authors.forename: David E
authors.initials: DE
authors.lastname: Anekwe
authors.affiliation: Department of Medicine, Western University, London, Ontario, Canada.|Swedish Medical Group, Seattle, Washington, DC, USA.
authors.forename: Karen Kin-Yue
authors.initials: KK
authors.lastname: Koo
authors.affiliation: Department of Adult Critical Care, Jewish General Hospital, Montreal, Quebec, Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: de Marchie
authors.affiliation: Adult Critical Care, McGill University Health Center, Royal Victoria Hospital, Montreal, Quebec, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Goldberg
authors.affiliation: Adult Critical Care, McGill University Health Center, Montreal General Hospital, Montreal, Quebec, Canada.
authors.forename: Dev
authors.initials: D
authors.lastname: Jayaraman
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.|Research Center, Sacré-Coeur Hospital, Montreal, Quebec, Canada.|Center for Interdisciplinary Research in Rehabilitation in Montreal, Jewish Rehabilitation Hospital, Laval, Quebec, Canada.
authors.forename: Jadranka
authors.initials: J
authors.lastname: Spahija
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D016638:Critical Illness / Q000628:therapy*; D003430:Cross-Sectional Studies; D004434:Early Ambulation; D006801:Humans; D007362:Intensive Care Units; D009726:Nurses; D059825:Physical Therapists; D010820:Physicians; D010818:Practice Patterns, Physicians'; D011792:Quebec; D012138:Respiratory Therapy; D011795:Surveys and Questionnaires
keywords: barriers; clinical practice patterns; critical illness; early ambulation; intensive care units; physical therapy specialty