Early mobilisation and rehabilitation in the PICU: a UK survey
Authors
Menzies, Julie C
Brush, Emily Clare
Ryde, Francesca
Brett, Stephen
Moore, David J
Geary, Michelle
Morris, Kevin P
Parslow, Roger Charles
Feltbower, Richard G
Lockley, Sophie
Kirkham, Fenella J
Scholefield, Barnaby R
Publication Date
2022-06Journal Title
BMJ Paediatrics Open
ISSN
2399-9772
Publisher
BMJ
Volume
6
Issue
1
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Thompson, J. Y., Menzies, J. C., Manning, J. C., McAnuff, J., Brush, E. C., Ryde, F., Rapley, T., et al. (2022). Early mobilisation and rehabilitation in the PICU: a UK survey. BMJ Paediatrics Open, 6 (1) https://doi.org/10.1136/bmjpo-2021-001300
Abstract
<jats:sec><jats:title>Objective</jats:title><jats:p>To understand the context and professional perspectives of delivering early rehabilitation and mobilisation (ERM) within UK paediatric intensive care units (PICUs).</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>A web-based survey administered from May 2019 to August 2019.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>UK PICUs.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>A total of 124 staff from 26 PICUs participated, including 22 (18%) doctors, 34 (27%) nurses, 28 (23%) physiotherapists, 19 (15%) occupational therapists and 21 (17%) were other professionals.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Key components of participants’ definitions of ERM included tailored, multidisciplinary rehabilitation packages focused on promoting recovery. Multidisciplinary involvement in initiating ERM was commonly reported. Over half of respondents favoured delivering ERM after achieving physiological stability (n=69, 56%). All age groups were considered for ERM by relevant health professionals. However, responses differed concerning the timing of initiation. Interventions considered for ERM were more likely to be delivered to patients when PICU length of stay exceeded 28 days and among patients with acquired brain injury or severe developmental delay. The most commonly identified barriers were physiological instability (81%), limited staffing (79%), sedation requirement (73%), insufficient resources and equipment (69%), lack of recognition of patient readiness (67%), patient suitability (63%), inadequate training (61%) and inadequate funding (60%). Respondents ranked reduction in PICU length of stay (74%) and improvement in psychological outcomes (73%) as the most important benefits of ERM.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>ERM is gaining familiarity and endorsement in UK PICUs, but significant barriers to implementation due to limited resources and variation in content and delivery of ERM persist. A standardised protocol that sets out defined ERM interventions, along with implementation support to tackle modifiable barriers, is required to ensure the delivery of high-quality ERM.</jats:p></jats:sec>
Keywords
Intensive care, 1506, rehabilitation, epidemiology
Sponsorship
Health Technology Assessment Programme (17/21)
National Institute for Health Research (NIHR) (17/21/ HTA)
Identifiers
bmjpo-2021-001300
External DOI: https://doi.org/10.1136/bmjpo-2021-001300
This record's URL: https://www.repository.cam.ac.uk/handle/1810/338069
Rights
Licence:
https://creativecommons.org/licenses/by/4.0/
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