Date of Graduation

Winter 12-17-2021

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Susan Mortell, DNP, RN, CNL

Second Advisor

Robin Jackson, MSN, MA, RN, OCN, CNL

Abstract

The Motivated2Move: ICU Liberation and Early Progressive Mobility in Ventilated Patients project was implemented in a 24-bed intensive care unit (ICU) in a 241-bed general care, stroke certified not-for-profit community hospital in northern California. The primary purpose of this project was to educate the nurses on the structure and implementation of the Society of Critical Care Medicine’s evidence-based ICU Liberation (ABCDEF) Bundle (Society of Critical Care Medicine, n.d.). A secondary purpose of this project was to coordinate an early progressive exercise and mobility protocol for all ventilated patients. The primary goal of the project is 100% compliance with the ICU Liberation Bundle elements and documentation and 100% compliance with the early and progressive exercise and mobility protocol as evidenced by all eligible ventilated patients on a documented mobility regimen beginning with bed mobility and leading to a minimum mobility level of out of bed to a reclining chair.

ICU-acquired delirium, post-intensive care syndrome (PICS), and ICU-acquired weakness are manageable conditions all critically ill patients are at risk for. Studies show that 20-50% of all critically ill patients and 50-80% of mechanically ventilated patients are at risk for ICU-acquired delirium, weakness, and PICS. Negative outcomes include increased length of ICU and hospital stay, higher cost, increased mortality, and long-term cognitive, social, and physical deficits (Society of Critical Care Medicine, 2018).

Early progressive mobility of ventilated patients shows a decrease in ICU-acquired delirium and PICS, and increase in function, and decrease in overall ventilator days and length of ICU stay (Hopkins et al., 2016). The global goal of this project is to develop a structured early mobility program with a strong multi-disciplinary team to champion early mobility with measurable outcomes.

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