A survey of healthcare providers about the feasibility and implementation of early mobilisation of patients in critical care units in a Lebanese hospital

Abstract

Background

Many survivors of critical care experience complications from bed rest after recovering from the acute phase. Early mobilisation helps patients recover faster. However, anecdotal evidence suggests that patients in critical care units are rarely mobilised.

Aim

The aims of the study were to assess the feasibility of early mobilisation of patients in intensive care units from the clinicians' perspective in a Lebanese hospital during the COVID-19 pandemic, identify associated institutional factors, and describe the knowledge, attitude, practices, and perceived barriers to early mobilisation among Lebanese clinicians.

Methods

A descriptive correlational design was used. Forty-nine healthcare providers (response rate: 41%) who work in critical care at a tertiary medical centre in Lebanon were recruited. Data were collected online via LimeSurvey using the Modified Mobility Survey Questionnaire. Descriptive statistics, bivariate correlations, and hierarchical multiple linear regression were used.

Results

Most respondents were nurses, and also included two physicians, four physiotherapists, and four respiratory therapists. Most respondents (67%) perceived early mobility to be crucial or very important, but only 33% thought its implementation was feasible. Many patient, provider, and institutional barriers to implementation were identified. Most clinicians thought that mobility must be started early, but 60% reported lack of training in mobilisation and identified patient instability, safety concerns, and lack of guidelines as barriers. Lack of equipment (unstandardised regression coefficient B = −0.87, 95% confidence interval = −1.7, −0.05; p = 0.039) and lack of guidelines (B = −0.67, 95% confidence interval = −1.37, 0.04; p = 0.063) were associated with lower feasibility of implementing early mobility in the multivariable analysis.

Conclusion

Despite appreciating benefits of early mobility, the respondents identified many barriers to its implementation. The findings suggest the need for staff education and training in early mobility and development of a multidisciplinary protocol on mobilisation. In addition, the needed human and physical resources ought to be assessed.