Exploring Facilitators and Barriers to Early Mobility in the ICU in Patients Post-Cardiovascular Procedures

Research Objectives: Explore what staff perceived barriers and facilitators to early mobility are within the intensive care unit among patients post cardiovascular procedures

Design: Convergent parallel mixed methods design

Setting: ICU within a tier 3 trauma hospital

Participants: ICU staff members responsible for direct patient care

Interventions: Interventions: Not applicable.

Main Outcome Measures: Time elapsed from patient ICU admission to initial mobility

Results: Five major themes and six subthemes emerged from a thematic analysis. Three themes identified facilitators to mobility and two themes described barriers. Simple correlations and logistic regressions were calculated among variables that predicted influence on timing of mobility. Patient variables that influenced early mobility that reached statistical significance were procedure type (p=.004), presence of surgical precautions (p <.001) and number of lines and tubes (p <.001). Patient's tolerance to mobility and discharge destination were marginally significant in affecting mobility timing after procedure. There was a monotonic linear relationship with number of comorbidities and timing of mobility. The statistically significant variables were validated through triangulation with the major themes and subthemes that emerged from the structured interviews among the ICU staff.

Conclusions: There was successful triangulation using quantitative data to support major qualitative themes. The ICU staff were intuitive to the barriers and facilitators to early mobility. The staff identified barriers to mobility that were found to be statistically significant in affecting mobility. Patients who required more time to engage in mobility were most likely to have undergone more invasive procedures, had more restrictive precautions and required more medical attention that monitored/managed hemodynamic status. Patients with a greater number of medical problems such as other physiological, musculoskeletal and/or psychological comorbidities took longer to partake in mobility.

Author(s) Disclosures: None reported