CHAPTER 2 : REVIEW OF LITERATURE
2.1 REVIEW OF RELEVANT STUDIES
The emerging themes noted throughout the research were safety of mobilization of critically ill patients, the effect of bed rest and various methods of repositioning on LOS and the effectiveness of a nurse-driven mobility protocol. Nursing staff or physical therapists can provide early mobilization in the ICU; however physical therapists are not always available in ICU. Any measure of mobility milestones in the ICU must be feasible, valid and reliable across both nursing and physical therapy disciplines. A previous survey suggested that few physical therapists use any specific instrument to evaluate mobility in ICU (Skinner, Berney, Warrillow, & Denehy, 2008).
Evidence from
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Kinetic therapy is better known as continuous side-to-side turning utilizing specialty patient beds. The study included 234 critically ill patients in the ICU with perfusion/ventilation (P/F) ratios less than 250, Glasgow Coma Scale score less than 11, and those patients requiring mechanical ventilation. Kinetic therapy was compared with standard repositioning. The study concluded the incidence of pneumonia was lower in the patient who received kinetic therapy versus standard repositioning. Significant differences in LOS were noted, and the cost of stay was less with kinetic therapy group. However, this study pointed out that kinetic therapy did not directly impact length of stay …show more content…
Nurses often depend on physical therapy to do even the simplest of mobility tasks, such as range of motion. However they are not regularly available. According to Bassett, Vollman, Brandwene, & Murray,(2012), barriers to the promotion of early mobility include clinicians’ knowledge deficits, sedation practices, lack of staff and equipment resources, patient physiologic instability and established ICU culture. Altering well-established routines and patterns of care requires a comprehensives approach to instituting not only individual behaviour change, but also a system that support a shift in group