A Critical Care Team's Primary Purpose
A critical care team's primary purpose is to reduce the period of hospitalization and to expedite safe departure from the hospital. In reality, the route for a critical care patient is fraught with dangers that include both foreseeable and unexpected difficulties. Maintaining a continuous path to recovery appears to be one of the most difficult tasks in patient treatment. Notably, this may be attributed to the systematic and complicated nature of critical disease, which will unavoidably cause constant alterations in patients' conditions (Parry, 2016). The goal of this research is to suggest a mobility team in the critical care department to assist patients in becoming more mobile. Fundamentally, forming a mobility team in the critical care department to increase patient mobilization helps to improve the patient outcomes and reduce costs.
Early Mobilization
Early mobilization refers to the initial application and intensification of the physical therapy, which is administered to the patients, who are critically ill. Fundamentally, early mobilization may as well encompass new concrete mobilization-enhancing interventions including mobilizations of patients that require mechanical ventilation and the utilization of new methods such as transcutaneous and ergometry electrical muscle stimulation (Hodgson, Berney, Harrold, Saxena, & Bellomo, 2013). Early mobilization in intensive care units is applied with the purpose of restoring or maintaining musculoskeletal function and strength; thus, possibly improving the patient-centered and functional outcomes. A significant hindrance in the capacity to determine the patient outcomes following early mobilization is the range of different methods used, and the absence of standardization and defining them across various studies (Hodgson et al., 2013).
A Comprehensive Mobility Team
Coming up with a mobility team encompassing the physical therapists, the nurses, and the physicians can play a great role in increasing mobilization of the patients. Comprehensive focus on the major issues in the patients who are critically ill may help in reducing the harmful effects of the critical care setting (Grap & McFetridge, 2012). Markedly, critical care rehabilitation does not just focus on the early mobilization but also encompasses psychological support for the patients, as well as their families. The phrase "critical care recovery" could be utilized as being an umbrella terminology that includes the various psychological and physiological aspects that are needed to boost the patient's long-term and short-term recovery (Grap & McFetridge, 2012). Recovering from the critical illness does not just mean the effective deterring of a particular patient from the vasoactive or mechanical ventilation drug therapy. In essence, critical care recovery is an all-inclusive journey that patients travel, and it encompasses psychological support and early mobilization.
Success of Mobilization Teams
Particular centers have realized immense success in changing their practice by forming active mobilization teams comprising of nurses and physiotherapists. Having such teams in place, the rates of mobilization have increased considerably, with the added advantage of eliminating adverse effects on the unit costs. On this note, it is imperative that this could turn out to be the "mobilization champions," dealing with the educational gap during early mobilization (Parry, 2016). According to Parry (2016), research shows that the patients that require critical care should sustain various life-changing psychological and physiological issues in the course of admission that has an adverse impact on the long-term outcome. Indeed, while evading such can be complicated, and some are unavoidable, the utilization of early mobilization could serve to offer favorable gains with the minimum financial implications. Ostensibly, one could present an argument that it would help to save finances by reducing the admission length (Parry, 2016). However, this could only be a gain to the NHS finances and patient; thus, there is a need to push on and ensure early mobilization is a daily occurrence in the critical care units.
An Example of Success: ICU Early Mobilization Group at the UCSF Medical Centre
As a demonstration of the benefits of the mobility team in the critical care, an example is given of ICU Early Mobilization Group at the UCSF Medical Centre. The quality improvement project was endorsed and started at this institution by a physical therapist in partnership with the critical care experts (Engel, Tatebe, Alonzo, Mustille, & Rivera, 2013). The benefits associated with the EM program encompassed the vigor observed in patients when they began physical therapy at an earlier time. This boosted patient mobility earlier, and the patients started walking for relatively longer distance than during the standard physical therapy care in the intensive care unit. Such EM program helped to realize improved patient outcomes and saving costs. Such benefits convinced the physicians, nurse practitioners, nurses, hospital administrators, and respiratory therapists at the institution to go on with the practice of committing a physical therapist to the intensive care unit for the early mobilization intention further than the quality improvement project experimental phase (Engel et al., 2013). From that time, they have intensified the program to the rest of UCSF Medical Center intensive care units.
Role of Physical Therapy in Intensive Care Units
The intervention of physical therapy in intensive care units is targeted to bar disability and weakness. Weakness prevents fifty per cent of the critically ill patients from going back to a pre-morbid function level (Engel et al., 2013). The physical therapists are armed to deal with this issue and can have the recognition that in a sophisticated intensive care unit setting, the inter-professional partnership is needed to deliver gainful interventions in a consistent and timely manner (Engel et al., 2013). For the quality improvement project, there was a promotion of the physical therapy-program across the healthcare professions with education, communication, and updates in continuing monthly intensive care units "Early Mobilization Group" meeting, as well as internal newsletters and publications. The program further set up better patient care with an inter-professional partnership at every opportunity of treatment. The findings show the capacity of a non-physician led healthcare professional to drive organizational change and to contribute to having quality improvement in the patterns of practice even in a big learning medical center with continuously rotating personnel (Engel et al., 2013). Nevertheless, several questions are still there concerning optimal intensity, dosage, and frequency of mobility interventions, as well as how best to undertake staffing allocation to perform such interventions.
Conclusion
To conclude, it is clear that forming a mobility team in the critical care department to increase patient mobilization helps to improve the patient outcomes and reduce costs. Indeed, such benefits can convince the physicians, nurse practitioners, nurses, hospital administrators, and respiratory therapists at any health care facility to go on with the practice of committing a physical therapist to the intensive care unit for the early mobilization intention further than the quality improvement project experimental phase. The success of this project will be defined when it will be realized that there is an increase in patient mobilization after the formation of the mobility team.
References
Engel, H., Tatebe, S., Alonzo, P., Mustille, R., & Rivera, M. (2013). Physical therapist–established intensive care unit early mobilization program: Quality improvement project for critical care at the University of California San Francisco Medical Center. Phys Ther., 93(7), 975–985.
Grap, M. J., & McFetridge, B. (2012). Critical care rehabilitation and early mobilization: An emerging standard of care. Intensive and Critical Care Nursing, 28(2), 55—57.
Hodgson, C., Berney, S., Harrold, M., Saxena, M., & Bellomo, R. (2013). Clinical review: Early patient mobilization in the ICU. Critical Care, 17, 1-7.
Parry, A. (2016). The importance of early mobilization in critical care patients. British Journal of Nursing, 25(9), 486-488.
