This reduced length of stay included a reduction of time in the medical intensive care unit (ICU) of more than a day. Initial therapy - called passive range of motion - was provided by nursing assistants who flexed the joints of the patients´ upper and lower limbs three times a day, seven days a week.
As patients progressed, they received more advanced physical therapy from a physical therapist. The therapy proved safe, and there was also no addition to hospital costs because the salaries of the employees who provided mobility therapy were offset by reduced lengths of stay in the hospital, according to Peter Morris, M.D., lead investigator and associate professor in the Section on Pulmonary, Critical Care, Allergy and Immunologic Diseases at Wake Forest University Baptist Medical Center.
Immobility and the resulting loss of physical conditioning are common problems for patients with respiratory failure, which means they cannot breathe without the assistance of a ventilator, said Morris. However, little data exist on whether early mobility therapy for ICU patients is associated with improved outcomes or cost benefits. “The project confirms that it is safe to administer early mobility to ICU patients and that it is of benefit”, Morris said.
During the two year study respiratory-failure patients admitted to the Medical Center´s ICUs were assigned to one of two groups: 165 to a protocol group, which received early therapy from a mobility team (a critical care nurse, a nursing assistant and a physical therapist), and 165 to a control group, which received usual care. Once patients were transferred to a regular nursing unit, both groups received usual care. In addition to shorter hospital stays, the protocol patients also progressed more quickly to active physical therapy, were out of bed earlier and experienced no adverse events during an ICU therapy session.
MEDICA.de; Source: Wake Forest University Baptist Medical Center