ABSTRACT
BACKGROUND: Staff in the surgical intensive care unit (SICU) had several concerns about mobilizing patients receiving mechanical ventilation. OBJECTIVE: To assess and improve the mindset of SICU staff toward early mobilization of patients receiving mechanical ventilation before, 6 months after, and 1 year after implementation of early mobilization. METHODS: The Plan-Do-Study-Act model was used to guide the planning, implementation, evaluation, and interventions to change the mindset and practice of SICU staff in mobilizing patients receiving mechanical ventilation. Interventions to overcome barriers to early mobilization included interdisciplinary collaboration, multimodal education, and operational changes. The mindset of the SICU staff toward early mobilization of patients receiving mechanical ventilation was assessed by using a survey questionnaire distributed 2 weeks before, 6 months after, and 1 year after implementation of early mobilization. RESULTS: The median score on 6 of 7 survey questions changed significantly from before, to 6 months after, to 1 year after implementation, indicating a change in the mindset of SICU staff toward early mobilization of patients receiving mechanical ventilation. The SICU staff agreed that most patients receiving mechanical ventilation are able to get out of bed safely with coordination among personnel and that early mobilization of intubated patients decreases length of stay and decreases occurrence of ventilator-associated pneumonia, deep vein thrombosis, and skin breakdown. CONCLUSIONS: SICU interdisciplinary team collaboration, multimodal education, and operational support contribute to removing staff bias against mobilizing patients receiving mechanical ventilation.
Subject(s)
Attitude of Health Personnel , Critical Care Nursing/methods , Critical Care/methods , Early Ambulation/methods , Respiration, Artificial , Adult , Humans , Middle Aged , Surveys and Questionnaires , Young AdultABSTRACT
Using remote video auditing (RVA) and real-time feedback, we replicated health care workers hand hygiene in a second intensive care unit. During the first 4 weeks using RVA without feedback, the compliance rate was 30.42%. The rate during the 64-week postfeedback period (initial 16 and 48 weeks maintenance) with RVA and feedback exceeded 80% on average. These data demonstrate that improved hand hygiene was achieved and sustained with the use of RVA and feedback.
