Early mobilisation in Windhoek intensive care units: Practices, attitudes and barriers.

Abstract

Background: Early mobilisation (EM) of critically ill patients in intensive care units (ICUs) has gained significant attention because of its potential to improve patient outcomes. Despite the recognised benefits of EM, implementation remains inconsistent.

Objectives: To describe the knowledge, attitudes and practices of healthcare professionals regarding EM of critically ill patients in Windhoek.

Method: A descriptive, cross-sectional design using a self-administered survey was conducted in Windhoek, Namibia, targeting nurses, doctors and physiotherapists working in private ICUs.

Results: A total of 174 surveys were distributed, with a response rate of 24.1% (n = 42). Respondents included 21 nurses, 5 doctors and 13 physiotherapists. Most participants underestimated the incidence of ICU-acquired weakness and reported unfamiliarity with EM literature (n = 19, 51.4%). Furthermore, 25 respondents (67.6%) reported that patients were not automatically assessed for mobilisation, the majority reported requiring a doctor's referral (n = 31, 83.8%). Mobility practices were conservative, especially when patients were intubated or in the presence of radial and femoral catheters. Major patient-level barriers included medical instability (n = 24, 72.7%) and excessive sedation (n = 18, 54.5%); whereas institutional barriers were the requirement for a doctor's referral (n = 22, 64.7%) and no written guidelines or protocols for mobilisation (n = 16, 47.1%). Provider level barriers were that mobility is not perceived as important by some individuals (n = 18, 78.3%).

Conclusion: Our study revealed knowledge gaps, conservative mobility practices and numerous barriers to EM implementation at the patient, provider and institutional levels.

Clinical implications: The findings highlight the need for targeted education, training programmes, standardised mobility protocols and the establishment of a dedicated mobility champion to promote EM in Windhoek ICUs.