The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

PROGRESSIVE UPRIGHT MOBILITY (PUM) – GETTING CRITICAL CARE MOVING!

Christy Wright; Maury Regional Medical Center, Columbia, TN

Introduction: Our goal is to set a higher standard of care, and mobilize our adult critical care population quickly. The critical care stay in itself can decrease a patient’s physical conditioning level in a very short period of time. One day of strict bed rest requires two weeks of reconditioning to return a patient back to baseline. This also leads to cardiovascular deconditioning, respiratory infections, skin breakdown, renal complications, gastrointestinal complications and neurological complications. The importance of early mobility is evident. A multidisciplinary team was established including: nursing, respiratory care, physical therapy, critical care nurse practitioners, intensivists and lift team. A protocol was written and everyone’s roles were established. Critical Care’s Role in PUM protocol: As a respiratory therapist in the critical care unit, the patient’s airway safety is the number one priority. The idea of early mobilization of an intubated patient was a foreign thought. The protocol calls for respiratory therapists to be in charge of the airway throughout the whole mobility process. The nurse is really the driving force and has to do their part to get this protocol started once the patients are stable. Physical Therapy will also coordinate with nursing and respiratory. The Lift Team joins the process when mobility is to take place on each patient. The Lift Team is present for mobilization to help all staff and the patients for lifting support. The protocol is initiated with an order from the physician or nurse practitioner. RESULTS: Our ICU length of stay was decreased by 0.8 days. The mobility protocol improved clinical outcomes for our ventilated patients, decreased mortality rates, and decreased morbid complications. These clinical outcomes are all based on comparisons of the top 15% of best practice hospitals nationally. Financial outcomes for ventilator patient’s pre and post mobility protocol represented a savings of approximately $436,000. The results have been great for our patient’s in critical care. Sponsored Research - None