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ICU Mobility scale

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https://www.readbyqxmd.com/read/27898220/intensive-care-physiotherapy-during-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#1
Laveena Munshi, Tadahiro Kobayashi, Julian DeBacker, Ravi Doobay, Teagan Telesnicki, Vincent Lo, Nathalie Cote, Marcelo Cypel, Shaf Keshavjee, Niall D Ferguson, Eddy Fan
RATIONALE: There are limited data on physiotherapy during extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS). OBJECTIVES: We sought to characterize physiotherapy delivered to ARDS patients supported with ECMO, and to evaluate the association of this therapeutic modality with mortality. METHODS: We conducted a retrospective cohort study of all adult ARDS patients supported with ECMO at our institution from 2010-2015...
November 29, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27793165/surviving-critical-illness-what-is-next-an-expert-consensus-statement-on-physical-rehabilitation-after-hospital-discharge
#2
M E Major, R Kwakman, M E Kho, B Connolly, D McWilliams, L Denehy, S Hanekom, S Patman, R Gosselink, C Jones, F Nollet, D M Needham, R H H Engelbert, M van der Schaaf
BACKGROUND: The study objective was to obtain consensus on physical therapy (PT) in the rehabilitation of critical illness survivors after hospital discharge. Research questions were: what are PT goals, what are recommended measurement tools, and what constitutes an optimal PT intervention for survivors of critical illness? METHODS: A Delphi consensus study was conducted. Panelists were included based on relevant fields of expertise, years of clinical experience, and publication record...
October 29, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27749432/the-abcde-bundle-a-survey-of-nurses-knowledge-and-attitudes-in-the-intensive-care-units-of-a-national-teaching-hospital-in-italy
#3
Floriana Pinto, Gianni Biancofiore
BACKGROUND: The ABCDE (Awakening and Breathing coordination of daily sedation and ventilator removal trials; Choice of sedative or analgesic exposure; Delirium monitoring and management; and Early mobility and exercise) bundle is a multidisciplinary set of evidence-based practices for improving patient outcomes in the intensive care unit. Nurses are critical to all the bundle's requirements. Therefore, understanding their knowledge, attitudes, and perception of the different bundle's components might help for an easier implementation into everyday clinical practice...
November 2016: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27600938/-algorithms-for-early-mobilization-in-intensive-care-units
#4
P Nydahl, R Dubb, S Filipovic, C Hermes, F Jüttner, A Kaltwasser, S Klarmann, H Mende, S Nessizius, C Rottensteiner
Immobility of patients in intensive care units (ICU) can lead to long-lasting physical and cognitive decline. During the last few years, bundles for rehabilitation were developed, including early mobilization. The German guideline for positioning therapy and mobilization, in general, recommends the development of ICU-specific protocols. The aim of this narrative review is to provide guidance when developing a best practice protocol in one's own field of work. It is recommended to a) implement early mobilization as part of a bundle, including screening and management of patient's awareness, pain, anxiety, stress, delirium and family's presence, b) develop a traffic-light system of specific in- and exclusion criteria in an interprofessional process, c) use checklists to assess risks and preparation of mobilization, d) use the ICU Mobility Scale for targeting and documentation of mobilization, e) use relative safety criteria for hemodynamic and respiratory changes, and Borg Scale for subjective evaluation, f) document and evaluate systematically mobilization levels, barriers, unwanted safety events and other parameters...
September 6, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27532117/rate-of-spontaneous-voiding-recovery-after-acute-urinary-retention-due-to-bed-rest-in-the-hospital-setting-in-a-nonurological-population-clinical-study-of-the-relationship-between-lower-limbs-and-bladder-function
#5
Paulo Rodrigues, Flávio Hering, Eli Cieli, João Carlos Campagnari
OBJECTIVES: To understand the clinical relationship between lower limbs functions and the recovery of spontaneous voiding after an acute urinary retention (AUR) in older patients admitted to hospitals for non-urological causes using clinical parameters. MATERIALS AND METHODS: 56 adult patients (32 men; mean age: 77.9 ± 8.3 and 24 women; mean age 82.1 ± 4.6) with AUR were prospectively followed with validated Physical Performance Mobility Exam (PPME) instrument to evaluate the relationship between the recovery of mobility capacity and spontaneous voiding...
