Early mobilisation and rehabilitation in the PICU: a UK survey

Jacqueline Y Thompson, Julie C Menzies, Joseph C Manning, Jennifer Mcanuff, Emily Clare Brush, Francesca Ryde, Tim Rapley, Nazima Pathan, Stephen Brett, David J Moore, Michelle Geary, Gillian A Colville, Kevin P Morris, Roger Charles Parslow, Richard G Feltbower, Sophie Lockley, Fenella J Kirkham, Rob J Forsyth, Barnaby R Scholefield

Research output: Contribution to journalArticlepeer-review

18 Downloads (Pure)

Abstract

Objective To understand the context and professional perspectives of delivering early rehabilitation and mobilisation (ERM) within UK paediatric intensive care units (PICUs).

Design A web-based survey administered from May 2019 to August 2019.

Setting UK PICUs.

Participants A total of 124 staff from 26 PICUs participated, including 22 (18%) doctors, 34 (27%) nurses, 28 (23%) physiotherapists, 19 (15%) occupational therapists and 21 (17%) were other professionals.

Results Key components of participants’ definitions of ERM included tailored, multidisciplinary rehabilitation packages focused on promoting recovery. Multidisciplinary involvement in initiating ERM was commonly reported. Over half of respondents favoured delivering ERM after achieving physiological stability (n=69, 56%). All age groups were considered for ERM by relevant health professionals. However, responses differed concerning the timing of initiation. Interventions considered for ERM were more likely to be delivered to patients when PICU length of stay exceeded 28 days and among patients with acquired brain injury or severe developmental delay. The most commonly identified barriers were physiological instability (81%), limited staffing (79%), sedation requirement (73%), insufficient resources and equipment (69%), lack of recognition of patient readiness (67%), patient suitability (63%), inadequate training (61%) and inadequate funding (60%). Respondents ranked reduction in PICU length of stay (74%) and improvement in psychological outcomes (73%) as the most important benefits of ERM.

Conclusion ERM is gaining familiarity and endorsement in UK PICUs, but significant barriers to implementation due to limited resources and variation in content and delivery of ERM persist. A standardised protocol that sets out defined ERM interventions, along with implementation support to tackle modifiable barriers, is required to ensure the delivery of high-quality ERM.

Data availability statement
Data are available upon reasonable request. Researchers who propose a methodologically sound proposal approved by an ethics review committee will be provided with anonymised data on request.
Original languageEnglish
Article numbere001300
JournalBMJ Paediatrics Open
Volume6
Issue number1
DOIs
Publication statusPublished - 9 Jun 2022

Keywords

  • epidemiology
  • rehabilitation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Fingerprint

Dive into the research topics of 'Early mobilisation and rehabilitation in the PICU: a UK survey'. Together they form a unique fingerprint.

Cite this