NURSES’ KNOWLEDGE, ATTITUDES, AND PRACTICES REGARDING EARLY MOBILIZATION OF CRITICALLY ILL PATIENTS
Keywords:knowledge, attitude, practice, early mobilization, critically ill patient
This descriptive study aimed to explore the level of knowledge, attitudes, and practices of nurses regarding early mobilization of critically ill patients and the relationship between the receiving of mobilization training for nurses with the working experiences of ICU nurses about the early mobilization of critically ill patients. The samples were 125 registered nurses who had been working at the critical care or intensive care unit from both medical and surgical departments of Maharaj Nakorn Chiang Mai Hospital and Lampang Hospital. The samples were selected according to the eligibility criteria which were having at least 3 months of working experiences in the ICU and willing to participate in this research. Data collection was conducted using a demographic data form and the Patient Mobilization Attitudes and Beliefs Survey for the Intensive Care Unit (PMABS-ICU). This research instrument was translated into the Thai language by the researcher and verified using back-translation. The Cronbach’s alpha reliability coefficient was .88. After collecting data, the researcher received 121copied back, equivalent to 96.80 % response rate. The data were analyzed using descriptive statistics and the relationship between factors was analyzed using the Point Biserial Correlation Coefficient and the Spearman’s Rank Correlation Coefficient.
The results were found as follows: 1) the mean of nurses’ knowledge regarding early mobilization of critically ill patients was at a high level (M = 14.39, SD = 2.62) out of 20 scores, equivalent to 71.95 %. On the other hand, the mean of their attitudes regarding early mobilization of critically ill patients was at a moderate level (M = 29.48, SD = 2.62) out of 45 scores, equivalent to 65.51%. Their practices regarding early mobilization of critically ill patients were also at a moderate level (M = 40.43, SD = 7.31) out of 65 scores, equivalent to 62.20%. 2) Receiving mobilization training for nurses had a positive relationship with the practice regarding early mobilization for critically ill patients (r = .26, p = .004). The working experiences of ICU nurses had no relationship with the practice.
Adler, J., & Malone, D. (2012). Early mobilization in the intensive care unit: A systematic review. Cardiopulmonary Physical Therapy Journal, 23(1), 5-13.
Akinremi, A., Sanusi, A., Osinaike, B., Ogwu, S., & Arinola, S. (2016). 1162: Clinicians’ knowledge, attitude, and practice of active mobilization in resource-limited hospitals. Critical Care Medicine, 44(12), 366. doi:10.1097/01.ccm.0000509837.99795.7d
Appleton, R. T., Kinsella, J., & Quasim, T. (2015). The incidence of intensive care unit-acquired weakness syndromes: A systematic review. Journal of the Intensive Care Society, 16(2), 126-136. doi:10.1177/1751143714563016
Autthamana, S. (2002). Organizational behavior: Theory and application (3rd ed.). Bangkok: Thammasat University.
Asfour, H. I. (2016). Contributing factors for acquired muscle weakness in intensive care unit. Journal of Nursing Education and Practice, 6(8), 102-111. doi:10.5430/jnep.v6n8p102
Barber, E. A., Everard, T., Holland, A. E., Tipping, C., Bradley, S. J., & Hodgson, C. L. (2015). Barriers and facilitators to early mobilization in intensive care: a qualitative study. Australian Critical Care, 28(4), 177-182. doi:10.1016/j.aucc.2014.11.001
Cabana, M. D., Rand, C. S., Powe, N. R., Wu, A. W., Wilson, M. H., Abboud, P. A. C., & Rubin, H. R. (1999). Why don't physicians follow clinical practice guidelines?: A framework for improvement. The Journal of the American Medical Association, 282(15), 1458-1465. doi:10.1001/jama.282.15.1458
California Pacific Medical Center [CPMC]. (2005). What is the ICU (intensive care unit)? Retrieved from http://www.cpmc.org/learning/documents/icu-ws.pdf
Chaiwong, W., Phetsuk, N., Liwsrisakun, C., & Pothirat, C. (2019). Short-term impact of mobilization of patients who are being mechanically ventilated in the medical intensive care unit. Journal of the Medical Association of Thailand, 102(2), 171-177.
