Effectiveness of Early Mobilisation on Length of Stay of Ventilated ICU Patients

Abstract

ABSTRACT Background: Intensive Care Unit (ICU) patients could have prolonged sedation and mechanical ventilation that would lead to their immobilisation which plays a significant role in patients’ physical outcomes and cognitive abilities as well as increasing the use of resources and hospitalisation costs. Thus, the early mobilisation (EM) technique is introduced to reduce ICU and hospital LOS and mechanical ventilation therapy among ventilated patients in critical care settings Objective: The objective of this systematic review is to measure the effectiveness of early mobilization technique on length of stay for ICU among adult ventilated patients in ICUs. The search question is: dose applying early mobilization care affect the length of stay in ICU for ventilated patients? Methods: This systematic review was conducted using five electronic databases: Medline, (CINAHL), Scopus, Cochrane and Embase as well as a manual search was performed to thoroughly search for relevant studies. To ensure the validity and reliability of findings, the studies included in this systematic review were assessed for method quality using the Cochrane risk-of-bias and Critical Appraisal Skills Programme (CASP) checklist tools. Result: Seven studies were included in this systematic review, three cohorts and four RCTs, with a total of 3501participants. In general, the findings indicated that EM therapy could reduce ICU length of stay, ventilation days and improve the patient’s functional status. However, the results show that EM therapy might have no significant effect on the time of the first day out of bed and mortality rate. Factors contribute to the efficacy of EM therapy are patients age, patients’ medical condition, nurse’s knowledge and the confidence of ICU nurses to perform the intervention. Conclusion: Overall, EM therapy consider a safe, feasible and effectiveness therapy for ventilated patients in critical care settings. Also, EM therapy benefits the health care organisations through reducing the use of resources and personnel costs. For future research focusing on relationship between the cost and EM therapy in critical care setting might be needed.