Early Progressive Mobility in the CVICU: Assessing Current Status

• ICU LOS [ Time Frame: Days ] [ Designated as safety issue: No ]
  Length of stay will be measured
• Type and Frequency of PM orders [ Time Frame: Daily ] [ Designated as safety issue: No ]
  The type and frequency of Progressive mobility orders will be assessed

The current study is proposed to assess the frequency and type of progressive mobility procedures currently performed in the CVICU The study will evaluate the type and frequency of progressive mobility orders, whether or not progressive mobility steps are being taken by the nursing teams, define what steps patients are receiving, and record time to first weight bearing. Other outcome measures will be the days of required mechanical ventilation, and current ICU length of stay and cost to treat.

This will be a descriptive 4 month study of standard care practice. Patients who meet the inclusion / exclusion criteria for study will be enrolled (Waiver of informed consent is requested) and followed for a maximum of 28 days. The type and frequency of progressive mobility orders, whether or not progressive mobility steps are being taken by the nursing teams, define what steps patients are receiving, and record time to first weight bearing will be recorded. Weight bearing will be defined as standing for at least 1 minute. ICU LOS, Ventilator Days will be assessed at ICU discharge for study patients. Barriers to PM procedures will also be assessed.

The study population will consist of patients admitted to the CV-Intensive Care Unit.

Inclusion Criteria:

• Patient is ≥ 18 years old.
• Patient has been admitted to the ICU for less than 3 days prior to study enrollment
• Patients require mechanical ventilation for >48 hours

Exclusion Criteria:

• Mobilization is contraindicated by Patient's condition. Such as hip fractures or other injury that would impede standing posture.
• Patient weighs less than 70 pounds or more than 440 pounds
• Mobilization is contraindicated by patient's condition or physician's orders exist that prevent the patient from participating in the mobility protocol.
• Patient was unable to walk or stand without assistance prior to ICU admission.
• Patient was cognitively unable to follow verbal commands prior to ICU admission.
• Patients current diagnosis includes acute stroke with neurologic impairment
• Patient's current diagnosis includes drug overdose.
• Patient has "Do not resuscitate" orders and/or is at an end stage terminal disease state.
• Patient requires a specialty bed or mattress.