November 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27307746/mobilization-of-intensive-care-patients-a-multidisciplinary-practical-guide-for-clinicians
#6
Margot Green, Vince Marzano, I Anne Leditschke, Imogen Mitchell, Bernie Bissett
OBJECTIVES: To describe our experience and the practical tools we have developed to facilitate early mobilization in the intensive care unit (ICU) as a multidisciplinary team. BACKGROUND: Despite the evidence supporting early mobilization for improving outcomes for ICU patients, recent international point-prevalence studies reveal that few patients are mobilized in the ICU. Existing guidelines rarely address the practical issues faced by multidisciplinary ICU teams attempting to translate evidence into practice...
2016: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/27176033/development-and-pilot-of-a-checklist-for-management-of-acute-liver-failure-in-the-intensive-care-unit
#7
Oren K Fix, Iris Liou, Constantine J Karvellas, Daniel R Ganger, Kimberly A Forde, Ram M Subramanian, Alice Boylan, James Hanje, R Todd Stravitz, William M Lee
INTRODUCTION: Acute liver failure (ALF) is an ideal condition for use of a checklist. Our aims were to develop a checklist for the management of ALF in the intensive care unit (ICU) and assess the usability of the checklist among multiple providers. METHODS: The initial checklist was developed from published guidelines and expert opinion. The checklist underwent pilot testing at 11 academic liver transplant centers in the US and Canada. An anonymous, written survey was used to assess the usability and quality of the checklist...
2016: PloS One
https://www.readbyqxmd.com/read/27109818/assessment-of-sleep-quality-post-hospital-discharge-in-survivors-of-critical-illness
#8
Kevin J Solverson, Paul A Easton, Christopher J Doig
BACKGROUND: Sleep quality is impaired during critical illness and may remain abnormal after discharge from hospital. Sleep dysfunction in patients after critical illness may impair recovery and health related quality of life. The purpose of this study was to use objective and subjective measures to evaluate sleep quality in critical illness survivors 3 months after hospital discharge. METHODS: This was a prospective cohort study of 55 patients admitted to a multidisciplinary intensive care unit (ICU) between April 1st, 2009 and March 31, 2010...
May 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27107920/benefits-of-early-active-mobility-in-the-medical-intensive-care-unit-a-pilot-study
#9
Ogochukwu Azuh, Harriet Gammon, Charlotte Burmeister, Donald Frega, David Nerenz, Bruno DiGiovine, Aamir Siddiqui
BACKGROUND: Pressure ulcer formation continues to be problematic in acute care settings, especially intensive care units (ICUs). Our institution developed a program for early mobility in the ICU using specially trained nursing aides. The goal was to impact hospital-acquired pressure ulcers incidence as well as factors associated with ICU deconditioning by using specially trained personnel to perform the acute early mobility interventions. METHODS: A 5-point mobility scale was developed and used to establish a patients' highest level of activity achievable during evaluation...
August 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27015233/the-icu-mobility-scale-has-construct-and-predictive-validity-and-is-responsive-a-multicenter-observational-study
#10
Claire J Tipping, Michael J Bailey, Rinaldo Bellomo, Susan Berney, Heidi Buhr, Linda Denehy, Meg Harrold, Anne Holland, Alisa M Higgins, Theodore J Iwashyna, Dale Needham, Jeff Presneill, Manoj Saxena, Elizabeth H Skinner, Steve Webb, Paul Young, Jennifer Zanni, Carol L Hodgson
RATIONALE: The ICU Mobility Scale (IMS) is a measure of mobility milestones in critically ill patients. OBJECTIVES: This study aimed to determine the validity and responsiveness of the IMS from a prospective cohort study of adults admitted to the intensive care unit (ICU). METHODS: Construct and predictive validity were assessed by comparing IMS values at ICU discharge in 192 patients to other variables using Spearman rank correlation coefficient, Mann-Whitney U tests, and logistic regression...
June 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/26968024/a-binational-multicenter-pilot-feasibility-randomized-controlled-trial-of-early-goal-directed-mobilization-in-the-icu
#11
Carol L Hodgson, Michael Bailey, Rinaldo Bellomo, Susan Berney, Heidi Buhr, Linda Denehy, Belinda Gabbe, Megan Harrold, Alisa Higgins, Theodore J Iwashyna, Rebecca Papworth, Rachael Parke, Shane Patman, Jeffrey Presneill, Manoj Saxena, Elizabeth Skinner, Claire Tipping, Paul Young, Steven Webb
OBJECTIVES: To determine if the early goal-directed mobilization intervention could be delivered to patients receiving mechanical ventilation with increased maximal levels of activity compared with standard care. DESIGN: A pilot randomized controlled trial. SETTING: Five ICUs in Australia and New Zealand. PARTICIPANTS: Fifty critically ill adults mechanically ventilated for greater than 24 hours. INTERVENTION: Patients were randomly assigned to either early goal-directed mobilization (intervention) or to standard care (control)...
