Intensive care unit mobility practices in Australia and New Zealand: A point prevalence study

Abstract

Objectives: To develop a comprehensive set of items describing physiotherapy mobilisation practices for critically ill patients, and to document current practices in intensive care units in Australia and New Zealand, focusing on patients having >48 hours of mechanical ventilation. Design: Prospective, observational, multicentre, single-day, point prevalence study. Participants and setting: All patients in 38 Australian and New Zealand ICUs at 10 am on one of three designated days in 2009 and 2010. Main outcome measures: Demographic data, admission diagnosis and mobilisation practices that had occurred in the previous 24 hours. Results: 514 patients were enrolled, with 498 complete datasets. Mean age was 59.2 years (SD, 16.7 years) and 45% were mechanically ventilated. Mobilisation activities were classified into five categories that were not mutually exclusive: 140 patients (28%) completed an in-bed exercise regimen, 93 (19%) sat over the side of the bed, 182 (37%) sat out of bed, 124 (25%) stood and 89 (18%) walked. Predefined adverse events occurred on 24 occasions (5%). No patient requiring mechanical ventilation sat out of bed or walked. On the study day, 391 patients had been in ICU for > 48 hours. There were 384 complete datasets available for analysis and, of these, 332 patients (86%) were not walked. Of those not walked, 76 (23%) were in the ICU for >/=7 days. Conclusion: Patient mobilisation was shown to be low in a single-day point prevalence study. Future observational studies are required to confirm the results.