经济欠发达国家早期多专业动员对重症监护质量指标的影响：巴西的 "康复 2030 "行动：巴西早期动员的效果。

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation Pub Date : 2025-01-01 DOI:10.1016/j.apmr.2024.08.010

Thaís Marina Pires de Campos Biazon PhD , Henrique Pott Jr. PhD , Flávia Cristina Rossi Caruso PhD , José Carlos Bonjorno Jr. PhD , Viviane Castello-Simões PhD , Maria Thereza Bugalho Lazzarini MD , Mariana Taconelli SD , Audrey Borghi-Silva PhD , Renata Gonçalves Mendes PhD

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引用次数: 0

摘要

摘要调查在巴西实施早期多专业动员对重症监护质量指标的影响：这是一项回顾性队列研究：地点：巴西一家教育和研究型重症监护病房（ICU）：2016年5月至2018年4月住院的1047名患者：通过MobilizAÇÃO计划（MAP）实施早期多专业动员.主要结果测量：临床、通气和安全质量指标，以及MAP实施前（计划实施前）和实施后（计划实施后）的身体功能：结果：镇静时间（4 天对 1 天）、住院时间（21 天对 14 天）、重症监护室住院时间（14 天对 7 天）、机械通气时间（8 天对 4 天）、住院死亡率（46% 对 26%）均有所减少（p 结论：通过改变低位截瘫患者的生活方式来实施早期动员，可以减少患者的住院时间：通过改变低移动性文化和多专业行动，早期实施移动改善了质量指标，包括临床、通气和身体功能质量，同时不影响重症监护室的患者安全。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Effect of Early Multiprofessional Mobilization on Quality Indicators of Intensive Care in a Less Economically Developed Country: An Action on “Rehabilitation 2030” in Brazil

Objective

To investigate the effects of implementing early multiprofessional mobilization on quality indicators of intensive care in Brazil.

Design

This is a retrospective cohort study.

Setting

A Brazilian educational and research-intensive care unit (ICU).

Participants

A total of 1047 patients were hospitalized from May 2016 to April 2018.

Interventions

Implementation of early multiprofessional mobilization using the MobilizAÇÃO Program (MAP).

Main Outcome Measures

Clinical, ventilation and safety quality indicators, and physical function before (preprogram period) and after (postprogram period) the MAP.

Results

There was a reduction in sedation time (4 vs 1d), hospital stay (21 vs 14d) and ICU stay (14 vs 7d), mechanical ventilation (8 vs 4d), hospital death rate (46% vs 26%) (P<.001), and ICU readmission (21% vs 16%; P=.030) from pre to post MAP. Successful weaning (42% vs 55%) and discharge rate (50% vs 71%) (P<.001) increased after MAP. No differences were found to safety quality indicators between periods. After MAP, complex physical functions assessed using the Manchester Mobility Score (MMS) were more frequent. The in-bed intervention was a predictor for readmission (P=.009; R²=0.689) and death (P=.035; R²=0.217), while walking was a predictor for successful weaning (P=.030; R²=0.907) and discharge (P=.033; R²=0.373). The postprogram period was associated with the MMS at ICU discharge (P<.001; R²=0.40).

Conclusions

Early mobilization implementation through changes in low mobility culture and multiprofessional actions improved quality indicators, including clinical, ventilation, and physical functional quality, without compromising patient safety in the ICU.

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来源期刊

Archives of physical medicine and rehabilitation 医学-康复医学

CiteScore

6.20

自引率

4.70%

发文量

495

审稿时长

38 days

期刊介绍： The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.