Patient, Practice, and Organizational Factors Associated With Early Mobility Performance in Critically Ill Adults.
Background: Adoption of early mobility interventions into intensive care unit (ICU) practice has been slow and varied. Objectives: To examine factors associated with early mobility performance in critically ill adults and evaluate factors' effects on predicting next-day early mobility performance. M...
| Publicado en: | American Journal of Critical Care Vol. 33; no. 5; pp. 324 - 334 |
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| Autores principales: | , , , , , , , , |
| Formato: | CEU research Journal Article |
| Publicado: |
American Association of Critical-Care Nurses
Sep2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=179362538&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 179362538 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10623264 44L jtl: American Journal of Critical Care issn: 10623264 maglogo: N pubinfo: dt: Sep2024 vid: 33 iid: 5 pid: 2559 pub: American Association of Critical-Care Nurses place: Alisa Veijo, California artinfo: ui: 179362538 179362538 179362538 10.4037/ajcc2024939 179362538 ppf: 324 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Patient, Practice, and Organizational Factors Associated With Early Mobility Performance in Critically Ill Adults. aug: au: Krupp, Anna E. Tan, Alai Vasilevskis, Eduard E. Mion, Lorraine C. Pun, Brenda T. Brockman, Audrey Hetland, Breanna Ely, E. Wesley Balas, Michele C. affil: an assistant professor, College of Nursing, University of Iowa, Iowa City sug: subj: Critically Ill Patients In Adulthood Early Ambulation Physical Mobility Task Performance and Analysis Human Male Female Adult Secondary Analysis Descriptive Statistics Data Analysis Software Odds Ratio Confidence Intervals Logistic Regression Intensive Care Units Education, Continuing (Credit) Adult: 19-44 years Male Female ab: Background: Adoption of early mobility interventions into intensive care unit (ICU) practice has been slow and varied. Objectives: To examine factors associated with early mobility performance in critically ill adults and evaluate factors' effects on predicting next-day early mobility performance. Methods: A secondary analysis of 66 ICUs' data from patients admitted for at least 24 hours. Mixed-effects logistic regression modeling was done, with area under the receiver operating characteristic curve (AUC) calculated. Results: In 12 489 patients, factors independently associated with higher odds of next-day mobility included significant pain (adjusted odds ratio [AOR], 1.16; 95% CI, 1.09–1.23), documented sedation target (AOR, 1.09; 95% CI, 1.01–1.18), performance of spontaneous awakening trials (AOR, 1.77; 95% CI, 1.59–1.96), spontaneous breathing trials (AOR, 2.35; 95% CI, 2.14–2.58), mobility safety screening (AOR, 2.26; 95% CI, 2.04–2.49), and prior-day physical/occupational therapy (AOR, 1.44; 95% CI, 1.30–1.59). Factors independently associated with lower odds of next-day mobility included deep sedation (AOR, 0.44; 95% CI, 0.39–0.49), delirium (AOR, 0.63; 95% CI, 0.59–0.69), benzodiazepine administration (AOR, 0.85; 95% CI, 0.79–0.92), physical restraints (AOR, 0.74; 95% CI, 0.68–0.80), and mechanical ventilation (AOR, 0.73; 95% CI, 0.68–0.78). Black and Hispanic patients had lower odds of next-day mobility than other patients. Models incorporating patient, practice, and between-unit variations displayed high discriminant accuracy (AUC, 0.853) in predicting next-day early mobility performance. Conclusions: Collectively, several modifiable and nonmodifiable factors provide excellent prediction of next-day early mobility performance. pubtype: Academic Journal doctype: CEU research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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