ArticlePediatric quality & safety
PICU Move! Improving Early Mobilization in a Large Pediatric Intensive Care Unit.
Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Guidelines support early mobilization in the pediatric intensive care unit (PICU). In our 75-bed PICU, we implemented "PICU Move!," a standardized early mobilization protocol using "Critical Care Illness Levels" (CCILs) that specify mobilization goals based on patients' medical status. Methods: We used systems-based interventions (electronic health record order sets and workflows, opt-out therapy consultations, and progressive mobilization equipment) and person-based interventions (education, mobility champions, simulations, and mobility rounds). Process measures were CCIL ordering compliance, early mobilization goal compliance, and the proportion of admissions with a length of stay (LOS) ≥ 72 hours that included consultations with physical therapy (PT) and occupational therapy (OT). Outcome measures included time to first registered nurse activity documentation (all admissions and admissions with LOS ≥72 h) and admissions with LOS ≥72 hours with multiple PT/OT contacts. Balancing measures included safety event reports related to early mobilization activities, unplanned extubations, and falls. Results: During the intervention period (July 2023-December 2024), median monthly CCIL compliance was 95.9%, and early mobilization goal compliance was 49.4%. Compared to baseline, the average monthly proportion of admissions with LOS ≥72 hours with PT or OT consultation increased from 38.8% to 82.6% and from 34.3% to 81.2%, respectively. Multiple PT and OT contacts increased from 40.9% to 81.7% and from 37.7% to 70.8%, respectively. Time to first activity decreased from 21.6 to 19.6 hours (all admissions) and from 67.9 to 59.1 hours (admissions with LOS ≥72 h). There were no documented safety events related to early mobilization activities. Conclusions: In a large PICU, systems-based interventions, supplemented by person-based interventions, safely reduced time to first activity and increased the number of repeated PT/OT contacts.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.