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American Journal of Critical Care. 2009;18: 212-221 doi:10.4037/ajcc2009598
Copyright © 2009 by the American Association of Critical-Care Nurses.
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Early Mobility and Walking Program for Patients in Intensive Care Units: Creating a Standard of Care

By Christiane Perme, PT, CCS and Rohini Chandrashekar, PT, MS, CCS. Christiane Perme is a senior physical therapist at Methodist Hospital in Houston, Texas. Rohini Chandrashekar is a physical therapist at Triumph Hospital, Clear Lake, in Webster, Texas.

Corresponding author: Christiane Perme, PT, CCS, Department of Physical and Occupational Therapy, Methodist Hospital (M1-024), 7575 Fannin, Houston, TX 77030 (e-mail: cperme{at}tmhs.org).

New technologies in critical care and mechanical ventilation have led to long-term survival of critically ill patients. An early mobility and walking program was developed to provide guidelines for early mobility that would assist clinicians working in intensive care units, especially clinicians working with patients who are receiving mechanical ventilation. Prolonged stays in the intensive care unit and mechanical ventilation are associated with functional decline and increased morbidity, mortality, cost of care, and length of hospital stay. Implementation of an early mobility and walking program could have a beneficial effect on all of these factors. The program encompasses progressive mobilization and walking, with the progression based on a patient’s functional capability and ability to tolerate the prescribed activity. The program is divided into 4 phases. Each phase includes guidelines on positioning, therapeutic exercises, transfers, walking reeducation, and duration and frequency of mobility sessions. Additionally, the criteria for progressing to the next phase are provided. Use of this program demands a collaborative effort among members of the multidisciplinary team in order to coordinate care for and provide safe mobilization of patients in the intensive care unit.


Related articles in AJCC:

Achieving Early Mobility in Mechanically Ventilated Patients
Linda Bell
AJCC 2009 18: 222. [Full Text]  





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Copyright © 2009 by the American Association of Critical-Care Nurses.