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Making Strides in Preventing ICU-Acquired Weakness: Involving Family in Early Progressive Mobility

Rukstele, Christina D. MSN, RN; Gagnon, Mary M. BSN, RN

doi: 10.1097/CNQ.0b013e31827539cc
Original Articles

As advances in research and technology expand our ability to optimize the short-term outcomes in critical illness, survivors are often left with long-term functional impairments. The complications of bed rest can be nearly as devastating as the illness itself. Prolonged periods of immobility during the acute phase of illness have been linked to severe weakness, self-care deficits, poor quality of life, and mortality in patients up to 5 years after discharge from the intensive care unit. Interventions targeted at early, progressive mobility have been shown to reduce the burden of these outcomes. Mobilizing the critically ill patient, however, requires an integrated approach.

Family presence has been described in the literature as providing a sense of personhood to patients. Involvement of key figures may yield purpose to nursing interventions, beyond the pathophysiological rationale. Conversely, having a family member in the intensive care unit can be frightening and leave a loved one feeling hopeless and helpless. Family engagement has been suggested to provide added opportunities for education and tangible knowledge about the patient's condition. Such an approach may be the fuel in motivating patients and families toward a meaningful recovery. Therefore, this article describes the process of incorporating family into an intensive care unit early, progressive, mobility protocol.

Intermediate Care and General Surgery/Medicine, University of Michigan Health System, Ann Arbor (Ms Rukstele); and Surgical Intensive Care Unit, University of Michigan Health System, Ann Arbor (Ms Gagnon).

Correspondence: Christina D. Rukstele MSN, RN, University of Michigan Health System, 1500 E. Medical Center Dr, Ann Arbor, MI 48109 (

The authors thank the University of Michigan staff and leadership in the Surgical Intensive Care Unit. The authors also thank them for their continued commitment to “doing the right thing.”

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

© 2013 Lippincott Williams & Wilkins, Inc.