Review Article

Effectiveness, Safety, and Barriers to Early Mobilization in the Intensive Care Unit

Table 11

Strategies for overcoming barriers.

BarriersStrategies

Patient-related barriers
(i) Hemodynamic instability(i) Stepwise approach
(ii) Pain(ii) Pain management before mobilization
(iii) Deep sedation(iii) Regular assessment, lighter sedation
(iv) Agitation and delirium(iv) Assessment, antipsychotic medications
(v) Patient denial, lacking motivation(v) Patient education and encouragement
(vi) ICU equipment and devices(vi) Portable devices, secure lines, drains, and interdisciplinary teamwork

Structural barriers
(i) Limited staff(i) Additional staff, independent mobility team
(ii) Lack of protocols and limited guidelines(ii) Develop protocols, safety criteria
(iii) Limited equipment(iii) Training for appropriate use of equipment, financial, and the cost analysis model of economic benefit

Cultural barriers
(i) Lack of mobilization culture(i) Promotion of mobility programs
(ii) Early mobilization, not a priority(ii) Interprofessional education

Process-related barriers
(i) A dearth of coordination and planning(i) Regular screening of patients, interprofessional coordination, and planning
(ii) Risks for mobility providers(ii) Training, appropriate equipment, and mobility team