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Amanda McRae
1 posts
Re:Topic 3 DQ 1
1.Berg, B., McMahon, P., & Ronnebaum, J. (2010). Use of mobility protocol decreases the length of stay in the intensive care unit. Journal Of Acute Care Physical Therapy (Acute Care Section - APTA, Inc.), 1(1), 41.
· The purpose of this study is to assess the effectiveness of a Mobility Protocol for patients with respiratory failure in the ICU. It will also assess the implementation of the Mobility Protocol across different medical diagnosis. The study includes a stratified sampling of 100 patients that were admitted to the ICU over the past year for the group with the implementation of the Mobility Protocol and the year prior to the implementation of the mobility protocol.
With this study using stratified sampling and examining outcomes in individuals with both respiratory failure as well different medical diagnosis, I feel it will support sufficient evidence for my practice change proposal. Unfortunately, I’m realized the article may be too old, as it was published in 2010.
2. Clark, D. E., Lowman, J. D., Griffin, R. L., Matthews, H. M., & Reiff, D. A. (2013). Effectiveness of an Early Mobilization Protocol in a Trauma and Burns Intensive Care Unit: A Retrospective Cohort Study. Physical Therapy, 93(2), 186-196. doi:10.2522/ptj.20110417
· The purpose of this study is to assess the effects of an early mobilization protocol on complication rates, ventilator days, and ICU and hospital length of stay for patients admitted to a trauma and burn ICU. This was a retrospective cohort study of an interdisciplinary quality- improvement program.
This article should support my practice change as it specifically examines positive effects of early mobilization has on complication rates, ventilator days, and length of stay. A disadvantage of this is that as a retrospective cohort study, some key statistics are unable to be measured.
3. Drolet, A., DeJuilio, P., Harkless, S., Henricks, S., Kamin, E., Leddy, E. A., & ... Williams, S. (2013). Move to Improve: The Feasibility of Using an Early Mobility Protocol to Increase Ambulation in the Intensive and Intermediate Care Settings. Physical Therapy, 93(2), 197-207. doi:10.2522/ptj.20110400
· The purpose of this study is to determine the effectiveness of a nurse-driven Mobility Protocol to increase the percentage of patients ambulating during the first 72 hours of their hospital stay. A quasi-experimental design was used before and after intervention.
This article should support my proposal as it examines the feasibility of a Mobility Protocol that is nurse-driven, and whether this can be successfully done within 72 hours of patient admission using this method. The disadvantage is that in a quasi-experimental design, there is a lack of random assignment, which can bring to question a study’s validity.
4. Guiyab, M., Leger, C., Smith, O., Mustard, M., Paramalingam, V., Savedra, P., & Swift, S. (2016). Development of an Early Mobility Protocol for Critical Care. Canadian Journal of Critical Care Nursing, 27(2), 38.
· The purpose of this study is to develop and implement an interdisciplinary critical care early Mobility Protocol that promotes the initiation of safe mobilization of medically stable patients within 24-48 hours of ICU admission. The mobility protocol used in this study will also guide mobility progression during the patient’s stay in the ICU, and facilitate communication among clinicians in regards to patient mobility.
This study supports my proposal as it examines the development of an interdisciplinary Mobility Protocol to be initiated within 24-48 hours of admission. The downside is how the study will decide if the patient is considered medically stable, and if this will hinder the EBP proposal in comparison to what the study supports versus the proposal itself for the patient population that is found to safely mobilize early.
5. Ronnebaum, J. A., Weir, J. P., & Hilsabeck, T. A. (2012). Earlier Mobilization Decreases the Length of Stay in the Intensive Care Unit. Journal Of Acute Care Physical Therapy (Acute Care Section - APTA, Inc.), 3(2), 204-210.
· The purpose of this study is to compare the effectiveness of two protocols, Mobility Protocol, and Standard Physical Therapy, for patients with respiratory failure in the ICU. This study is a retrospective review of 28 charts of patients admitted to the ICU with a diagnosis of respiratory distress.
This study supports my proposal as it compares patient outcomes utilizing Mobility Protocol versus Standard Physical Therapy. It is however questionable in the validity of the study as to how the 28 patient charts were chosen.
6. Winkelman, C., Johnson, K. D., Hejal, R., Gordon, N. H., Rowbottom, J., Daly, J., & ... Levine, (2012). Examining the positive effects of exercise in intubated adults in ICU: A prospective repeated measures clinical study. Intensive & Critical Care Nursing, 28(6), 307-318. doi:10.1016/j.iccn.2012.02.007
· This study compared standard care with care delivered using a Mobility Protocol. It examined the effects of exercise on vital signs and inflammatory biomarkers and the effects of the nurse-initiated Mobility Protocol on outcomes.
This study supports my proposal as it compares the Mobility Protocol with the standard care, and examines specific patient outcomes of both such as vital signs and inflammatory markers. The questionable part of this study is the patient population used, and if their specific condition will affect the results of their vital signs and biomarkers.