June 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26825278/muscle-mass-strength-and-functional-outcomes-in-critically-ill-patients-after-cardiothoracic-surgery-does-neuromuscular-electrical-stimulation-help-the-catastim-2-randomized-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
Arabella Fischer, Matthias Spiegl, Klaus Altmann, Andreas Winkler, Anna Salamon, Michael Themessl-Huber, Mohamed Mouhieddine, Eva Maria Strasser, Arno Schiferer, Tatjana Paternostro-Sluga, Michael Hiesmayr
BACKGROUND: The effects of neuromuscular electrical stimulation (NMES) in critically ill patients after cardiothoracic surgery are unknown. The objectives were to investigate whether NMES prevents loss of muscle layer thickness (MLT) and strength and to observe the time variation of MLT and strength from preoperative day to hospital discharge. METHODS: In this randomized controlled trial, 54 critically ill patients were randomized into four strata based on the SAPS II score...
2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26795215/-delirium-and-delirium-management-in-critically-ill-patients
#13
A Kersten, S Reith
Delirium in critically ill patients is a common entity in the intensive care unit (ICU) and is an expression of the cerebral organ dysfunction of the patient. The hallmark signs are disturbed consciousness and cognition in combination with inattentiveness and alterations in perception, which are manifested within a time interval of hours to days during treatment on the ICU. Delirium has been shown to have negative effects on patient short-term and long-term outcome parameters and increases morbidity and mortality...
February 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/26763340/practice-patterns-and-opinions-on-current-clinical-practice-guidelines-regarding-the-management-of-delirium-in-the-intensive-care-unit
#14
Yoonsun Mo, Anthony E Zimmermann, Michael C Thomas
OBJECTIVE: The aim of this study was to determine current delirium practices in the intensive care unit (ICU) setting and evaluate awareness and adoption of the 2013 Pain, Agitation, and Delirium (PAD) guidelines with emphasis on delirium management. DESIGN, SETTING, AND PARTICIPANTS: A large-scale, multidisciplinary, online survey was administered to physician, pharmacist, nurse, and mid-level practitioner members of the Society of Critical Care Medicine (SCCM) between September 2014 and October 2014...
January 13, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/26530213/early-rehabilitation-for-severe-acquired-brain-injury-in-intensive-care-unit-multicenter-observational-study
#15
Michelangelo Bartolo, Stefano Bargellesi, Carlo A Castioni, Donatella Bonaiuti, Roberto Antenucci, Angelo Benedetti, Valeria Capuzzo, Federica Gamna, Giulio Radeschi, Giuseppe Citerio, Carolina Colombo, Laura Del Casale, Elena Recubini, Saimir Toska, Marco Zanello, Carlo D'Aurizio, Tullio Spina, Alredo Del Gaudio, Filomena Di Rienzo, Domenico Intiso, Giulia Dallocchio, Giovanna Felisatti, Susanna Lavezzi, Roberto Zoppellari, Valentina Gariboldi, Luca Lorini, Giovanni Melizza, Guido Molinero, Giorgio Mandalà, Amedeo Pignataro, Andrea Montis, Alessandro Napoleone, Felicita Pilia, Marina Pisu, Monica Semerjian, Giuseppina Pagliaro, Lorella Nardin, Federico Scarponi, Mauro Zampolini, Raffaele Zava, Maria A Massetti, Carlo Piccolini, Fulvio Aloj, Sergio Antonelli, Chiara Zucchella
BACKGROUND: The increased survival after a severe acquired brain injury (sABI) raise the problem of making most effective the treatments in Intensive Care Unit (ICU)/Neurointensive Care Unit (NICU), also integrating rehabilitation care. Despite previous studies reported that early mobilization in ICU was effective in preventing complications and reducing hospital stay, few studies addressed the rehabilitative management of sABI patients in ICU/NICU. AIM: To collect clinical and functional data about the early rehabilitative management of sABI patients during ICU/NICU stay...
