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Table 1 Barriers and facilitators to mobilization

From: Early Mobilization of Patients in Intensive Care: Organization, Communication and Safety Factors that Influence Translation into Clinical Practice

Barriers

Facilitators

Patient Factors

 Physiological instability (hemodynamic, respiratory, neurological)

 Sedation

 Low Glasgow Coma Scale

 Delirium/agitation

 Psychological state

 Pain

 Medical procedures/orders

 Patient refusal/anxiety

Manage patient physiological instability

Management of sedation & delirium

Sleep

Delirium screening/management

Analgesia prior to mobilization

Patient goals

Family engagement and education

Intensive Care Team Factors

 Poor culture

 Lack of communication

 Lack of leadership

 Disengaged team members

 Inexperienced staff

 Lack of planning and coordination

 Unclear expectations

 Risk for mobility providers

 Femoral lines

 Early ward transfers

 Anticipated risks

Develop a positive team culture

Ward rounds, multidisciplinary team meetings

Designated leaders

Team planning and communication

Education and up-skilling staff

Screening of appropriate patients

Flexible and cooperative team members

Utilization of safety criteria for mobilizing mechanically ventilated patients

Anticipated benefits

Organizational Factors

 Lack of funding

 Time constraints

 Lack of equipment and resources

 Lack of staffing or availability

 Busy caseloads

Business case for additional staff to outline the economic benefits for the organization

Appropriate equipment & resources

Dedicated staffing

Mobility guidelines/protocol

Training on appropriate equipment