Dubb, R., Nydahl, P., Hermes, C., Schwabbauer, N., Toonstra, A., Parker, A. M., . . . Needham, D. M. (2016). Barriers and strategies for early mobilization of patients in intensive care units. Annals of the American Thoracic Society, 13(5), 724-730. doi:10.1513/AnnalsATS.201509586CME
Fontela, P. C., Forgiarini Jr, L. A., & Friedman, G. (2018). Clinical attitudes and perceived barriers to early mobilization of critically ill patients in adult intensive care units. Revista Brasileira de Terapia Intensiva, 30(2), 187-194. doi:10.5935/0103-507X.20180037
Goodson, C. M., Friedman, L. A., Mantheiy, E., Heckle, K., Lavezza, A., Toonstra, A., . . . & Outten, C. (2018). Perceived barriers to mobility in a medical ICU: The patient mobilization attitudes & beliefs survey for the ICU. Journal of Intensive Care Medicine. doi:10.1177/0885066618807120.
Grimm, J., Silvestri-Elmore, A., Grimm, E., Klinger, K., Nye, S., & Bhullar, J. (2019). Perceived barriers to early progressive mobilization in the ICU: Multidisciplinary perspectives in an underserved population. Journal of Nursing Education and Practice, 9(5), 102-109.
Hermans, G., & Van den Berghe, G. (2015). Clinical review: Intensive care unit acquired weakness. Critical Care, 19(274). doi:10.1186/s13054-015-0993-7
Hodgson, C. L., Berney, S., Harrold, M., Saxena, M., & Bellomo, R. (2013). Clinical review: early patient mobilization in the ICU. Critical Care, 17(1), 207. doi:10.1186/cc11820
Jantaraprapa, J. (2015). Body of knowledge – knowledge – knowledge management (km). Retrieved from http://www.royin.go.th/?knowledges=body-of-knowledge-knowledge-knowledge-management-km
Johnson, K., Petti, J., Olson, A., & Custer, T. (2017). Identifying barriers to early mobilisation among mechanically ventilated patients in a trauma intensive care unit. Intensive and Critical Care Nursing, 42, 51-54. doi:10.1016/j.iccn.2017.06.005
Jolley, S. E., Regan-Baggs, J., Dickson, R. P., & Hough, C. L. (2014). Medical intensive care unit clinician attitudes and perceived barriers towards early mobilization of critically ill patients: A cross-sectional survey study. BMC Anesthesiology, 14(84). doi:10.1186/1471-2253-14-84
Laurent, H., Aubreton, S., Richard, R., Gorce, Y., Caron, E., Vallat, A., . . . Coudeyre, E. (2016). Systematic review of early exercise in intensive care: A qualitative approach. Anaesthesia Critical Care & Pain Medicine, 35(2), 133-149. doi:10.1016/j.accpm.2015.06.014
Leong, Y., Rasnah, A., Chong, M. (2017). Patient early mobilization: A Malaysia’s study of nursing practices. Journal of Intensive and Critical Care, 3(3), 29. doi:10.21767/2471-8505.100088
Lin, F., Phelan, S., Chaboyer, W., & Mitchell, M. (2019). Early mobilisation of ventilated patients in the intensive care unit: A survey of critical care clinicians in an Australian tertiary hospital. Australian Critical Care, 33(2), 130-136. doi:10.1016/j.aucc.2019.02.002
Messer, A., Comer, L., & Forst, S. (2015). Implementation of a progressive mobilization program in a medical-surgical intensive care unit. Critical Care Nurse, 35(5), 28-42. doi:10.4037/ccn2015469
Mullins, P. M., Goyal, M., & Pines, J. M. (2013). National growth in intensive care unit admissions from emergency departments in the United States from 2002 to 2009. Academic Emergency Medicine, 20(5), 479-486. doi:10.1111/acem.12134
National Institute for Emergency Medicine (NIEM). (2019). Emergency medical criteria: Continuous monitoring report. Retrieved from https://ws.niems.go.th/KPI57/2557/kpireportcontinue01.aspx
Nittayanggoon, S. (2008). Standard for critical care nursing. In Jirasinthipok, T., Jermviwatkul, P., Nittayanggoon, S., Wongsuvansiri, S., & Wongjareun, S. (Eds.), Standard of care in hospitals (pp. 187-219) (2nd ed.). Nonthaburi: The War Veterans Organization of Thailand.