February 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/26077081/more-than-half-the-families-of-mobile-intensive-care-unit-patients-experience-inadequate-communication-with-physicians
#16
Guillaume Debaty, François-Xavier Ageron, Laetitia Minguet, Guillaume Courtiol, Christophe Escallier, Adeline Henniche, Maxime Maignan, Raphaël Briot, Françoise Carpentier, Dominique Savary, José Labarere, Vincent Danel
PURPOSE: This study aimed to assess comprehension by family members of the patient's severity in the prehospital setting. METHOD: We conducted a cross-sectional study in four mobile intensive care units (ICUs, medicalized ambulances) in France from June to October 2012. Nurses collected data on patients, patient's relatives, and mobile ICU physicians. For each patient, one relative and one physician independently rated the patient's severity using a simplified version of the Clinical Classification of Out-of-Hospital Emergency Patients scale (CCMS)...
July 2015: Intensive Care Medicine
https://www.readbyqxmd.com/read/25978337/dichotomous-good-outcome-indicates-mobility-more-than-cognitive-or-social-quality-of-life
#17
Andrew M Naidech, Jennifer L Beaumont, Michael Berman, Brandon Francis, Eric Liotta, Matthew B Maas, Shyam Prabhakaran, Jane Holl, David Cella
OBJECTIVE: Worthwhile interventions for intracerebral hemorrhage or subarachnoid hemorrhage generally hinge on whether they improve the odds of good outcome. Although good outcome is correlated with mobility, correlations with other domains of health-related quality of life, such as cognitive function and social functioning, are not well described. We tested the hypothesis that good outcome is more closely associated with mobility than other domains. DESIGN: We defined "good outcome" as 0 through 3 (independent ambulation or better) versus 4 through 5 (dependent) on the modified Rankin Scale at 1, 3, and 12 months...
August 2015: Critical Care Medicine
https://www.readbyqxmd.com/read/25976892/rethinking-critical-care-decreasing-sedation-increasing-delirium-monitoring-and-increasing-patient-mobility
#18
Rick Bassett, Kelly McCutcheon Adams, Valerie Danesh, Patricia M Groat, Angie Haugen, Angi Kiewel, Cora Small, Mark Van-Leuven, Sam Venus, E Wesley Ely
BACKGROUND: Sedation management, delirium monitoring, and mobility programs have been addressed in evidence-based critical care guidelines and care bundles, yet implementation in the ICU remains variable. As critically ill patients occupy higher percentages of hospital beds in the United States and beyond, it is increasingly important to determine mechanisms to deliver better care. The Institute for Healthcare Improvement's Rethinking Critical Care (IHI-RCC) program was established to reduce harm of critically ill patients by decreasing sedation, increasing monitoring and management of delirium, and increasing patient mobility...
February 2015: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/25888469/functional-outcomes-in-icu-%C3%A2-what-should-we-be-using-%C3%A2-an-observational-study
#19
RANDOMIZED CONTROLLED TRIAL
Selina M Parry, Linda Denehy, Lisa J Beach, Sue Berney, Hannah C Williamson, Catherine L Granger
INTRODUCTION: With growing awareness of the importance of rehabilitation, new measures are being developed specifically for use in the intensive care unit (ICU). There are currently 26 measures reported to assess function in ICU survivors. The Physical Function in Intensive care Test scored (PFIT-s) has established clinimetric properties. It is unknown how other functional measures perform in comparison to the PFIT-s or which functional measure may be the most clinically applicable for use within the ICU...
2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/25715872/early-mobilization-and-recovery-in-mechanically-ventilated-patients-in-the-icu-a-bi-national-multi-centre-prospective-cohort-study
#20
MULTICENTER STUDY
Carol Hodgson, Rinaldo Bellomo, Susan Berney, Michael Bailey, Heidi Buhr, Linda Denehy, Megan Harrold, Alisa Higgins, Jeff Presneill, Manoj Saxena, Elizabeth Skinner, Paul Young, Steven Webb
INTRODUCTION: The aim of this study was to investigate current mobilization practice, strength at ICU discharge and functional recovery at 6 months among mechanically ventilated ICU patients. METHOD: This was a prospective, multi-centre, cohort study conducted in twelve ICUs in Australia and New Zealand. Patients were previously functionally independent and expected to be ventilated for >48 hours. We measured mobilization during invasive ventilation, sedation depth using the Richmond Agitation and Sedation Scale (RASS), co-interventions, duration of mechanical ventilation, ICU-acquired weakness (ICUAW) at ICU discharge, mortality at day 90, and 6-month functional recovery including return to work...
February 26, 2015: Critical Care: the Official Journal of the Critical Care Forum
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