Earlier mobilization of patients in the intensive care unit (ICU) improves outcomes and decreases the length of stay in the hospital. Not all facilities are adhering to this approach due to concern regarding patient safety and/or medical clearance. The purpose of this study was to compare the effectiveness of two protocols (Mobility Protocol (MP), and Standard Physical Therapy (SPT)) for patients with respiratory failure in the ICU.
This study was a retrospective review of 28 charts of patients admitted to the intensive care unit with a diagnosis of respiratory distress. Patients qualifying for the MP group were compared with patients in the SPT on total days in the ICU, time spent on the ventilator, and days before physical therapy was ordered. The MP is an interdisciplinary approach to care for patients in the intensive care unit.
The patients on the MP protocol spent a mean (± SD) of 13.3 ± 6.3 days in the ICU compared with patients on the SPT protocol who spent 24.9 ± 13.7 days (p=.007, d=1.11). Time spent on the ventilator for the MP group was 14.5 ± 8.7 days compared with 30.9 ± 20.0 days for the SPT group (p=.007, d=1.09). Physical Therapy was ordered on average 1.9 days earlier for those patients in the MP group relative to those in the SPT group.
Early mobilization in the ICU with an interdisciplinary approach improved outcomes in the ICU for patients with respiratory distress. This approach led to decreased days spent the ICU and decreased days spent on the ventilator, equating to a savings of $22,000 per patient in the ICU.