Staff Perceptions of the Barriers to Mobilizing ICU Patients

Purpose: Whilst early progressive mobilization is known to be safe and beneficial for patients in an intensive care unit (ICU), barriers still exist to its implementation. As part of a broader quality improvement project that had the overall aim of increasing the frequency of mobilization in our ICU, we conducted a survey of ICU staff to investigate their perceptions of the barriers to the early progressive mobilization of ICU patients. Method: A prospective survey of ICU staff in an Australian, tertiary care, public hospital ICU was undertaken. A total of 93 medical, nursing, and physiotherapy staff participated. A purpose-designed survey that investigated staff perceptions of the barriers to the early progressive mobilization of ICU patients was developed. The survey predominantly comprised closed statements requiring responses using a visual analogue scale. Barriers to early progressive mobilization were separated into three sections: patient-related, institutional-related, and other barriers. Results: Patient-related barriers were generally perceived as having the greatest influence on the mobilization of ICU patients, followed closely by institutional-related barriers. The factors that were perceived as most frequently preventing mobilization were hemodynamic instability, reduced level of consciousness, sedation, agitation, impending medical procedure, staff availability, and time constraints. Conclusions: ICU staff perceived that barriers to the early progressive mobilization of ICU patients were multifactorial and most frequently involved patients’ medical condition and resource limitations.