Parry, S. M., Remedios, L., Denehy, L., Knight, L. D., Beach, L., Rollinson, T. C., . . . & Granger, C. L. (2017). What factors affect implementation of early rehabilitation into intensive care unit practice? A qualitative study with clinicians. Journal of Critical Care, 38, 137-143. doi:10.1016/j.jcrc.2016.11.005
Phasook, K., & Ua-Kit. N. (2015). The effect of early mobilization program on duration of mechanical ventilation in critically ill medical patients. Thai Journal of Cardio-Thoracic Nursing, 26(1), 57-72.
Prasanth S., Rajani, V., & Mathai, A. K. (2013). Common mistake in adjusting sample size for anticipated dropout in clinical trial. Retrieved from https://pdfs.semanticscholar.org/d7df/a6cb72872238df33fd9249b4a103a17489a8.pdf
Prousoontron, M., & Oumtanee, A. (2008). Working as a membership of professional nurses. Journal of Nursing Science Naresuan University, 2(2), 15-23.
Rawal, G., Yadav, S., & Kumar, R. (2017). Post-intensive care syndrome: An overview. Journal of Translational Internal Medicine, 5(2), 90-92. doi:10.1515/jtim-2016-0016
Sanusi, A. A., Osinaike, B., Ogwu, S., Sanya, A., & Akinremi, A. A. (2015). Knowledge, attitude and practices of care-providers about early mobilization in the ICU-report from a Nigerian Hospital. American Journal of Respiratory and Critical Care Medicine, 191, A2276.
Sawasdipanich, N., Tiansawad, S. (2011). Research instrument translation for cross-cultural research: techniques and characteristics that need to be considered. Thai Journal of Nursing Council, 26(1), 19-28.
Schwartz, N. E. (1975). Nutritional knowledge, attitudes, and practices of high school graduates. Journal of the American Dietetic Association, 66(1), 28-31.
Smithikrai, C., (2012). Personnel training in organization (Revised version). Chiang Mai: Faculty of Humanities, Chiang Mai University.
Society of Critical Care Medicine [SCCM]. (2018). Critical care statistics. Retrieved from http://www.sccm.org/Communications/Critical-Care-Statistics
Sutamma, P., & Teeranut, A. (2018). Effects of an evidence-based nursing model on mobilization promoting of critically ill patients: Pilot study. Journal of Nursing Science & Health, 41(1), 56-63.
Sutthilertarun, S. (2000). Human behavior and development. Bangkok: Aksarapipat.
Taweerat., P. (2000). Research method in behavior science and social science (7th ed.). Bangkok: Srinakharinwirot University.
Thorndike, R. M. (1978). Correlational Procedures for Research. New York, NY: Gardner Press.
Vollman, K. M. (2010). Introduction to progressive mobility. Critical Care Nurse, 30(2), S3-S5.
Winkelman, C., & Peereboom, K. (2010). Staff-perceived barriers and facilitators. Critical Care Nurse, 30(2), S13-S16. doi:10.4037/ccn2010393
Zhu, Y. P., Xia, L. X., & Li, G. H. (2018). Management of early mobilization in intensive care units: A multicenter cross-sectional study. Frontiers of Nursing, 5(4), 291-299. doi:10.1515/fon-2018-0043
How to Cite