The Study Status And Influencing Factors Of Early Mobilization In ICU

Critical care medicine is a place for intensive care and treatment of severe patients.With the continuous development of medical technology,the survival rate of critically ill patients has improved significantly.However,these critically ill patients suffer from a series of physiological and psychological complications caused by long-term immobilization,which seriously affect the quality of life and physical function of critically ill patients.Only understanding the barriers and influencing factors that impede the early activities of critically ill patients can early mobilization be carried out effectively in the ICU.Therefore,it is necessary to explore the current status of early mobilization and the causes and influencing factors of early stage mobilization in critically ill patients.Objective: To investigate the states of early mobilization of critically ill patients in Critical Care Medicine department of the First Hospital of Lanzhou University,and to identify the barriers hindering the early mobilization of critically ill patients,and to explore the influencing factors of early mobilization of ICU patients.Methods: Using convenience sampling method,290 patients were selected in ICU of the First Hospital of Lanzhou University from October 2016 to October 2017.According to the purpose of the study,we designed the record of the early mobilization of the critically ill patients.To carry out cross-sectional study,researchers recorded the baseline data of patients included in this study,activity time and the prevalence of early mobilization among ICU patients,immobilization barriers,hospitalization time,mechanical ventilation time and clinical medication,and to explore the influencing factors of early mobilization of ICU patients.Results: The rate of the early mobilization of ICU patients in the First Hospital of Lanzhou University was low,the rate of the early mobilization in ICU patients with mechanical ventilation was 19.15%(36/188),and the rate of the early mobilization in ICU patients with non mechanical ventilation was 23.5%(24/102).The rate with tracheal intubation was 5.31%(10/188),The first early activity time of out of bed in patients with mechanical ventilation was 6.5(3,9),patients without mechanical ventilation was 3(2,3).The main barriers to the early mobilization of ICU patients with mechanical ventilation were tracheal intubation and sedation,and the top 5 barriers were tracheal intubation,sedation,postoperative,circulatory instability,and CRRT.The main barriers of the ICU patients without mechanical ventilation is the lack of doctors' support,ranked in the top 5 barriers are: lack of physician support and circulatory system instability,nurses' attitudes and beliefs,after surgery,CRRT.The results of Poisson regression analysis showed that the factors affecting early activity included age,ICU hospitalization time(ICULOS),muscle strength and vasoactive drugs.Conclusion: The rate of early mobilization of ICU patients is low in the First Hospital of Lanzhou University.The proportion of early mobilization in non mechanical ventilation patients is slightly higher than in mechanically ventilated patients,and the first time of the activity is earlier.The proportion of mobilization of the patients with tracheal intubation is lower.Tracheal intubation and sedation are the main barriers to the early mobilization of patients with mechanical ventilation.Lack of support from doctors and instability of circulatory system are the main barriers that hinder the early mobilization of patients with non mechanical ventilation.The patient's age,ICULOS,strength of the patient and vasoactive drugs are the main influencing factors of the patient's early activities.Therefore,we should promote the implementation of early activities in ICU,and the future research should expand the scope of influencing factors in order to make it an early part of ICU nursing routine.